43 The assessment of work endurance in disability evaluations across European countries endurance available?”; “What causes are considered to be acceptable for limited work endurance?”; “By which methods is work endurance measured?”; “Do controversies on the assessment of work endurance exist?” MATERIALS AND METHODS Study setting and participants We invited experts from 19 European countries: Belgium, Croatia, Czech Republic, Finland, France, Germany, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Sweden, Switzerland and the United Kingdom (UK). We identified experts through the secretariat of the European Union of Medicine in Assurance and Social Security (EUMASS), a network of national associations of insurance medicine in 19 European countries [27]. EUMASS aims to offer a platform to exchange experiences within the field of insurance medicine between various insurance-related organizations in Europe, mainly focusing on public social security. Each national association is represented in the EUMASS council by up to two staff medical advisor(s), i.e. experts in disability assessment, and may nominate one deputy for each representative. We invited all council members, 35 experts, representing the 19 countries. In the total group of EUMASS expert representatives, the number of eligible respondents per country ranged from one to three. As we invited the total group of 35 eligible EUMASS representatives we were not able to expand the sample by additional members. Design and procedures We invited the participants to fill in two self-constructed surveys consecutively from June 2014 through April 2015. The language of the survey administration was English for all countries. The questionnaire used in the first survey was independently pilot-tested for readability and usability by four practicing insurance physicians and the questionnaire in the second survey by three researchers with expertise in disability assessment. In the first survey experts received a link to a webbased questionnaire with items on the assessment of work endurance. A second questionnaire was sent by email directly to 17 participants in the first survey from 13 countries who had volunteered for the second survey. In both surveys a first and second reminder was sent after four and eight weeks, respectively. Participants from the same country whose answers were not unanimous, were approached separately by email with a request to clarify. Under Dutch law approval of this study by the Medical Ethical Board of the University Medical Centre Groningen was not necessary. 3
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