Skip to main content

Archived Comments for: The prognosis for individuals on disability retirement An 18-year mortality follow-up study of 6887 men and women sampled from the general population

Back to article

  1. Randomised controlled trial (RCT) of sick leave

    Inge Axelsson, Ostersund County Hospital and Mid Sweden University

    7 March 2007

    At the end of your paper, you write: "If the disability retirement per se includes a damaging factor one might wonder whether the outcome would have been different if the retired person had not been granted a disability pension but were allowed to stay at work with some kind of adjusted work situation. This is an important scientific and medical issue that warrants further research. The final solution to the problem might be a randomized clinical trial, even though such a design involves ethical and other controversial issues."

    Most candidates for disability pension in Sweden are first on sick leave for several months. It is probably easier to perform RCTs of sick leave and randomise patients to different extent of sick leave (100%, 75%, 50%, 25%, 0%). I have used Clinical evidence, Cochrane Library, Campbell Library and PubMed for an extensive literature search after such studies (Axelsson I, unpublished). Several databases came up with one and the same study: Borchgrevink et al, Spine 1998;23:25-31. Patients brought to the accident and emergency department at the university hospital in Trondheim, Norway, after a car accident and who were suspected of having whiplash injuries were randomly assigned to 14 days of neck collar and sick leave or neither neck collar nor sick leave. The latter group had a better outcome.

    The important pioneering work by Borchgrevink et al. has shown that RCTs of sick leave are possible.

    Competing interests