| Methods |
Randomisation "by computer‐generated random number" |
| Participants |
710 patients (workers) who have mandatory insurance that introduced a benefit claim after open lumbar discectomy. Age between 15 and 64 years and no longer than one year off work before surgery. Interventions start six weeks postsurgery |
| Interventions |
(I) (N = 345) Rehabilitation‐oriented approach (in insurance medicine) by medical advisor (MA). First visit six weeks postsurgery, functional evaluation, information on medicolegal aspects, rehabilitation, natural history and expected work incapacity period. Encourage and stimulate personal activities and early mobilisation. MA asks treating physician for information regarding diagnosis and treatment, encourages rehabilitation measures, promotes multidisciplinary approach. (C) (N = 365) MA: usual care |
| Outcomes |
On return to work at follow‐up (52 weeks): (I) 89.9% (C) 81.9%. Statistically significant |
| Notes |
|
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
Computer‐generated random number |
| Allocation concealment (selection bias) |
High risk |
Medical advisors were randomly assigned |
| Blinding (performance bias and detection bias)
All outcomes ‐ patients? |
High risk |
Rehabilitation versus usual care |
| Blinding (performance bias and detection bias)
All outcomes ‐ care providers? |
High risk |
Rehabilitation versus usual care |
| Blinding (performance bias and detection bias)
All outcomes ‐ outcome assessors? |
Unclear risk |
Unclear from text |
| Incomplete outcome data (attrition bias)
All outcomes ‐ drop‐outs? |
Low risk |
Results last paragraph: No participants dropped out |
| Incomplete outcome data (attrition bias)
All outcomes ‐ ITT analysis? |
Low risk |
Personal communication |
| Selective reporting (reporting bias) |
High risk |
RTW only |
| Similarity of baseline characteristics? |
Low risk |
Results paragraph two: significant difference in gender only |
| Co‐interventions avoided or similar? |
Unclear risk |
Unclear from text |
| Compliance acceptable? |
Low risk |
Personal communication |
| Timing outcome assessments similar? |
Low risk |
52 weeks |
