Development of a clinical practice guideline on work functioning assessment of the physically impaired person
Bibliographic record
Abstract
Cliquez ici pour la version française de ce rapport_x000D_ L’évaluation des capacités reliées au travail (ÉCT) de personnes souffrant d’une déficience physique est courante en ergothérapie. Les résultats obtenus servent à déterminer l’admissibilité à des services de réadaptation, à aider à la décision lors d’un processus de réorientation professionnelle ou encore l’admissibilité à des indemnités de remplacement de revenus. Ils peuvent aussi être utilisés dans la planification des interventions de réadaptation visant le retour en emploi ou pour l’adaptation d’un poste de travail. Cependant, la pratique des cliniciens à l’égard de l’ÉCT présente une grande variabilité qui pose un questionnement sur la qualité des résultats qui en sont issus._x000D_ Le recours à des guides de pratique constitue une des solutions proposées pour réduire cette variabilité et augmenter la qualité des soins de santé. Ces guides consistent en des recommandations élaborées à partir de données probantes d’un domaine et constituent une des sources d’informations de qualité sur lesquelles les cliniciens appuient leurs décisions._x000D_ Les auteurs ont élaboré un guide de pratique dont ils ont fait évaluer une première version par des ergothérapeutes experts. Ceux-ci ont dit apprécier le format du guide ; la plupart ont affirmé être en accord avec les recommandations qu’il contient, même si certaines ont dû être précisées ou complétées. Ils ont, de plus, confirmé son utilité. La rétroaction des cliniciens experts a permis de produire un guide de pratique utile et de qualité._x000D_ Cette étude a donc permis de recenser les connaissances actuelles concernant l’ÉCT, d’en tirer les éléments significatifs pour la pratique clinique des ergothérapeutes et de produire un guide de pratique à leur intention._x000D_ Abstract_x000D_ Work functioning assessments (WFA) of physically impaired people are a regular part of occupational therapy clinical practice. WFA results serve to determine eligibility for rehabilitation, aid career-transition decision making or determine eligibility for income-replacement benefits. They can also be used to plan a back-to-work rehabilitation program or to adapt a workstation. However, there is enormous variability in WFA clinical practice, which raises questions about the overall quality of WFA results. Inaccurate or incomplete WFA results can have major adverse impacts, such as injury, and loss of job, income or self-confidence, on the health and quality of life of workers with physical impairments. One of the ways currently being proposed to reduce this variability and increase the quality of health care is the development and dissemination of evidence-based clinical practice guidelines, as they provide reliable information on which clinicians can base their decisions. To our knowledge, there are currently no clinical practice guidelines for occupational therapists on WFA._x000D_ The purpose of this study was to develop a clinical practice guideline for occupational therapists assessing the work functioning of people with physical impairments. It involved conducting a systematic review of the literature and using the results of the review to prepare a first draft of the guideline. That draft was presented to 24 occupational therapists specialized in WFA (four focus groups and two individual interviews). They were consulted on the format and clarity of the guideline, the appropriateness of each clinical recommendation presented in the guideline and whether the set of recommendations covered the field adequately. The focus group discussions and individual interviews were recorded and transcribed, and a qualitative content analysis was performed._x000D_ The consultation revealed that the guideline is easy to use. Most of the consultation participants said they concurred with the recommendations drawn from the review of the literature. Although they felt that some recommendations should have been more precise or more complete, they agreed that they covered the field comprehensively. They also confirmed the usefulness of the guideline to both novice and experienced occupational therapists._x000D_ To conclude, the study provided a view of current knowledge related to WFA and how it should be applied by occupational therapists. The feedback from experienced therapists helped us to be more precise and more complete with some recommendations and to produce a useful, quality clinical practice guideline.
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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 | 0.034 | 0.076 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.005 |
| Bibliometrics | 0.008 | 0.006 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.005 | 0.006 |
| Research integrity | 0.008 | 0.012 |
| Insufficient payload (model declined to judge) | 0.006 | 0.007 |
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".