51 The assessment of work endurance in disability evaluations across European countries prevalent accepted causes of limited work endurance. These chronic diseases range among the most prevalent conditions where work adjustments as to working times are needed and implemented [15]. This indicates that these categories of chronic diseases are broadly recognized as being importantly associated with limited work endurance. A variety of methods is used to assess functional limitations including work endurance, such as clinical interview, physical examination, functional capacity evaluation, self-report questionnaire, expert assessment by medical specialists. None of these methods have proven reliability and validity [23]. This study shows that a guideline on assessing work endurance is used only in the Netherlands. In general, guidelines for the evaluation of work disability are scarce, do not meet sufficient quality levels and are not evidence-based [30]. The indications for limited work endurance included in the Dutch guideline and confirmed by some other countries, especially general energy deficit, are not based on scientific evidence. Lack of evidence-based guidelines will cause variability across assessors [23,31,32]. Strengths and limitations To our best knowledge, the present study is the first to examine work endurance and its assessment in disability settings in different countries. This study provides information which can facilitate understanding of similarities and differences in the assessment of work endurance across a number of European countries. The participants were contacted through the EUMASS network and may therefore be considered to be experts in the field. Our study has limitations as well. In the total group, of the number of potential respondents per country differed from one to three. The group of expert representatives did not change during the study period, making it impossible to look for inconsistencies when only one respondent from a country responded. We checked for inconsistencies in respondents in those countries with two or three representatives. If inconsistencies were found, we contacted the representatives and tried to reach consensus. If no consensus could be reached we included the positive answer in the analysis. We were not able to expand to other experts from the same country to discuss inconsistencies due to the chosen sampling method. In the first survey, 24 of the 35 potential responders reacted, from which 17 agreed to participate in the second survey. Of them, 12 responded in the second survey. Whether respondents and non-respondents differ in sociodemographics, cultural aspects and/or how it may have influenced their responses on the survey could not be examined, because we and/or EUMASS did not have this information available. This may restrict the generalisability of our results. We have insufficient reliable data to assess whether non-response has caused selection bias. It is an exploratory description of opinions of experts, not allowing any statements about the practice in these countries. 3
RkJQdWJsaXNoZXIy MTk4NDMw