Regina Kunz, Adrian Verbel, Rebecca Weida-Cuignet, Jan L. Hoving, Susanne Weinbrenner, Emilie Friberg, Andreas Klipstein, Christiaan Van Haecht, Ilona Autti-Rämö, Nadine Agosti, Sergio Vargas-Prada, Robert Kneepkens, Gert Lindenger, Wout de Boer, Frederieke G. Schaafsma
Evidence-based Insurance Medicine (EbIM) Research and Education, Department of Clinical Research, University of Basel Hospital, Basel, Switzerland. E-mail: regina.kunz@usb.ch
DOI: 10.2340/16501977-2821

Objective: To perform a European survey of the evidence needs and training demands of insurance medicine professionals related to professional tasks and evidence-based practice.
Design: International survey.
Subjects: Professionals working in insurance medicine. Methods: Experts designed an online questionnaire including 26 questions related to 4 themes: evidence needs; training demands; evidence-seeking behaviour; and attitudes towards evidence-based medicine. Descriptive statistics were presented by country/conference and the total sample.
Results: A total of 782 participants responded. Three-quarter of participants experienced evidence needs at least once a week, related to mental disorders (79%), musculoskeletal disorders (67%) and occupational health (65%). Guidelines (76%) and systematic reviews (60%) were the preferred types of evidence and were requested for assessment of work capacity (64%) and prognosis of return-to-work (51%). Evidence-based medicine was thought to facilitate decision-making in insurance medicine (95%). Fifty-two percent of participants felt comfortable finding, reading, interpreting, and applying evidence. Countries expressed similar needs for reviews on typical topics.
Conclusion: This study reveals evidence gaps in key areas of insurance medicine, supporting the need for further research, guidelines and training in evidence-based insurance medicine. Importantly, insurance medicine professionals should recognize that evidence-based practice is crucial in producing high-quality assessments.

Evidence-based medicine (EBM) means the consideration of research findings when taking decisions in clinical medicine. This approach has become standard in health and social care. Since it is less clear to what degree EBM is applied in insurance medicine, European insurance physicians performed a joint survey among colleagues in 8 countries and 2 conferences. More than 700 professionals participated. Half of respondents experienced a need at least once a week to look for guidelines and systematic reviews about work capacity assessments related to mental or musculoskeletal disorders. Almost all thought that EBM would facilitate decision-making. Not all felt competent in finding, reading, interpreting, and applying research evidence. Overall, findings were similar across countries. These results illustrate important evidence gaps in insurance medicine, supporting the need for further research and guidelines. Importantly, professionals should recognize that evidence-based practice is crucial in producing high-quality assessments.

Appendix S1-S6