Evidence needs, training demands, and opportunities for knowledge translation in social security and insurance medicine: A European survey

Abstract

Objective To perform a European survey of the evidence needs and training demands of insurance medicine professionals related to professional tasks and evidence-based practice. Design International survey. Subjects Professionals working in insurance medicine. Methods Experts designed an online questionnaire including 26 questions related to 4 themes: evidence needs; training demands; evidence-seeking behaviour; and attitudes towards evidence-based medicine. Descriptive statistics were presented by country/conference and the total sample. Results A total of 782 participants responded. Three-quarter of participants experienced evidence needs at least once a week, related to mental disorders (79%), musculoskeletal disorders (67%) and occupational health (65%). Guidelines (76%) and systematic reviews (60%) were the preferred types of evidence and were requested for assessment of work capacity (64%) and prognosis of return-to-work (51%). Evidence-based medicine was thought to facilitate decision-making in insurance medicine (95%). Fifty-two percent of participants felt comfortable finding, reading, interpreting, and applying evidence. Countries expressed similar needs for reviews on typical topics. Conclusion This study reveals evidence gaps in key areas of insurance medicine, supporting the need for further research, guidelines and training in evidence-based insurance medicine. Importantly, insurance medicine professionals should recognize that evidence-based practice is crucial in producing high-quality assessments. LAY ABSTRACT Evidence-based medicine (EBM) means the consideration of research findings when taking decisions in clinical medicine. This approach has become standard in health and social care. Since it is less clear to what degree EBM is applied in insurance medicine, European insurance physicians performed a joint survey among colleagues in 8 countries and 2 conferences. More than 700 professionals participated. Half of respondents experienced a need at least once a week to look for guidelines and systematic reviews about work capacity assessments related to mental or musculoskeletal disorders. Almost all thought that EBM would facilitate decision-making. Not all felt competent in finding, reading, interpreting, and applying research evidence. Overall, findings were similar across countries. These results illustrate important evidence gaps in insurance medicine, supporting the need for further research and guidelines. Importantly, professionals should recognize that evidence-based practice is crucial in producing high-quality assessments.

Designing an evidence-based working method for medical work disability prognosis evaluation–an intervention mapping approach

“…The results indicated that adequate feedback provision would be an important behavior change technique for this target population. A relevant theory (57) was identified, offering an explanation for findings in earlier studies that physicians who were educated in the use of guidelines or other evidence sources, still found it hard to consistently use these in practice [e.g., (16,20,58)]. For example, when physicians take efforts to deliver high quality evidence based disability evaluations, but do not receive any positive feedback from their supervisor or the organization, internal mechanisms will influence their motivation and decrease their intentions to take these efforts again.…”

“…Although physicians need to make evidence-based considerations [e.g., (49,69)] and although they received EBM training (13,19), EBM usage remains limited [e.g., (16,58)]. They still consider EBM usage difficult (20,58) and are in need of EBM assistance (2,17,18).…”

“…Although physicians need to make evidence-based considerations [e.g., (49,69)] and although they received EBM training (13,19), EBM usage remains limited [e.g., (16,58)]. They still consider EBM usage difficult (20,58) and are in need of EBM assistance (2,17,18). Moreover, since most EBM questions involved the topic of prognosis (7), EBM steps (such as finding, appraising and applying evidence) were integrally included within the working method and the education.…”

Dissemination of Evidence by Cochrane Public Health Europe in German-Speaking Countries: An Online Stakeholder Survey

“…Translating such knowledge can be facilitated when the accessible evidence is high quality, understandable and appropriately disseminated to relevant stakeholder groups [9,10]. Ideally, end-users' evidence needs are already known before any knowledge translation activity begins: a recent survey of social security and insurance medicine professionals in the European Union showed that synthesised evidence based on primary research, as reported in guidelines and systematic reviews, is more often needed for their work than primary study evidence alone [11].…”