Workforce requirements in rheumatology: a systematic literature review informing the development of a workforce prediction risk of bias tool and the EULAR points to consider

Julia Unger, Polina Putrik, Frank Buttgereit, Daniel Aletaha, Gerolamo Bianch, Johannes W. J. Bijlsma, Annelies Boonen, Nada Cikes, Joao Madruga Dias, Louise Falzon, Axel Finckh, Laure Gossec, Tore K. Kvien, Eric L. Matteson, Francisca Sivera, Tanja A. Stamm, Zoltan Szekanecz, Dieter Wiek, Angela Zink, Christian Dejaco*Sofia Ramiro

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

10 Citations (Web of Science)


Objective To summarise the available information on physician workforce modelling, to develop a rheumatology workforce prediction risk of bias tool and to apply it to existing studies in rheumatology.

Methods A systematic literature review (SLR) was performed in key electronic databases (1946-2017) comprising an update of an SLR in rheumatology and a hierarchical SLR in other medical fields. Data on the type of workforce prediction models and the factors considered in the models were extracted. Key general as well as specific need/demand and supply factors for workforce calculation in rheumatology were identified. The workforce prediction risk of bias tool was developed and applied to existing workforce studies in rheumatology.

Results In total, 14 studies in rheumatology and 10 studies in other medical fields were included. Studies used a variety of prediction models based on a heterogeneous set of need/demand and/or supply factors. Only two studies attempted empirical validation of the prediction quality of the model. Based on evidence and consensus, the newly developed risk of bias tool includes 21 factors (general, need/demand and supply). The majority of studies revealed high or moderate risk of bias for most of the factors.

Conclusions The existing evidence on workforce prediction in rheumatology is scarce, heterogeneous and at moderate or high risk of bias. The new risk of bias tool should enable future evaluation of workforce prediction studies. This review informs the European League Against Rheumatism points to consider for the conduction of workforce requirement studies in rheumatology.

Original languageEnglish
Article number000756
Number of pages19
JournalRMD Open
Issue number2
Publication statusPublished - Jul 2018



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