A systematic review of measurement properties of instruments assessing presenteeism

Am J Manag Care. 2015 Feb 1;21(2):e171-85.


Background: Presenteeism (decreased productivity while at work) is reported to be a major occupational problem in many countries. Challenges exist for identifying the optimal approach to measure presenteeism. Evidence of the relative value of presenteeism instruments to support their use in primary studies is needed.

Objectives: To assess and compare the measurement properties (ie, validity, reliability, responsiveness) and the quality of the evidence of presenteeism instruments.

Study design: Systematic review.

Methods: Comprehensive searches of electronic databases were conducted up to October 2012. Twenty-three presenteeism instruments were examined. Methodological quality was appraised with the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) checklist. A best-evidence synthesis approach was used in the analysis.

Results: The titles and abstracts of 1767 articles were screened, with 289 full-text articles reviewed for eligibility. Of these, 40 studies assessing the measurement properties of presenteeism instruments were identified. The 3 presenteeism instruments with the strongest level of evidence on more than 1 measurement property were the Stanford Presenteeism Scale, 6-item version (content validity, internal consistency, construct validity, convergent validity, and responsiveness); the Endicott Work Productivity Scale (internal consistency, convergent validity, and responsiveness); and the Health and Work Questionnaire (HWQ; internal consistency and structural validity). Only the HWQ was assessed for criterion validity, with unknown quality of the evidence.

Conclusions: Most presenteeism instruments have been examined for some form of validity; evidence for criterion validity is virtually absent. The selection of instruments for use in primary studies depends on weak forms of validity. Further research should focus on the goal of a comprehensive evaluation of the psychometric properties of existing tests of presenteeism, with emphasis on criterion validity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Checklist
  • Efficiency*
  • Evidence-Based Medicine
  • Female
  • Humans
  • Male
  • Middle Aged
  • Organizational Innovation
  • Presenteeism / organization & administration*
  • Presenteeism / statistics & numerical data*
  • Psychometrics
  • Reproducibility of Results
  • Sickness Impact Profile
  • United States
  • Workplace / psychology*
  • Workplace / statistics & numerical data