SmaRTWork - a digital system for personalised return to work recommendations for sick-listed with musculoskeletal disorders

Long-term sickness absence has vast consequences, both for the sick listed worker and society. Musculoskeletal disorders are the most common reason for sickness absence. Despite extensive research on return to work interventions, the results are inconsistent and there is a lack of evidence regarding who needs what measures and at what time. This project aims is to develop and evaluate an intelligent decision support system (SmaRTWork) that 1) enables early identification of individuals at risk of long-term sick leave due to musculoskeletal disorders, and 2) provides personalized recommendations to facilitate sustainable return to work. The SmaRTWork intervention consists of an mobile app that uses case-based reasoning (CBR). The main principle of CBR is to reuse knowledge from previous successful cases to suggest solutions for new and similar cases. The aim of the app is to increase self-management of musculoskeletal pain and to empower the user in the process of returning to work after sick leave. In addition, the user will be put in contact with the social insurance office if that is considered useful. We will evaluate the effect of SmaRTWork on return to work compared to usual care for people sick listed due to musculoskeletal disorders in a randomized controlled trial. Individuals who have been sick listed up to 12 weeks due to musculoskeltal disorders will be invited to participate in the study. The main outcome will be time to sustainable return to work based on registry data with 12 months of follow-up. We will also assess other work outcomes and health outcomes. We will also perform qualitative studies and a process evaluation there we will assess the users’ experiences with the intervention.

Musculoskeletal disorders are the most common reason for sickness absence. Despite extensive research on return to work interventions the results are inconsistent and there is a lack of evidence in regards to who needs what measures. Furthermore, it is not only a question about who needs what; it is also a question about when. The aim of this project is to develop and evaluate an intelligent decision support system that i) enables early identification of individuals at risk of long-term sick leave due to musculoskeletal disorders, and ii) provides personalised recommendations to facilitate sustainable return to work. The SmaRTWork tool will utilize state-of-the-art artificial intelligence (AI) methodologies for the early risk prediction and subsequent tailoring of a personalised intervention to facilitate sustainable return to work. The core foundation for the decision support system will be case-based reasoning (CBR). The main principle of CBR is to reuse knowledge from previous successful cases to suggest solutions for new and similar cases. Workers who have been sick listed for up to 12 weeks due to musculoskeletal disorders will be invited to use The SmaRTWork tool. After consent they will receive credentials to access app-based SmaRTWork tool. The effect of the SmaRTWork tool will be evaluated in a randomized controlled trial. The main outcome will be time to sustainable return to work (i.e. one month back at work without relapse) based on registry data. There will be a process evaluation that will assess facilitators and barriers for implementation, and qualitative studies to explore how the sick-listed workers and other relevant stakeholders experience using the system.