# Universal benefit of vocational rehabilitation: distinguishing specific vocational advice and delivery systems — an evidence checklist Verdict 2944 · Evidence Check Stored-material review date: Not recorded Original evidence cut-off: 2026-08-26 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-11 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - Population: Distinguish SWAP workers with musculoskeletal pain from MI-NAV populations, systems and delivery; no universal population is established - Ingredient, formulation and route: Early stepped physiotherapist vocational advice and case management in UK primary care and other programs delivered through NAV - Dose: Detailed original service components, frequency and adherence have not been read; no treatment or support instructions for users - Comparator: Detailed SWAP control management is unverified; MI-NAV stratified vocational advice or motivational interviewing versus usual case management - Measured outcome: The selected question is generalization across vocational rehabilitation; direct original outcomes are SWAP four-month self-reported absence days and MI-NAV absence at individual time points - Duration: SWAP four-month original results and 12-month follow-up; distinguish MI-NAV six- and 12-month reports - Questions outside this scope: Generalizing specific advice to all vocational rehabilitation; Repurposing time-point-specific MI-NAV effects as sustained SWAP effects; Mixing absence, pain, quality of life and economic benefit; Treatment or vocational-support instructions for users ## Checklist items ### N01 · Are the general vocational-rehabilitation verdict and the specific SWAP parent verdict distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The subclaim is ‘Universal benefit of vocational rehabilitation’, with original grade D and a note about MI-NAV results at different time points and the lack of independent confirmation. The parent concerns the specific SWAP comparison: B, 72 points, safety Unknown. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Subclaim score, status and axes are absent; do not fill them with parent values. No new verdict that all vocational rehabilitation is ineffective is made. - Reason for missing information: Subclaim score, status and axes are absent; do not fill them with parent values. No new verdict that all vocational rehabilitation is ineffective is made. - Required materials and conditions: Separate records of the subclaim, grade and note and the parent verdict - Materials to obtain first: Subclaim score, status and axes are absent; do not fill them with parent values. No new verdict that all vocational rehabilitation is ineffective is made. - Further research: If additional material is provided, link direct evidence for each population, program and outcome. - Conditions for verification: Separate records of the subclaim, grade and note and the parent verdict - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R03, R04 ### N02 · Are SWAP workers with musculoskeletal pain and other vocational-rehabilitation populations the same? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: SWAP included 338 workers with musculoskeletal pain in UK primary care. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Detailed eligibility by occupation, condition and baseline absence and direct effects in other populations have not been read. Do not automatically apply this to other rehabilitation populations. - Reason for missing information: Detailed eligibility by occupation, condition and baseline absence and direct effects in other populations have not been read. Do not automatically apply this to other rehabilitation populations. - Required materials and conditions: Original materials on occupation, baseline work status, condition, eligibility and denominators - Materials to obtain first: Detailed eligibility by occupation, condition and baseline absence and direct effects in other populations have not been read. Do not automatically apply this to other rehabilitation populations. - Further research: Obtain original eligibility, baseline characteristics, work and absence status and direct comparisons for each population. - Conditions for verification: Original materials on occupation, baseline work status, condition, eligibility and denominators - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N03 · What program was early stepped physiotherapist vocational advice and case management? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original intervention was vocational advice and case management by primary-care physiotherapists, an early stepped service in UK primary care. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not equate it with all vocational rehabilitation, employment support or other programs, or create treatment or support instructions for users. Components, frequency and adherence have not been read. - Reason for missing information: Do not equate it with all vocational rehabilitation, employment support or other programs, or create treatment or support instructions for users. Components, frequency and adherence have not been read. - Required materials and conditions: Study records of providers, services, support, accompanying management and actual exposure - Materials to obtain first: Do not equate it with all vocational rehabilitation, employment support or other programs, or create treatment or support instructions for users. Components, frequency and adherence have not been read. - Further research: Obtain original service components, providers, start time, actual exposure and accompanying management materials. - Conditions for verification: Study records of providers, services, support, accompanying management and actual exposure - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N04 · What were SWAP control management and the comparator for the generalization question? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: SWAP was a cluster-randomized trial comparing 158 intervention and 180 control participants. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Specific control management, contact and service exposure are not established by this summary. Do not recast it as the effects of all services versus no support. - Reason for missing information: Specific control management, contact and service exposure are not established by this summary. Do not recast it as the effects of all services versus no support. - Required materials and conditions: Original group records of usual management, contact, additional support and existing treatment - Materials to obtain first: Specific control management, contact and service exposure are not established by this summary. Do not recast it as the effects of all services versus no support. - Further research: Obtain original control and accompanying management, contact differences and direct comparisons for the generalization question. - Conditions for verification: Original group records of usual management, contact, additional support and existing treatment - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N05 · Are cluster allocation across 6 practices and the denominator of 338 participants distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: SWAP randomized 6 general practices as clusters and compared 338 participants, 158/180. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not treat 338 people as independent allocation units or create cluster allocations, ICC or design effects absent from the original paper. - Reason for missing information: Do not treat 338 people as independent allocation units or create cluster allocations, ICC or design effects absent from the original paper. - Required materials and conditions: Original materials on clusters, individuals, allocation and analysis denominators, cluster sizes and adjustment - Materials to obtain first: Do not treat 338 people as independent allocation units or create cluster allocations, ICC or design effects absent from the original paper. - Further research: Obtain original cluster allocation, sizes, analysis adjustment and participant flow materials. - Conditions for verification: Original materials on clusters, individuals, allocation and analysis denominators, cluster sizes and adjustment - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N06 · Are four-month self-reported absence days the same outcome for all vocational rehabilitation? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The direct endpoint was patient-questionnaire-reported absence days over 4 months. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not equate it with return to work, work participation, job retention, income or all work function. Detailed outcome definitions and questionnaire procedures have not been read. - Reason for missing information: Do not equate it with return to work, work participation, job retention, income or all work function. Detailed outcome definitions and questionnaire procedures have not been read. - Required materials and conditions: Absence definitions, recall period, questionnaire, denominators and analysis units - Materials to obtain first: Do not equate it with return to work, work participation, job retention, income or all work function. Detailed outcome definitions and questionnaire procedures have not been read. - Further research: Obtain original absence definitions, time points, questionnaire and denominators separately from direct material for other outcomes. - Conditions for verification: Absence definitions, recall period, questionnaire, denominators and analysis units - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N07 · Are mean absence days, mean difference and IRR different effect measures? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original account gives 4-month means of 9.3 versus 14.4 days, mean difference −5.1 days, IRR 0.51 (95% CI 0.26–0.99), P=0.048. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not change IRR into a recurrence risk ratio or return-to-work proportion. No new differences, rates, denominators or CI are calculated. The mean-difference CI and analysis model have not been read. - Reason for missing information: Do not change IRR into a recurrence risk ratio or return-to-work proportion. No new differences, rates, denominators or CI are calculated. The mean-difference CI and analysis model have not been read. - Required materials and conditions: Original group means, between-group mean difference, incidence rate ratio, CI and tests - Materials to obtain first: Do not change IRR into a recurrence risk ratio or return-to-work proportion. No new differences, rates, denominators or CI are calculated. The mean-difference CI and analysis model have not been read. - Further research: Obtain the original absence-analysis model, cluster adjustment and separate estimation tables for mean difference and IRR. - Conditions for verification: Original group means, between-group mean difference, incidence rate ratio, CI and tests - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N08 · Are borderline statistical results distinguished from certification of universal benefit? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original account notes only 6 practices and borderline CI and P results. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not extend significance into certification of benefit for every population, delivery system and duration. Do not replace the parent's unrecorded precision with a new value. - Reason for missing information: Do not extend significance into certification of benefit for every population, delivery system and duration. Do not replace the parent's unrecorded precision with a new value. - Required materials and conditions: Original effects, precision, prespecified plans and scope of application - Materials to obtain first: Do not extend significance into certification of benefit for every population, delivery system and duration. Do not replace the parent's unrecorded precision with a new value. - Further research: Link populations, periods, effects, CI and scope of application for new direct comparisons separately. - Conditions for verification: Original effects, precision, prespecified plans and scope of application - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N09 · Do gaps remain in four-month response, attrition and analysis populations? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original abstract did not provide 4-month questionnaire response, so the preserved account says attrition cannot be estimated. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not certify the randomized denominator of 338 as the questionnaire-analysis denominator or calculate attrition. - Reason for missing information: Do not certify the randomized denominator of 338 as the questionnaire-analysis denominator or calculate attrition. - Required materials and conditions: Original group questionnaire returns, missingness, analysis populations and sensitivity analyses - Materials to obtain first: Do not certify the randomized denominator of 338 as the questionnaire-analysis denominator or calculate attrition. - Further research: Obtain original questionnaire returns, group reasons for missingness, analysis populations and sensitivity-analysis materials. - Conditions for verification: Original group questionnaire returns, missingness, analysis populations and sensitivity analyses - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N10 · Are allocation concealment, blinding and self-report measurement procedures directly described? Verification status: Unverified Reading scope: Summary read; external materials not read - Current findings: The information that SWAP was cluster randomized and used patient-questionnaire outcomes is preserved. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Detailed concealment and participant, assessor and analyst blinding are unverified in this summary. Do not use the B0 axis as certification of a current review. - Reason for missing information: Detailed concealment and participant, assessor and analyst blinding are unverified in this summary. Do not use the B0 axis as certification of a current review. - Required materials and conditions: Cluster allocation, concealment, measurement and analysis procedures and original methods - Materials to obtain first: Detailed concealment and participant, assessor and analyst blinding are unverified in this summary. Do not use the B0 axis as certification of a current review. - Further research: Obtain original trial methods and measurement and analysis procedures. - Conditions for verification: Cluster allocation, concealment, measurement and analysis procedures and original methods - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N11 · What were the prespecified primary endpoint, registration and success threshold? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: 4-month absence days were the prespecified primary endpoint, with follow-up to 12 months. A two-sided 5% level and 80% power were declared, but an important absence-day difference was not set as a success threshold. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not recast test level and power as a clinical success threshold. Registration, protocol and SAP have not been read in this work. - Reason for missing information: Do not recast test level and power as a clinical success threshold. Registration, protocol and SAP have not been read in this work. - Required materials and conditions: Original registration, protocol, SAP, primary hierarchy and clinical-importance materials - Materials to obtain first: Do not recast test level and power as a clinical success threshold. Registration, protocol and SAP have not been read in this work. - Further research: Link original registration, SAP, changes and importance plans separately. - Conditions for verification: Original registration, protocol, SAP, primary hierarchy and clinical-importance materials - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R02 ### N12 · Are net societal benefit, absence costs and healthcare costs distinguished from generalized cost-effectiveness? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original account gives net societal benefit of £733 per person and preserves the original explanation of £748 lower absence costs and £15 higher healthcare costs. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not add new calculations or exchange rates or transfer these to cost-effectiveness in other countries or benefits of every rehabilitation program. Cost CI and detailed perspective have not been read. - Reason for missing information: Do not add new calculations or exchange rates or transfer these to cost-effectiveness in other countries or benefits of every rehabilitation program. Cost CI and detailed perspective have not been read. - Required materials and conditions: Original setting, currency, perspective, period, costs and uncertainty materials - Materials to obtain first: Do not add new calculations or exchange rates or transfer these to cost-effectiveness in other countries or benefits of every rehabilitation program. Cost CI and detailed perspective have not been read. - Further research: Obtain the original economic analysis period, perspective, cost components and uncertainty and materials from other systems. - Conditions for verification: Original setting, currency, perspective, period, costs and uncertainty materials - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N13 · Can pain, quality of life and other secondary outcomes replace absence effects? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original account explicitly says pain and quality-of-life secondary outcomes should not be used to stand in for absence benefits. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not create secondary-outcome figures or superiority absent from this summary. Do not fill in universal vocational-rehabilitation function. - Reason for missing information: Do not create secondary-outcome figures or superiority absent from this summary. Do not fill in universal vocational-rehabilitation function. - Required materials and conditions: Outcome-specific definitions, hierarchy, denominators, effects and intervals - Materials to obtain first: Do not create secondary-outcome figures or superiority absent from this summary. Do not fill in universal vocational-rehabilitation function. - Further research: Obtain secondary-outcome tables and prespecified hierarchy and multiplicity plans for each endpoint. - Conditions for verification: Outcome-specific definitions, hierarchy, denominators, effects and intervals - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N14 · Are SWAP's 12-month follow-up and MI-NAV's 12-month results the same? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: SWAP is recorded as followed to 12 months, while its direct figures concern 4 months. MI-NAV has separate 12-month results. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not fill SWAP's sustained effects with MI-NAV's 12-month effects. SWAP follow-up figures are absent from this summary. - Reason for missing information: Do not fill SWAP's sustained effects with MI-NAV's 12-month effects. SWAP follow-up figures are absent from this summary. - Required materials and conditions: Trial-specific follow-up periods, time points, effects and denominators - Materials to obtain first: Do not fill SWAP's sustained effects with MI-NAV's 12-month effects. SWAP follow-up figures are absent from this summary. - Further research: Link original SWAP results at each time point and MI-NAV materials by trial. - Conditions for verification: Trial-specific follow-up periods, time points, effects and denominators - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R04 ### N15 · What were MI-NAV populations, NAV delivery and the three intervention comparisons? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: MI-NAV compared motivational interviewing or stratified vocational advice delivered through NAV with usual case management. The original account says SWAP used advisers within UK primary care and had different populations and systems. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not merge different services and populations into the same program. Six-month group denominators and specific populations have not been read. - Reason for missing information: Do not merge different services and populations into the same program. Six-month group denominators and specific populations have not been read. - Required materials and conditions: Distinguish original populations, delivery systems, motivational interviewing, stratified advice and usual management - Materials to obtain first: Do not merge different services and populations into the same program. Six-month group denominators and specific populations have not been read. - Further research: Obtain original MI-NAV eligibility, service components, group comparisons and delivery-system materials. - Conditions for verification: Distinguish original populations, delivery systems, motivational interviewing, stratified advice and usual management - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R03, R04 ### N16 · Which intervention and outcome does MI-NAV's six-month null result concern? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: At 6 months, the absence difference in the stratified-vocational-advice group is recorded as null. The evidence-list sample is ‘MI-NAV participants’. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not create six-month figures, CI, P or group analysis denominators. Do not add the same null result for motivational interviewing. - Reason for missing information: Do not create six-month figures, CI, P or group analysis denominators. Do not add the same null result for motivational interviewing. - Required materials and conditions: Time-point-specific interventions, denominators, effects, CI and tests - Materials to obtain first: Do not create six-month figures, CI, P or group analysis denominators. Do not add the same null result for motivational interviewing. - Further research: Obtain original six-month effects, denominators, models, CI and test materials. - Conditions for verification: Time-point-specific interventions, denominators, effects, CI and tests - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R03 ### N17 · Are MI-NAV's two 12-month effects and denominator preserved separately? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: In the 12-month trial of 509 people, stratified advice was −17.6 days (95% CI −33.0 to −2.2) and motivational interviewing −15.6 days (95% CI −31.0 to −0.2), each versus usual case management. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not repurpose 509 as group analysis counts or six-month denominators. Do not calculate direct superiority between the two interventions or new P values. - Reason for missing information: Do not repurpose 509 as group analysis counts or six-month denominators. Do not calculate direct superiority between the two interventions or new P values. - Required materials and conditions: Time-point- and group-specific original effects, CI, denominators and analysis plans - Materials to obtain first: Do not repurpose 509 as group analysis counts or six-month denominators. Do not calculate direct superiority between the two interventions or new P values. - Further research: Obtain 12-month group denominators, missingness, original models and direct intervention-comparison plans. - Conditions for verification: Time-point- and group-specific original effects, CI, denominators and analysis plans - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R04 ### N18 · Are MI-NAV time-point reports and overlapping SWAP authors independent replication? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original account says MI-NAV authors overlap with SWAP and this is not independent confirmation by different research teams and funding sources; the parent R1 is retained. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not add two MI-NAV time-point reports as two new independent trials. Exact follow-up mapping of the same population has not been read externally. - Reason for missing information: Do not add two MI-NAV time-point reports as two new independent trials. Exact follow-up mapping of the same population has not been read externally. - Required materials and conditions: Link reports, trials, time points, populations and author and funding relationships - Materials to obtain first: Do not add two MI-NAV time-point reports as two new independent trials. Exact follow-up mapping of the same population has not been read externally. - Further research: Preserve original same-trial, time-point and participant mapping and funding and author connections. - Conditions for verification: Link reports, trials, time points, populations and author and funding relationships - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R03, R04 ### N19 · Do direct gaps remain by population, service and system for vocational rehabilitation in general? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original account explicitly limits the verified scope to the specific early stepped service in UK primary care, rather than universal benefit of all vocational rehabilitation. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not extend specific benefits and time-point results into effectiveness or ineffectiveness of every rehabilitation program. - Reason for missing information: Do not extend specific benefits and time-point results into effectiveness or ineffectiveness of every rehabilitation program. - Required materials and conditions: Direct comparisons for different populations, programs, delivery systems and outcomes - Materials to obtain first: Do not extend specific benefits and time-point results into effectiveness or ineffectiveness of every rehabilitation program. - Further research: Direct comparative evidence with clearly specified population, system, service, period and outcome is needed. - Conditions for verification: Direct comparisons for different populations, programs, delivery systems and outcomes - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R03, R04 ### N20 · Are SWAP public and nonprofit funding and four involvement gaps distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: SWAP is preserved as supported by NIHR, Arthritis Research UK and the UK Department of Health. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Details of free product or service provision, organizational affiliation, contracted external analysis and sponsor manuscript roles are unverified in this summary. Do not newly certify independence from public support alone. - Reason for missing information: Details of free product or service provision, organizational affiliation, contracted external analysis and sponsor manuscript roles are unverified in this summary. Do not newly certify independence from public support alone. - Required materials and conditions: Records of funding, free provision, affiliated authors and external analysis roles - Materials to obtain first: Details of free product or service provision, organizational affiliation, contracted external analysis and sponsor manuscript roles are unverified in this summary. Do not newly certify independence from public support alone. - Further research: Obtain separate funding, provision, affiliation, analysis, design and manuscript disclosures. - Conditions for verification: Records of funding, free provision, affiliated authors and external analysis roles - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N21 · Are MI-NAV funding labels distinguished from service delivery systems? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: MI-NAV's funding field describes NAV delivery and overlapping SWAP authors. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not turn the delivery organization into new certification of the exact research funding source, product provision or employee authors. - Reason for missing information: Do not turn the delivery organization into new certification of the exact research funding source, product provision or employee authors. - Required materials and conditions: Separate materials on delivery, support, affiliation, analysis and author relationships - Materials to obtain first: Do not turn the delivery organization into new certification of the exact research funding source, product provision or employee authors. - Further research: Obtain separate original support, delivery, affiliation and research-role disclosures. - Conditions for verification: Separate materials on delivery, support, affiliation, analysis and author relationships - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R03, R04 ### N22 · What is the scope of serious adverse events not assessed and harm signals not reported? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The original SWAP account records that serious adverse events were not assessed as a separate endpoint and no harm signal was reported. Parent safety is Unknown. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not extend this to zero events, safety of all vocational rehabilitation or absence of MI-NAV harms. - Reason for missing information: Do not extend this to zero events, safety of all vocational rehabilitation or absence of MI-NAV harms. - Required materials and conditions: Prespecified harms plans, collection, group events, exposure and denominators - Materials to obtain first: Do not extend this to zero events, safety of all vocational rehabilitation or absence of MI-NAV harms. - Further research: Obtain trial-specific original harms plans, group events, denominators, exposure and discontinuation materials. - Conditions for verification: Prespecified harms plans, collection, group events, exposure and denominators - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01 ### N23 · Do direct gaps remain in long-term and rare harms and service discontinuation? Verification status: Unverified Reading scope: Summary read; external materials not read - Current findings: The original parent materials record a limited harms summary and follow-up period. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not certify evaluation of rare harms from long-term follow-up alone. Do not create harm counts, rates or discontinuation reasons absent from the original paper. - Reason for missing information: Do not certify evaluation of rare harms from long-term follow-up alone. Do not create harm counts, rates or discontinuation reasons absent from the original paper. - Required materials and conditions: Time-point-specific exposure, discontinuation, severity, direct harms and follow-up - Materials to obtain first: Do not certify evaluation of rare harms from long-term follow-up alone. Do not create harm counts, rates or discontinuation reasons absent from the original paper. - Further research: Actual service-specific exposure, discontinuation, long-term harms and rare-event materials are needed. - Conditions for verification: Time-point-specific exposure, discontinuation, severity, direct harms and follow-up - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R03, R04 ### N24 · Are application to other populations, repeated harm evidence and support instructions distinguished? Verification status: Unverified Reading scope: Summary read; external materials not read - Current findings: Compared with the universal vocational-rehabilitation question, current materials concern specific SWAP and MI-NAV services. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not newly establish effects or harms in other populations or instruct users on treatment or vocational-support actions. - Reason for missing information: Do not newly establish effects or harms in other populations or instruct users on treatment or vocational-support actions. - Required materials and conditions: Direct harms and application by population and program and same-population relationships - Materials to obtain first: Do not newly establish effects or harms in other populations or instruct users on treatment or vocational-support actions. - Further research: Link direct comparisons and harms materials for new populations by service. - Conditions for verification: Direct harms and application by population and program and same-population relationships - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R03, R04 ### N25 · Are registration reports and external access status shown for each material? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: SWAP registration ISRCTN52269669 is linked through its actual citation URL; the three other papers retain their original PubMed URLs. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not label a registration URL as a paper's full text or abstract. Preserve unread status and Not applicable identifiers as originally recorded; link tests were not performed. - Reason for missing information: Do not label a registration URL as a paper's full text or abstract. Preserve unread status and Not applicable identifiers as originally recorded; link tests were not performed. - Required materials and conditions: Original links and actual access records for summaries, papers, registration, protocol and SAP - Materials to obtain first: Do not label a registration URL as a paper's full text or abstract. Preserve unread status and Not applicable identifiers as originally recorded; link tests were not performed. - Further research: Link original materials obtained by the user with their actual access status for each material. - Conditions for verification: Original links and actual access records for summaries, papers, registration, protocol and SAP - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R02, R03, R04 ### N26 · Are original dates, subclaim and parent values, Korean and English text, corrections and empty values retained? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: The date 2026-08-26, empty correction and deliberation records, Korean and English text, parent B72, safety Unknown, axes and subclaim D are preserved. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. Do not turn this generation date into a new clinical verification date. Past cross-checking is not completion of this review. - Reason for missing information: Do not turn this generation date into a new clinical verification date. Past cross-checking is not completion of this review. - Required materials and conditions: Preservation of the whole parent verdict summary and selected verdict record, languages and history - Materials to obtain first: Do not turn this generation date into a new clinical verification date. Past cross-checking is not completion of this review. - Further research: Link new materials and decisions with preservation of the entire original text and separate change events. - Conditions for verification: Preservation of the whole parent verdict summary and selected verdict record, languages and history - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R02, R03, R04 ### N27 · Are production completion and original-content review and independence certification distinguished? Verification status: Partly verified Reading scope: Summary read; external materials not read - Current findings: Original review-pending/production-eligible indicators and boundary-review requirements are preserved as history. The original content review remains incomplete; active-pending and completion flags for model, content and boundary reviews are false. - Why unverified: Only the relevant information from the stored summary is recorded. Detailed original materials have not been read, and the original content review remains incomplete. No new verdict, split or independence certification is made; added verdict units are 0 and the final independence count is not recorded. - Reason for missing information: No new verdict, split or independence certification is made; added verdict units are 0 and the final independence count is not recorded. - Required materials and conditions: Separate records of original candidate history, production and review - Materials to obtain first: No new verdict, split or independence certification is made; added verdict units are 0 and the final independence count is not recorded. - Further research: Proposal: Reflect only user-provided materials or decisions as separate events. - Conditions for verification: Separate records of original candidate history, production and review - Why this condition is needed: An individual production condition recording original values, direct comparisons and application boundaries for the selected question - Application exceptions: Unread external materials, different comparisons or out-of-scope results do not substitute for fulfilled conditions, zero effect or safety. - Remaining uncertainty: Unread or unverified materials do not mean zero effect, zero events, safety or new clinical certification. - Referenced methods: Universal benefit of vocational rehabilitation - Related sources: R01, R02, R03, R04 ## Evidence and sources ### R01 Wynne-Jones G, Artus M, Bishop A, et al. Effectiveness and costs of a vocational advice service to improve work outcomes in patients with musculoskeletal pain in primary care: a cluster randomised trial (SWAP). Pain. 2018;159:128-138. PMID: 28976423. [PubMed](https://pubmed.ncbi.nlm.nih.gov/28976423/) Materials actually read: Summary read; external materials not read Findings recorded in the summary: 9.3 versus 14.4 days; mean difference −5.1 days; IRR 0.51 (0.26–0.99), P=0.048 Record level: Stored review summary; not results from directly reading the original paper or review Independent replication: The original SWAP trial and its registration report; MI-NAV reports at different time points retain the same-program relationship described in the original text, while exact follow-up population mapping has not been read. Family IDs link relationships rather than certify unique trial counts; reports, time points, reviews, sibling sheets and the same participants are not newly added as independent evidence. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | local_summary | Original source link preserved | Summary read | Summary read | Preserved parent verdict summary | | abstract | Original source link preserved | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | fulltext | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | registration | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | protocol_sap | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | ### R02 ISRCTN52269669. SWAP - Study of Work And Pain. [Official source](https://www.isrctn.com/ISRCTN52269669) Materials actually read: Summary read; external materials not read Findings recorded in the summary: 9.3 versus 14.4 days; mean difference −5.1 days; IRR 0.51 (0.26–0.99), P=0.048 Record level: Linked context for the same original trial; no new certification as registration results Independent replication: The original SWAP trial and its registration report; MI-NAV reports at different time points retain the same-program relationship described in the original text, while exact follow-up population mapping has not been read. Family IDs link relationships rather than certify unique trial counts; reports, time points, reviews, sibling sheets and the same participants are not newly added as independent evidence. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | local_summary | Original source link preserved | Summary read | Summary read | Preserved parent verdict summary | | abstract | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | fulltext | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | registration | Original source link preserved | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | protocol_sap | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | ### R03 Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management…. PMID: 36428098. [PubMed](https://pubmed.ncbi.nlm.nih.gov/36428098/) Materials actually read: Summary read; external materials not read Findings recorded in the summary: Null absence difference in the stratified-vocational-advice group Record level: Stored review summary; not results from directly reading the original paper or review Independent replication: The original SWAP trial and its registration report; MI-NAV reports at different time points retain the same-program relationship described in the original text, while exact follow-up population mapping has not been read. Family IDs link relationships rather than certify unique trial counts; reports, time points, reviews, sibling sheets and the same participants are not newly added as independent evidence. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | local_summary | Original source link preserved | Summary read | Summary read | Preserved parent verdict summary | | abstract | Original source link preserved | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | fulltext | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | registration | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | protocol_sap | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | ### R04 Effectiveness of two vocational interventions on sickness absence and costs for people with musculoskeletal disorders. PMID: 40927942. [PubMed](https://pubmed.ncbi.nlm.nih.gov/40927942/) Materials actually read: Summary read; external materials not read Findings recorded in the summary: Stratified vocational advice −17.6 days (95% CI −33.0 to −2.2) and motivational interviewing −15.6 days (95% CI −31.0 to −0.2), each versus usual case management Record level: Stored review summary; not results from directly reading the original paper or review Independent replication: The original SWAP trial and its registration report; MI-NAV reports at different time points retain the same-program relationship described in the original text, while exact follow-up population mapping has not been read. Family IDs link relationships rather than certify unique trial counts; reports, time points, reviews, sibling sheets and the same participants are not newly added as independent evidence. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | local_summary | Original source link preserved | Summary read | Summary read | Preserved parent verdict summary | | abstract | Original source link preserved | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | fulltext | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | registration | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | | protocol_sap | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed. ## What the statuses mean - Partly verified: Some information exists in the preserved review summary; detailed original materials remain unverified. This does not certify a passed review or clinical efficacy. - Unverified: Detailed materials for the selected condition could not be established within the stored scope; this does not mean zero effect, zero studies or safety - Review incomplete: Review of existing content incomplete - Met: Use only within the relevant conditions after existing content review; no automatic designation in this preparation - Not reported: Distinguish only within materials actually read; do not turn unread external materials into unreported findings - Inaccessible: Not applied during this preparation because actual access was not tested - Not applicable: Use with a reason for non-applicability based on an explicit question boundary - Conflicting data: Judge after actual material comparison; review was not performed during this preparation - Insufficient evidence for the conditions: Do not use as a clinical grade encompassing currently unread materials ## Change history 2026-10-11 · Public page/materials 1.0. Public pages and materials were prepared from the existing 27 items. No new clinical search, verification-status change or scoring was performed.