@article{AdroherProdingerFellinghaueretal.2018, author = {Adroher, N{\´u}ria Duran and Prodinger, Birgit and Fellinghauer, Carolina Saskia and Tennant, Alan}, title = {All metrics are equal, but some metrics are more equal than others: A systematic search and review on the use of the term 'metric'}, series = {PLoS One}, volume = {13}, journal = {PLoS One}, number = {3}, editor = {Public Library of Science,}, pages = {e0193861}, year = {2018}, abstract = {Objective: To examine the use of the term 'metric' in health and social sciences' literature, focusing on the interval scale implication of the term in Modern Test Theory (MTT). Materials and methods: A systematic search and review on MTT studies including 'metric' or 'interval scale' was performed in the health and social sciences literature. The search was restricted to 2001-2005 and 2011-2015. A Text Mining algorithm was employed to operationalize the eligibility criteria and to explore the uses of 'metric'. The paradigm of each included article (Rasch Measurement Theory (RMT), Item Response Theory (IRT) or both), as well as its type (Theoretical, Methodological, Teaching, Application, Miscellaneous) were determined. An inductive thematic analysis on the first three types was performed. Results: 70.6\% of the 1337 included articles were allocated to RMT, and 68.4\% were application papers. Among the number of uses of 'metric', it was predominantly a synonym of 'scale'; as adjective, it referred to measurement or quantification. Three incompatible themes 'only RMT/all MTT/no MTT models can provide interval measures' were identified, but 'interval scale' was considerably more mentioned in RMT than in IRT. Conclusion: 'Metric' is used in many different ways, and there is no consensus on which MTT metric has interval scale properties. Nevertheless, when using the term 'metric', the authors should specify the level of the metric being used (ordinal, ordered, interval, ratio), and justify why according to them the metric is at that level.}, language = {en} } @article{BallertHopfeKusetal.2019, author = {Ballert, C.S. and Hopfe, M. and Kus, M. and Mader, L. and Prodinger, Birgit}, title = {Using the refined ICF Linking Rules to compare the content of existing instruments and assessments: a systematic review and exemplary analysis of instruments measuring participation.}, series = {Disability and Rehabilitation}, volume = {41}, journal = {Disability and Rehabilitation}, number = {5}, pages = {584 -- 600}, year = {2019}, abstract = {Background: Existing instruments measuring participation may vary with respect to various aspects. This study aimed to examine the comparability of existing instruments measuring participation based on the International Classification of Functioning, Disability and Health (ICF) by considering aspects of content, the perspective adopted and the categorization of response options. Methods: A systematic literature review was conducted to identify instruments that have been commonly used to measure participation. Concepts of identified instruments were then linked to the ICF following the refined ICF Linking Rules. Aspects of content, perspective adopted and categorization of response options were documented. Results: Out of 315 instruments identified in the full-text screening, 41 instruments were included. Concepts of six instruments were linked entirely to the ICF component Activities and Participation; of 10 instruments still 80\% of their concepts. A descriptive perspective was adopted in most items across instruments (75\%), mostly in combination with an intensity rating. An appraisal perspective was found in 18\% and questions from a need or dependency perspective were least frequent (7\%). Conclusion: Accounting for aspects of content, perspective and categorization of responses in the linking of instruments to the ICF provides detailed information for the comparison of instruments and guidance on narrowing down the choices of suitable instruments from a content point of view. Implications for Rehabilitation For clinicians and researchers who need to identify a specific instrument for a given purpose, the findings of this review can serve as a screening tool for instruments measuring participation in terms of the following: • Their content covered based on the ICF. • The perspective adopted in the instrument (e.g., descriptive, need/dependency or appraisal). • The categorization of their response options (e.g., intensity or frequency).}, language = {en} } @article{BanzWagenpfeilNeissetal.2004, author = {Banz, K. and Wagenpfeil, S. and Neiss, A. and Hammerschmidt, Thomas and Wutzler, P.}, title = {The burden of varicella in Germany}, series = {The European Journal of Health Economics}, volume = {2004}, journal = {The European Journal of Health Economics}, number = {5 / 1}, pages = {46 -- 53}, year = {2004}, language = {en} } @article{BartoszekFischerMuelleretal.2016, author = {Bartoszek, G. and Fischer, U. and M{\"u}ller, Martin and Strobl, R. and Grill, E. and Nadolny, S. and Meyer, G.}, title = {Outcome measures in older persons with acquired joint contractures: a systematic review and content analysis using the ICF (International Classification of Functioning, Disability and Health) as a reference}, series = {BMC Geriatrics}, journal = {BMC Geriatrics}, editor = {BioMed Central,}, year = {2016}, abstract = {Background: Joint contractures are a common health problem in older persons with significant impact on activities of daily living. We aimed to retrieve outcome measures applied in studies on older persons with joint contractures and to identify and categorise the concepts contained in these outcome measures using the ICF (International Classification of Functioning, Disability and Health) as a reference. Methods: Electronic searches of Medline, EMBASE, CINAHL, Pedro and the Cochrane Library were conducted (1/2002-8/2012). We included studies in the geriatric rehabilitation and nursing home settings with participants aged ≥ 65 years and with acquired joint contractures. Two independent reviewers extracted the outcome measures and transferred them to concepts using predefined conceptual frameworks. Concepts were subsequently linked to the ICF categories. Results: From the 1057 abstracts retrieved, 60 studies met the inclusion criteria. We identified 52 single outcome measures and 24 standardised assessment instruments. A total of 1353 concepts were revealed from the outcome measures; 96.2 \% could be linked to 50 ICF categories in the 2nd level; 3.8 \% were not categorised. Fourteen of the 50 categories (28 \%) belonged to the component Body Functions, 4 (8 \%) to the component Body Structures, 26 (52 \%) to the component Activities and Participation, and 6 (12 \%) to the component Environmental Factors. Conclusions: The ICF is a valuable reference for identifying and quantifying the concepts of outcome measures on joint contractures in older people. The revealed ICF categories remain to be validated in populations with joint contractures in terms of clinical relevance and personal impact.}, language = {en} } @article{BartoszekFischerClarmannvonClarenauetal.2015, author = {Bartoszek, Gabriele and Fischer, Uli and Clarmann von Clarenau, Stephan and Grill, Eva and Mau, Wilfried and Meyer, Gabriele and Strobl, Ralf and Thiesemann, R{\"u}diger and Nadolny, Stephan and M{\"u}ller, Martin}, title = {Development of an International Classification of Functioning, Disability and Health (ICF)-based standard set to describe the impact of joint contractures on participation of older individuals in geriatric care settings}, series = {Archives of gerontology and geriatrics}, volume = {61}, journal = {Archives of gerontology and geriatrics}, editor = {Science direct,}, year = {2015}, abstract = {Introduction Joint contractures are characterized as impairment of the physiological movement of joints due to deformity, disuse or pain and have major impact especially for older individuals in geriatric care. Some measures for the assessment of the impact of joint contractures exist. However, there is no consensus on which aspects should constantly be measured. Our objective was to develop a standard-set based on the ICF for describing functioning and disability in older individuals with joint contractures in geriatric care settings, giving special emphasis to activities and participation. Methods The ICF-based standard set was developed in a formal decision-making and consensus process and based on an adapted version of the protocol to develop ICF Core Sets. These are sets of categories from the ICF, serving as standards for the assessment, communication and reporting of functioning and health for clinical studies, clinical encounters and multi-professional comprehensive assessment and management. Results Twenty-three experts from Germany and Switzerland selected 105 categories of the ICF component Activities and Participation for the ICF-based standard set. The largest number of categories was selected from the chapter Mobility (50 categories, 47.6\%). Conclusions The standard set for older individuals with joint contractures provides health professionals with a standard for describing patients' activity limitations and participation restrictions. The standard set also provides a common basis for the development of patient-centered measures and intervention programs. The preliminary version of the ICF-based standard set will be tested in subsequent studies with regard to its psychometric properties.}, language = {en} } @article{BauernfeindAringerProdingeretal.2009, author = {Bauernfeind, B. and Aringer, M. and Prodinger, Birgit and Kirchberger, I. and Machold, K. and Smolen, J. and Stamm, T.}, title = {Identification of relevant concepts of functioning in daily life in people with systematic Lupus Erythematosus: A patient Delphi exercise}, series = {Arthritis Care \& Research}, volume = {61}, journal = {Arthritis Care \& Research}, number = {1}, pages = {21 -- 28}, year = {2009}, abstract = {Objective To identify the most important and relevant concepts of daily functioning from the perspective of patients with systemic lupus erythematosus (SLE). Methods We conducted a consensus-building, 3-round, electronic mail survey with SLE patients using the Delphi technique. The Delphi technique is a structured communication process with 4 key characteristics: anonymity, iteration with controlled feedback, statistical group response, and informed input. The concepts contained in the answers of the patients were extracted and linked to the International Classification of Functioning, Disability and Health (ICF). Results Of the total 225 participants, 194 (86.2\%) completed the questionnaires from all 3 Delphi rounds. In total, after the third Delphi round, 307 concepts were identified. Ninety concepts (55 in the domain body functions and structures, 16 in activities and participation, and 19 in environmental factors) were considered relevant by at least 50\% of the participants in the third round and linked to the ICF. Twelve concepts were considered important by at least 75\% of the participants. Conclusion The high number of concepts resulting from this large-scale patient Delphi approach underlines the great variety of SLE patients' problems in daily functioning. The results of this patient Delphi project supplement the findings of our focus-group study in establishing a comprehensive overview of the patient perspective in SLE.}, language = {en} } @article{BayerstadlerBenstetterHeumannetal.2014, author = {Bayerstadler, Andreas and Benstetter, Franz and Heumann, Christian and Winter, Fabian}, title = {A predictive modeling approach to increasing the economic effectiveness of disease management programs}, series = {Health Care Management Science}, volume = {17}, journal = {Health Care Management Science}, pages = {284 -- 301}, year = {2014}, abstract = {Predictive Modeling (PM) techniques are gaining importance in the worldwide health insurance business. Modern PM methods are used for customer relationship management, risk evaluation or medical management. This article illustrates a PM approach that enables the economic potential of (cost-)effective disease management programs (DMPs) to be fully exploited by optimized candidate selection as an example of successful data-driven business management. The approach is based on a Generalized Linear Model (GLM) that is easy to apply for health insurance companies. By means of a small portfolio from an emerging country, we show that our GLM approach is stable compared to more sophisticated regression techniques in spite of the difficult data environment. Additionally, we demonstrate for this example of a setting that our model can compete with the expensive solutions offered by professional PM vendors and outperforms non-predictive standard approaches for DMP selection commonly used in the market.}, language = {en} } @article{BenstetterWambach2006, author = {Benstetter, Franz and Wambach, Achim}, title = {The treadmill effect in a fixed budget system}, series = {Journal of Health Economics}, volume = {25}, journal = {Journal of Health Economics}, number = {1}, pages = {146 -- 169}, year = {2006}, abstract = {We examine the interaction in the market for physician services when the total budget for reimbursement is fixed. Physicians obtain points for the services they render. At the end of the period the budget is divided by the sum of all points submitted, which determines the price per point. We show that this retrospective payment system involves - compared to a fee-for-service remuneration system - a severe coordination problem, which potentially leads to the "treadmill effect". We argue that when market entry is possible, a budget can be efficiency enhancing, if in addition a price floor is used.}, language = {en} } @article{BergmannKrewerBaueretal.2018, author = {Bergmann, Jeannine and Krewer, Carmen and Bauer, Petra and K{\"o}nig, Alexander and Riener, Robert and M{\"u}ller, Friedemann}, title = {Virtual reality to augment robot-assisted gait training in non-ambulatory patients with a subacute stroke: a pilot randomized controlled trial}, series = {European Journal of Physical and Rehabilitation Medicine}, volume = {2018}, journal = {European Journal of Physical and Rehabilitation Medicine}, number = {3}, edition = {54}, pages = {397 -- 407}, year = {2018}, abstract = {BACKGROUND: Active performance is crucial for motor learning, and, together with motivation, is believed to be associated with a better rehabilitation outcome. Virtual reality (VR) is an innovative approach to engage and motivate patients during training. There is promising evidence for its efficiency in retraining upper limb function. However, there is insufficient proof for its effectiveness in gait training. AIM: To evaluate the acceptability of robot-assisted gait training (RAGT) with and without VR and the feasibility of potential outcome measures to guide the planning of a larger randomized controlled trial (RCT). DESIGN: Single-blind randomized controlled pilot trial with two parallel arms. SETTING: Rehabilitation hospital. POPULATION: Twenty subacute stroke patients (64±9 years) with a Functional Ambulation Classification (FAC) ≤2. METHODS: Twelve sessions (over 4 weeks) of either VR-augmented RAGT (intervention group) or standard RAGT (control group). Acceptability of the interventions (drop-out rate, questionnaire), patients' motivation (Intrinsic Motivation Inventory [IMI], individual mean walking time), and feasibility of potential outcome measures (completion rate and response to interventions) were determined. RESULTS: We found high acceptability of repetitive VR-augmented RAGT. The drop-out rate was 1/11 in the intervention and 4/14 in the control group. Patients of the intervention group spent significantly more time walking in the robot than the control group (per session and total walking time; P<0.03). In both groups, motivation measured with the IMI was high over the entire intervention period. The felt pressure and tension significantly decreased in the intervention group (P<0.01) and was significantly lower than in the control group at the last therapy session (r=-0.66, P=0.005). The FAC is suggested as a potential primary outcome measure for a definitive RCT, as it could be assessed in all patients and showed significant response to interventions (P<0.01). We estimated a sample size of 44 for a future RCT. CONCLUSIONS: VR-augmented RAGT resulted in high acceptability and motivation, and in a reduced drop-out rate and an extended training time compared to standard RAGT. This pilot trial provides guidance for a prospective RCT on the effectiveness of VR-augmented RAGT. CLINICAL REHABILITATION IMPACT: VR might be a promising approach to enrich and improve gait rehabilitation after stroke.}, language = {en} } @article{CarrierProdinger2014, author = {Carrier, A. and Prodinger, Birgit}, title = {Visions of possibility: Using institutional ethnography as a theory and method for understanding contexts and their ruling relations}, series = {Occupational Therapy Now}, volume = {16}, journal = {Occupational Therapy Now}, number = {2}, pages = {18 -- 21}, year = {2014}, language = {en} }