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Scand J Public Health. 2017 Jun;45(4):350-356. doi: 10.1177/1403494817702759. Epub 2017 Apr 7.

Predictive validity of the Work Ability Index and its individual items in the general population.

Author information

1 Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
2 Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
3 Swedish Social Insurance Inspectorate, Stockholm, Sweden.
4 Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
5 Department of Clinical Neuroscience, Karolinska Institutet, Division of Insurance Medicine, Stockholm, Sweden.
6 Department of Medical Science, Uppsala University, Uppsala, Sweden.



This study assesses the predictive ability of the full Work Ability Index (WAI) as well as its individual items in the general population.


The Work, Health and Retirement Study (WHRS) is a stratified random national sample of 25-75-year-olds living in Sweden in 2000 that received a postal questionnaire ( n = 6637, response rate = 53%). Current and subsequent sickness absence was obtained from registers. The ability of the WAI to predict long-term sickness absence (LTSA; ⩾ 90 consecutive days) during a period of four years was analysed by logistic regression, from which the Area Under the Receiver Operating Characteristic curve (AUC) was computed.


There were 313 incident LTSA cases among 1786 employed individuals. The full WAI had acceptable ability to predict LTSA during the 4-year follow-up (AUC = 0.79; 95% CI 0.76 to 0.82). Individual items were less stable in their predictive ability. However, three of the individual items: current work ability compared with lifetime best, estimated work impairment due to diseases, and number of diagnosed current diseases, exceeded AUC > 0.70. Excluding the WAI item on number of days on sickness absence did not result in an inferior predictive ability of the WAI.


The full WAI has acceptable predictive validity, and is superior to its individual items. For public health surveys, three items may be suitable proxies of the full WAI; current work ability compared with lifetime best, estimated work impairment due to diseases, and number of current diseases diagnosed by a physician.


Self-assessment; WAI; absenteeism; discriminative ability; public health; sick leave; sickness absence; work capacity evaluation

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