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Biomedical subjects

Jos H Verbeek

Publications and source records attributed to Jos H Verbeek.

8 recordsLinked to original sources
PubMed2006

Changes in the incidence of occupational disability as a result of back and neck pain in the Netherlands.

BACKGROUND: Back pain (including neck pain) is one of the most prevalent health problems for which physicians are consulted. Back pain can decrease the quality of life considerably during a great part of the lives of those who suffer from it. At the same time it has an enormous economic impact, mainly through sickness absence and long-term disability. The objective of this paper is to compare the incidence of occupational disability as a result of back and neck pain in 1980-1985 to 1999-2000 and to explain the findings. METHODS: A descriptive study was performed at population level of changes in incidence of occupational disability as a result of back and neck pain. Statistics from the National Institute of Social Insurance in the Netherlands are used to calculate age and gender specific incidence rates for back pain diagnoses based on the ICD-classification. Incidence rate ratios stratified according to gender and adjusted for age were calculated to indicate changes over time. RESULTS: The incidence of occupational disability as a result of back pain decreased significantly by 37% (95% CI 37%-38%) in men and with 21% (95% CI 20%-24%) in women, after adjustment for age. For overall occupational disability as a result of all diagnoses this was 18% (95% CI 18%-19%) and 34% (95% CI 33%-35%) respectively. Changes were not homogeneous over diagnostic subcategories and age groups. Spondylosis decreased most in men by 59% (95% CI 57%-61%). The incidence of non-specific back pain and neck pain increased most by 196% (95% CI 164%-215%). Post-laminectomy syndrome increased over all age categories both for men (85%, 95% CI 61%-113%) and women (113%, 95% CI 65%-179%). CONCLUSION: The decrease in occupational disability as a result of back pain was larger than the decrease in occupational disability over all diagnoses. However, time trends were not homogeneous over age-, nor over sex- nor back pain categories. Most of this decrease was due to general changes such as legal and economic changes. One of several additional explanations for a decrease is the changed view on management of back pain.

Adult↗
PubMed2006

Evidence on the effectiveness of occupational health interventions.

BACKGROUND: At present there exists no overview of the range of evidence currently available regarding the effectiveness of occupational health interventions (OHI). METHODS: Articles published in 2000 and 2001 in 16 general and specialized biomedical journals were searched for evaluations of OHI studies. RESULTS: Out of 8,687 articles searched there were 148 OHI studies. In 21% of the studies the study design was a randomized controlled trial, in 28% it was a controlled trial, an interrupted time-series in 7% and a different design in 44%. The occupational health outcome was exposure in 27% of the studies, worker behavior in 12%, disease symptoms in 30%, disability or sickness absence in 24%, injuries in 4%, and quality of care in 3%. CONCLUSIONS: High quality evaluation studies are conducted in all areas of occupational health. However, it is clear that more are needed and the methodology used could be improved.

Absenteeism↗
PubMed2006

Occupational health systematic reviews: An overview.

Systematic reviews have been described by leaders in the field of evidence-based practice as the most powerful and useful evidence available to guide practice. This paper gives a description and analysis of systematic reviews currently included in the Cochrane Database for Systematic Reviews which have been identified by newly formed Cochrane Occupational Health Field as having an occupational health focus.

Databases, Bibliographic↗
PubMed2003

Problem-based learning versus lecture-based learning in postgraduate medical education.

OBJECTIVES: The objective of this study was to investigate the effectiveness of problem-based learning in comparison with lecture-based learning in a postgraduate medical training program concerning the management of mental health problems for occupational health physicians. METHODS: A randomized controlled trial in 1999, with a mean follow-up of 14 months after the educational intervention, was used involving postgraduate medical education and training for occupational health physicians in The Netherlands, with 118 physicians in training as occupational health physicians. The experimental program was based on the principles of problem-based learning; the control program used the traditional lecture-based approach. Both programs were aimed at improving knowledge of and performance in the occupational management of work-related mental health problems. As the main outcome measures, knowledge tests consisting of true-or-false and open-answer questions and performance in practice based on self-reports and performance indicators were used. Satisfaction with the course was rated by the participants. RESULTS: In both groups, knowledge had increased equally directly after the programs and decreased equally after the follow-up. The gain in knowledge remained positive. The performance indicator scores also increased in both groups, but significantly more so in the problem-based group. The problem-based group was less satisfied with the course. CONCLUSIONS: Both forms of postgraduate medical training are effective. In spite of less favorable evaluations, the problem-based program appeared to be more effective than the lecture-based program in improving performance. Both programs, however, were equally effective in improving knowledge levels.

Adult↗
PubMed2002

Early occupational health management of patients with back pain: a randomized controlled trial.

STUDY DESIGN: A randomized controlled trial in occupational health practice was conducted. OBJECTIVE: To study the efficacy of early management of workers with low back pain by occupational physicians, as compared with management by the supervisor only. SUMMARY OF BACKGROUND DATA: Health care and university workers with back pain and on sick leave for less than 1 month were included in the study. METHODS: Patients with low back pain for at least 10 days on sick leave were randomly assigned to early management by the occupational physician (n = 61) or to a reference group with management by the worker's supervisor during the first 3 months of sick leave (n = 59). The patients were observed for 1 year and compared in terms of time until return to work, pain intensity, functional disability, and general health perception. The occupational physicians were provided with management guidelines. RESULTS: No significant differences were found after 3 and 12 months of follow-up evaluation in terms of time until return to work (hazard ratio, 1.3; 95% CI, 0.90-1.90) or in terms of other health outcomes. Recurrences, however, occurred more frequently in the intervention group, but the total duration of sick leave in 1 year did not differ between the groups. CONCLUSIONS: The findings do not show a significant positive effect of an early intervention by occupational physicians on workers with low back pain. This might reflect the early phase of disability or the low intensity of the intervention resulting from overestimation of the physicians' compliance with the guidelines.

Adult↗
PubMed2002

Evidence-based medicine for occupational health.

OBJECTIVES: This study attempted to determine the feasibility and utility of methods used in evidence-based medicine for some common questions in the practice of occupational medicine. METHODS: The following clinical questions were generated that were representative of the type of problems encountered by occupational health physicians: is work a cause of health problems and is impaired health a cause of diminished work capacity for a specific job? Answers were generated according to the method used in evidence-based medicine by formulating an answerable question, searching the literature, critically appraising the results, and applying the results to the clinical question. RESULTS: Answers were found to all the questions in a reasonable amount of time. The searches revealed a need for more systematic reviews and studies that use work-related health outcomes like return to work. However, there is more evidence available in Medline than is generally assumed by occupational health physicians. Using this evidence led to better clinical decisions. Pitfalls during the literature search were typing mistakes, problems in using medical subject headings, and unreliable search strategies. With the use of the abstracts only, most clinical questions could be answered satisfactorily, but concrete risk estimates were often lacking. The lack of availability of full text journals decreased the reliability of the critical appraisal and risk estimation. CONCLUSIONS: Evidence-based medicine is a feasible and useful method for occupational medicine. Instruction and training is needed for most occupational health physicians to increase their searching and critical appraisal skills. More research is needed to determine the information needs of occupational health physicians and to develop tools that facilitate literature searches.

Adult↗