relevant literature. Disability evaluation is a poorly understood process14-16 that lacks any reference standard to confirm the validity of the findings. Health professionals who perform this task assess medical restrictions and limitations of claimants and are often asked to infer consequences on the ability to work. This, however, requires expertise in vocational rehabilitation, as medical restrictions do not correlate well with function and the ability to work.5 In such situations, reliability studies evaluate the mea- surement properties of observers.47 At each step of dis- ability evaluation, multiple sources of variation come into play (box 1),15 16 including experts’ personal atti- tudes, beliefs, and values towards disability, all of which affect the global judgment of work disability. Left unmanaged, these sources of variation can lead to low inter-rater reliability. We found higher agreement when disability evalua- tion was guided by a standardised instrument. Instru- ments that standardise the collection, interpretation, and reporting of information are one promising approach to reduce variation.15 Five of the seven Dutch studies that used instruments to guide assessment of work disability all achieved fair to good reliability. As all Dutch insurance physicians undergo four years of specialty training in insurance medicine,48 however, we cannot disentangle whether higher agreement is a result of use of a formal instrument or calibration by training, or both. We did not detect any association between inter-rater reliability and subjectivity or chronicity of the health conditions, or overall generalisability to real world dis- ability evaluation. The low number of studies in the analyses, however, precludes any premature conclu- sions that such associations do not exist. Not all sources of variations are easily accessible to change. Other sources, in particular attitudes, beliefs, and value judgments, will require other approaches.49 Implicit in the use of evaluations of disability by a third party is the concern that treating clinicians could have difficulty providing impartial assessments of their patients. Indeed, our findings suggest that medical experts (versus treating physicians) are more likely to conclude that claimants are capable of working. Claim- ant lawyers and patients’ organisations have raised concerns that experts who are paid to assess claimants for insurers might feel pressure to render opinions that favour the referral source. implications for pra...
relevant literature. MOMRP needs knowledgeable research staff who understand how to conduct evidence-based reviews to help make informed decisions relevant to suicidality and suicide among military and veteran populations. We approach technical and literature reviews as opportunities to examine published information in a particular subject area and sometimes within a certain time period. For this project, we reviewed literature and studies published between 2001 and 2017. The years 2001–2009 are critical because they were at the height of military suicide (see Section 1). To remain current with industry trends relative to suicide prevention, we will conduct literature reviews on best practices and new developments in the areas of prevention, intervention, and postvention. As appropriate, we will leverage our institutional knowledge to identify scholarly, policy, scientific, and gray literature that identifies new policy, program, or methodological challenges relevant to MOMRP. To supplement our understanding of the attitudes, behavioral intentions, and opinions related to suicidal attitudes and behaviors, we will review relevant DoD-sponsored literature. We will leverage suicide prevention, public health, and research method Subject Matter Experts to assess the validity of theoretical models and the fit of research methods applied in the literature to current or proposed research problems on suicide in the military. In our work, we structure complex search algorithms using controlled and free- text terms within bibliographic databases in the life sciences (Medline, EmBase, PubMed, Xxxxxxxx).
