External validation of a prediction model and decision tree for sickness absence due to mental disorders
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ORIGINAL ARTICLE
External validation of a prediction model and decision tree for sickness absence due to mental disorders Marieke F. A. van Hoffen1,2,4 · Giny Norder1 · Jos W. R. Twisk2 · Corné A. M. Roelen2,3 Received: 8 October 2019 / Accepted: 24 April 2020 © The Author(s) 2020
Abstract Purpose A previously developed prediction model and decision tree were externally validated for their ability to identify occupational health survey participants at increased risk of long-term sickness absence (LTSA) due to mental disorders. Methods The study population consisted of N = 3415 employees in mobility services who were invited in 2016 for an occupational health survey, consisting of an online questionnaire measuring the health status and working conditions, followed by a preventive consultation with an occupational health provider (OHP). The survey variables of the previously developed prediction model and decision tree were used for predicting mental LTSA (no = 0, yes = 1) at 1-year follow-up. Discrimination between survey participants with and without mental LTSA was investigated with the area under the receiver operating characteristic curve (AUC). Results A total of n = 1736 (51%) non-sick-listed employees participated in the survey and 51 (3%) of them had mental LTSA during follow-up. The prediction model discriminated (AUC = 0.700; 95% CI 0.628–0.773) between participants with and without mental LTSA during follow-up. Discrimination by the decision tree (AUC = 0.671; 95% CI 0.589–0.753) did not differ significantly (p = 0.62) from discrimination by the prediction model. Conclusion At external validation, the prediction model and the decision tree both poorly identified occupational health survey participants at increased risk of mental LTSA. OHPs could use the decision tree to determine if mental LTSA risk factors should be explored in the preventive consultation which follows after completing the survey questionnaire. Keywords Health surveys · Mental health · Reproducibility of results · ROC analysis · Validation studies
Introduction Mental disorders are the major cause of long-term sickness absence (LTSA) in member countries of the Organization of Economic Co-operation and Development (OECD 2015). Mental LTSA disconnects employees from the workplace * Marieke F. A. van Hoffen [email protected] 1
Department of Research and Development, Human Total Care, Utrecht, The Netherlands
2
Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
3
Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
4
HumanCapitalCare, Laan van Nieuw Oost‑Indië 133‑G, 2593 BM Den Haag, The Netherlands
and marginalizes them from the labor market, leading to unemployment, social isolation, and poorer mental health (Henderson et al. 2011). Therefore, it is important to identify employees at risk of mental LTSA before t
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