Study

Practitioners involved

Methods for interdisciplinary collaboration

Intervention intensity

Anema 2007

Ergonomist, physiotherapist

"The workplace intervention consisted of a workplace assessment and work adjustments in which all major stakeholders in the return‐to‐work process participated: i.e., the worker, the employer, the occupational physician, and the worker’s general practitioner.”

The entire program consisted of two 1‐hour sessions a week, with 26 sessions maximally (13 weeks) = low intensity

Bultmann 2009

Occupational physician, occupational physiotherapist, chiropractor, psychologist, social worker

“The formulation and implementation of a coordinated, tailored and action‐oriented work rehabilitation plan collaboratively developed by an interdisciplinary team using a feedback guided approach.”

The duration of the intervention was for up to three months; insufficient information to categorize intervention intensity.

Campello 2012

Physical therapist, psychologist, physician

“Backs to Work is a coordinated multidisciplinary reconditioning program”

The duration of the intervention was 3 hours per day, 3 days/week for 4 weeks = 36 hours = mid‐intensity

Jensen 2011

Rehabilitation physician, specialist in clinical social medicine, physiotherapist, social worker, occupational therapist

Coordinated through case manager

The duration of the intervention was 18 weeks, average of 4 meetings with case manager = low intensity

Karjalainen 2003

Physician, physiotherapist, company nurse, company physician

Physiotherapist visited patient’s workplace to involve work supervisor and company health care professionals in treatment

The duration of the mini‐intervention was 1.25‐1.5 hours and the worksite visit was approximately 75 minutes = low intensity

Loisel 1997

Occupational physician, ergonomist, back pain specialist

“All described interventions were provided by a multidisciplinary medical, ergonomic, and rehabilitation staff at the Sherbrooke University Hospital back pain clinic.”

In a previous study using the same protocol (Loisel 1994), the duration of functional rehabilitation therapy ranged from 2 to 13 weeks. Insufficient information to categorize intervention intensity.

Schiltenwolf 2006

Physician, physiotherapist, psychotherapist

This does not appear to be an integrated program. The physiotherapists were blind to treatment condition, indicating no communication between the physiotherapists and psychotherapists.

The duration of the intervention was 6 hours of daily treatment for 15 days in 3 weeks = mid‐intensity

Slater 2009

Physician, masters‐level clinician for behavioural medicine intervention

The extent to which health care professionals communicated wasn't clear from the article text.

The duration of the intervention was 6‐10 weeks, 4 hours a week = mid‐intensity

Whitfill 2010

Physical therapy and behavioral medicine sessions “provided by licensed professionals trained in their respective fields;” occupational therapist

Case management sessions and interdisciplinary team conferences held at baseline and discharge.

The duration of the intervention was from 4 to 10 weeks; 6‐9 behavioral medicine sessions; 6‐9 physical therapy sessions; Up to 6 work transitions sessions; one or more case management sessions = low intensity

Bias Domain

Source of Bias

PossibleAnswers

Selection

(1) Was the method of randomizations adequate?

Yes/No/Unsure

Selection

(2) Was the treatment allocation concealed?

Yes/No/Unsure

Performance

(3) Was the patient blinded to the intervention?

Yes/No/Unsure

Performance

(4) Was the care provider blinded to the intervention?

Yes/No/Unsure

Detection

(5) Was the outcome assessor blinded to the intervention?

Yes/No/Unsure

Attrition

(6) Was the drop‐out rate described and acceptable?

Yes/No/Unsure

Attrition

(7) Were all randomised participants analysed in the group to which they were allocated?

Yes/No/Unsure

Reporting

(8) Are reports of the study free of suggestion of selective outcome reporting?

Yes/No/Unsure

Performance

(9) Were cointerventions avoided or similar?

Yes/No/Unsure

Performance

(10) Was the compliance acceptable in all groups?

Yes/No/Unsure

Detection

(11) Was the timing of the outcome assessment similar in all groups?

Yes/No/Unsure

Other

(12) Are other sources of potential bias unlikely?

Yes/No/Unsure

1

A random (unpredictable) assignment sequence. Examples of adequate methods are coin toss (for studies with 2
groups), rolling a dice (for studies with 2 or more groups), drawing of balls of different colours, drawing of
ballots with the study group labels from a dark bag, computer‐generated random sequence, preordered
sealed envelopes, sequentially‐ordered vials, telephone call to a central office, and preordered list of
treatment assignments. Examples of inadequate methods are: alternation, birth date, social insurance/security number, date in which
they are invited to participate in the study, and hospital registration number.

2

Assignment generated by an independent person not responsible for determining the eligibility of the patients.
This person has no information about the persons included in the trial and has no influence on the
assignment sequence or on the decision about eligibility of the patient.

3

Index and control groups are indistinguishable for the patients or if the success of blinding was tested among
the patients and it was successful.

4

Index and control groups are indistinguishable for the care providers or if the success of blinding was tested
among the care providers and it was successful.

5

Adequacy of blinding should be assessed for each primary outcome separately. This item should be scored
''yes'' if the success of blinding was tested among the outcome assessors and it was successful or:

‐for patient‐reported outcomes in which the patient is the outcome assessor (e.g., pain, disability): the blinding
procedure is adequate for outcome assessors if participant blinding is scored ''yes''
‐for outcome criteria assessed during scheduled visit and that supposes a contact between participants and
outcome assessors (e.g., clinical examination): the blinding procedure is adequate if patients are blinded, and
the treatment or adverse effects of the treatment cannot be noticed during clinical examination
‐for outcome criteria that do not suppose a contact with participants (e.g., radiography, magnetic resonance
imaging): the blinding procedure is adequate if the treatment or adverse effects of the treatment cannot be
noticed when assessing the main outcome
‐for outcome criteria that are clinical or therapeutic events that will be determined by the interaction between
patients and care providers (e.g., cointerventions, hospitalization length, treatment failure), in which the care
provider is the outcome assessor: the blinding procedure is adequate for outcome assessors if item ''4''
(caregivers) is scored ''yes''
‐for outcome criteria that are assessed from data of the medical forms: the blinding procedure is adequate if
the treatment or adverse effects of the treatment cannot be noticed on the extracted data

6

The number of participants who were included in the study but did not complete the observation period or
were not included in the analysis must be described and reasons given. If the percentage of withdrawals and
dropouts does not exceed 20% for short‐term follow‐up and 30% for long‐term follow‐up and does not lead
to substantial bias, a ''yes'' is scored. (N.B. these percentages are arbitrary, not supported by literature).

7

All randomised patients are reported/analysed in the group they were allocated to by randomizations for the
most important moments of effect measurement (minus missing values) irrespective of noncompliance and
cointerventions.

8

All the results from all prespecified outcomes have been adequately reported in the published report of the
trial. This information is either obtained by comparing the protocol and the report, or in the absence of the
protocol, assessing that the published report includes enough information to make this judgment.

9

If there were no cointerventions or they were similar between the index and control groups.

10

The reviewer determines if the compliance with the interventions is acceptable, based on the reported
intensity, duration, number and frequency of sessions for both the index intervention and control
intervention(s). For example, physiotherapy treatment is usually administered for several sessions; therefore, it
is necessary to assess how many sessions each patient attended. For single‐session interventions (e.g.,
surgery), this item is irrelevant.

11

Timing of outcome assessment should be identical for all intervention groups and for all primary outcome
measures.

12

Other types of biases. For example:
‐When the outcome measures were not valid. There should be evidence from a previous or present scientific
study that the primary outcome can be considered valid in the context of the present.
‐Industry‐sponsored trials. The conflict of interest (COI) statement should explicitly state that the researchers
have had full possession of the trial process from planning to reporting without funders with potential COI
having any possibility to interfere in the process. If, for example, the statistical analyses have been done by a
funder with a potential COI, usually ''unsure'' is scored.