A systematic review of return-to-work after mild traumatic brain injury: Results of the International Collaboration on MTBI Prognosis (ICoMP)
Bibliographic record
Abstract
Objective: To synthesize the best available evidence on return-to-work (RTW) after mild traumatic brain injury (MTBI). Data sources: MEDLINE and other databases were searched (2001–2012) with terms including ‘craniocerebral trauma’ and ‘employment’. Reference lists of eligible articles were also searched. Study selection: Controlled trials and cohort and case-control studies were selected according to pre-defined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases. Data extraction: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. Data synthesis: Evidence was synthesized qualitatively according to modified SIGN criteria and prioritized according to design as exploratory or confirmatory. After 77 911 records were screened; 299 articles were eligible and reviewed, 101 (34%) of these with a low risk of bias were accepted as scientifically admissible and four of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3–6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11 years of formal education), nausea or vomiting on hospital admission, extra-cranial injuries, severe head/bodily pain early after injury and limited job independence and decision-making latitude. Conclusions: These findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2 years post-MTBI).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.035 | 0.128 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.013 |
| Bibliometrics | 0.032 | 0.028 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".