@article{HopfeStuckiBickenbachetal.2018, author = {Hopfe, Maren and Stucki, Gerold and Bickenbach, Jerome E. and Prodinger, Birgit}, title = {Accounting for what matters to patients in the G-DRG System: A stakeholder's perspective on integrating functioning information}, series = {Health Services Insights}, journal = {Health Services Insights}, number = {11}, pages = {1 -- 10}, year = {2018}, abstract = {Functioning information constitutes a relevant component for determining patients' service needs and respective resource use. Diagnosis-Related Group (DRG) systems can be optimized by integrating functioning information. First steps toward accounting for functioning information in the German DRG (G-DRG) system have been made; yet, there is no systematic integration of functioning information. The G-DRG system is part of the health system; it is embedded in and as such dependent on various stakeholders and vested interests. This study explores the stakeholder's perspective on integrating functioning information in the G-DRG system. A qualitative interview study was conducted with national stakeholders in 4 groups of the G-DRG system (health policy, administration, development, and consultations). Interviews were analyzed using inductive thematic analysis. In total, 14 interviews were conducted (4 administration and 10 consultation group). Three main themes were identified: (1) functioning information in the G-DRG system: opportunities and obstacles, (2) general aspects concerning optimizing G-DRG systems by integrating additional information, and (3) ideas and requirements on how to proceed. The study offers insights into the opportunities and obstacles of integrating functioning information in the G-DRG system. The relevance of functioning information was evident. However, the value of functioning information for the G-DRG system was seen critically. Integrating functioning information alone does not seem to be sufficient and a systems approach is needed.}, language = {en} } @article{MaritzScheelSailerSchmittetal.2019, author = {Maritz, Roxanne and Scheel-Sailer, Anke and Schmitt, Klaus and Prodinger, Birgit}, title = {Overview of quality management models for inpatient healthcare settings: A scoping review}, series = {International Journal of Quality in Health Care}, volume = {31}, journal = {International Journal of Quality in Health Care}, number = {6}, editor = {Oxford Jounals,}, pages = {404 -- 410}, year = {2019}, abstract = {This scoping review aimed to generate an overview of existing quality management (QM) models for inpatient healthcare published in peer-reviewed literature. Data sources Peer-reviewed publications published until June 2016 were retrieved from the databases Medline, PubMed, CINAHL and Cochrane Library using search terms related to QM and models. Study selection Publications mentioning a QM model for general application in healthcare or inpatient care in their title or abstract were included. Languages considered were: English, French, German, Italian and Spanish. Data extraction was 3-fold. First, publication characteristics were summarized. Second, the frequency of each identified model was documented and the publications were divided into conceptual and implementation publications. Third, relevant QM models were identified and information regarding the model, including content and relationship with other models, was extracted. Of 925 retrieved publications, 213 were included. The included publications reported on 64 different QM models that were suitable for or used in inpatient care. Seventeen models were identified as being relevant. The 17 models were then categorized into three different levels: conceptual quality improvement models, concrete application models and country specific adaptations. This scoping review provides an overview of 17 existing QM models for inpatient care and their relationships with each other. Various types of models with differing aspects and components exist. In searching for QM models, many different concepts like QM system, accreditation or methodologies appeared. For future investigation, concepts of interest should be clarified.}, language = {en} } @article{ProdingerRastallKalraetal.2018, author = {Prodinger, Birgit and Rastall, Paul and Kalra, Dipak and Wooldridge, Darren and Carpenter, Iain}, title = {Documenting Routinely What Matters to People: Standardized Headings for Health Records of Patients with Chronic Health Conditions}, series = {Applied Clinical Informatics}, volume = {9}, journal = {Applied Clinical Informatics}, number = {2}, editor = {Thieme E-Journals,}, pages = {348 -- 365}, year = {2018}, abstract = {Objective Specifying the content in electronic health records (EHRs) through standardized headings based on international reference classifications will facilitate their semantic interoperability. The objective of this study was to specify potential chapter headings for EHRs aligned with the World Health Organization's (WHO) International Classification of Functioning, Disability, and Health (ICF) based on the perspectives of people living with chronic health conditions, carers, and professionals. Methods A multistage process was established including (1) a patient workshop, (2) an online survey of both patients and carers, and (3) an online consultation with patient and professional bodies. The ICF served as a starting point. Based on the first stage, a first draft of the headings was developed and further refined based on the feedback at each stage. We examined in a fourth step whether items from existing assessment tools support the operationalization of the identified headings. Therefore, we used the WHO Disability Assessment Schedule 2.0 (WHODAS2.0), a patient-reported instrument, and interRAI, a clinician-administered instrument. Results The first workshop was attended by eight people, the survey was completed by 250 persons, and the online consultation received detailed feedback by 18 professional bodies. This study resulted in 16 potential chapter headings for EHRs which capture aspects related to the body, such as emotions, motivation, sleep, and memory or thoughts, to being involved in social life, such as mobility, social activities, and finances, as well as to the care process, such as understanding of health issues and treatment or care priorities and goals. When using the WHODAS2.0 and interRAI together, they capture all except one of the proposed headings. Conclusion The identified headings provide a high level structure for the standardized recording, use, and sharing of information. Once implemented, these headings have the potential to facilitate the delivery of personalized care planning for patients with long-term health problems.}, language = {en} } @article{GimiglianoDeSireGestaldoetal.2019, author = {Gimigliano, Francesca and De Sire, Alessandro and Gestaldo, Marco and Maghini, Irene and Paoletta, Marco and Pasquini, Andrea and Baldrini, Paolo and Selb, Melissa and Prodinger, Birgit and SIMFER Residents Section Group,}, title = {Use of the International Classification of Functioning, Disability and Health Generic-30 Set for the characterization of outpatients: Italian Society of Physical and Rehabilitative Medicine Residents Section Project}, series = {European Journal of Physical and Rehabilitation Medicine}, volume = {55}, journal = {European Journal of Physical and Rehabilitation Medicine}, number = {2}, editor = {Minerva Medica,}, pages = {258 -- 264}, year = {2019}, abstract = {The International Classification of Functioning, Disability and Health (ICF) Generic- 30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) developed an Italian modification of the simple and intuitive descriptions (SID) of these categories. This study was the first one to implement the use of the SID in practice.1) To implement the use of the ICF in clinical practice and research among Italian Residents in PRM. 2) To verify if the SID made the application of ICF Generic 30 Set more user-friendly than the original descriptions. 3) To examine the prevalence of functioning problems of patients accessing Rehabilitation Services to serve as reference for the development of an ICF-based clinical data collection tool.Multicenter cross-sectional study. Italian Physical Medicine and Rehabilitation (PRM) outpatient rehabilitation services. Patients referring to Italian PRM outpatient rehabilitation services and Italian Residents in PRM.Each School of Specialization involved, randomly, received the ICF Generic-30 Set with the original descriptions or with the SID. Residents collected over a 4-month period (April-July 2016) patients data related to the ICF Generic-30 Set categories. Moreover, the residents self- assessed their difficulty in using the ICF Generic-30 Set with the original descriptions or with the SID, through a Numeric Rating Scale (NRS).Ninety-three residents collected functioning data of 864 patients (mean aged 57.7±19.3) with ICF Generic-30 Set: 304 with the original descriptions and 560 with SID. The difficulty in using the ICF Generic-30 Set with SID was rated as lower than using the original descriptions (NRS = 2.8±2.5 vs 3.5±3.1; p<0.001). The most common disease was the back pain (9.6\%) and the most common altered ICF categories were b280 (76.3\%) and b710 (72.9\%).This multicenter cross-sectional study shown that the ICF Generic-30 Set is a valuable instrument for reporting and assessing functioning and disability in clinical populations with different health conditions and along the continuum of care and that SID facilitate the understanding of the ICF categories and therefore their use in clinical practice. This National survey, improving the knowledge of ICF among Italian PRM residents, represents an important step towards the system-wide implementation of ICF in the healthcare system.}, language = {en} } @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{ProdingerTaylor2018, author = {Prodinger, Birgit and Taylor, Paul}, title = {Improving quality of care through patient-reported outcome measures (PROMs): expert interviews using the NHS PROMs Programme and the Swedish quality registers for knee and hip arthroplasty as examples}, series = {BMC Health Services Research}, volume = {18}, journal = {BMC Health Services Research}, publisher = {Springer Nature}, pages = {87}, year = {2018}, abstract = {Background: Patient reported outcome measures (PROMs) have been integrated in national quality registries or specific national monitoring initiatives to inform the improvement of quality of care on a national scale. However there are many unanswered questions, such as: how these systems are set up, whether they lead to improved quality of care, which stakeholders use the information once it is available. The aim of this study was to examine supporting and hindering factors relevant to integrating patient-reported outcome measures (PROMs) in selected health information systems (HIS) tailored toward improving quality of care across the entire health system. Methods: First, a systematic search and review was conducted to outline previously identified factors relevant to the integration of PROMs in the selected HIS. A social network analysis was performed to identify networks of experts in these systems. Second, expert interviews were conducted to discuss and elaborate on the identified factors. Directive content analysis was applied using a HIS Evaluation Framework as the frame of reference. This framework is structured into four components: Organization, Human, Technology, and Net benefits. Results: The literature review revealed 37 papers for the NHS PROMs Programme and 26 papers for the SHPR and SKAR: Five networks of researchers were identified for the NHS PROMs Programme and 1 for the SHPR and SKAR. Seven experts related to the NHS PROMs Programme and 3 experts related to the SKAR and SHPR participated in the study. The main themes which revealed in relation to Organization were Governance and Capacity building; to Human: Reporting and Stakeholder Engagement; to Technology: the Selection and Collection of PROMs and Data linkage. In relation to Net benefits, system-specific considerations are presented. Conclusion: Both examples succeeded in integrating PROMs into HIS on a national scale. The lack of an established standard on what change PROMs should be achieved by an intervention limits their usefulness for monitoring quality of care. Whether the PROMs data collected within these systems can be used in routine clinical practice is considered a challenge in both countries.}, language = {en} } @article{EhrmannProdingerGmuenderetal.2018, author = {Ehrmann, Cristina and Prodinger, Birgit and Gm{\"u}nder, Hans Peter and Hug, Kerstin and Bickenbach, Jerome E. and Stucki, Gerold}, title = {Describing Functioning in People Living With Spinal Cord Injury in Switzerland: A Graphical Modeling Approach}, series = {Archives of Physical Medicine and Rehabilitation}, volume = {99}, journal = {Archives of Physical Medicine and Rehabilitation}, number = {10}, publisher = {Elsevier}, pages = {1965 -- 1981}, year = {2018}, abstract = {Objective: To describe functioning in people living with spinal cord injuries (SCI) in Switzerland. Design: Secondary analysis of cross-sectional survey data. Setting Community, Switzerland. Participants: Individuals (N=1549) 16 years of age or older with a history of traumatic or nontraumatic SCI and permanently residing in Switzerland. Interventions: Not applicable. Main Outcome Measures: Functioning was operationalized through 4 domains: (1) impairments in body functions; (2) impairments in mental functions; (3) independence in performing activities; and (4) performance problems in participation. Results: Univariate analysis indicated a high prevalence of problems in 5 areas: (1) housework; (2) climbing stairs; (3) tiredness; (4) spasticity; and (5) chronic pain. Graphical modeling showed a strong association among the four domains of functioning. Moreover, we found that the differences in the dependence structures were significant between the paraplegia SCI population and the tetraplegia SCI population. Conclusions: This study is a first study in the epidemiology of functioning of people living with SCI in Switzerland. Using univariate and graphical modeling approaches, we proposed an empirical foundation for developing hypotheses on functioning in each domain and category that could inform health systems on people's health needs.}, language = {en} } @article{FellinghauerProdingerTennant2018, author = {Fellinghauer, Carolina Saskia and Prodinger, Birgit and Tennant, Alan}, title = {The Impact of Missing Values and Single Imputation upon Rasch Analysis Outcomes: A Simulation Study}, series = {Journal of Applied Measurement}, volume = {19}, journal = {Journal of Applied Measurement}, number = {1}, publisher = {JAM Press}, pages = {1 -- 25}, year = {2018}, abstract = {Imputation becomes common practice through availability of easy-to-use algorithms and software. This study aims to determine if different imputation strategies are robust to the extent and type of missingness, local item dependencies (LID), differential item functioning (DIF), and misfit when doing a Rasch analysis. Four samples were simulated and represented a sample with good metric properties, a sample with LID, a sample with DIF, and a sample with LID and DIF. Missing values were generated with increasing proportion and were either missing at random or completely at random. Four imputation techniques were applied before Rasch analysis and deviation of the results and the quality of fit compared. Imputation strategies showed good performance with less than 15\% of missingness. The analysis with missing values performed best in recovering statistical estimates. The best strategy, when doing a Rasch analysis, is the analysis with missing values. If for some reason imputation is necessary, we recommend using the expectation-maximization algorithm.}, language = {en} } @article{LampartGemperliBaumbergeretal.2018, author = {Lampart, Patricia and Gemperli, Armin and Baumberger, Michael and Bersch, Ines and Prodinger, Birgit and Schmitt, Klaus and Scheel-Sailer, Anke}, title = {Administration of assessment instruments during the first rehabilitation of patients with spinal cord injury: a retrospective chart analysis.}, series = {Spinal Cord}, volume = {56}, journal = {Spinal Cord}, number = {4}, publisher = {Springer Nature}, pages = {322 -- 331}, year = {2018}, abstract = {Objectives To examine which professionals administered which assessment instruments in which patient in clinical practice during first rehabilitation after newly acquired spinal cord injury (SCI) and the differences in the frequencies of different assessments between patient groups. Setting Specialized SCI acute care and rehabilitation clinic. Methods Patients after SCI, aged 18 years and above, admitted for first rehabilitation between December 2014 and December 2015 were analyzed. Descriptive statistics of 54 selected assessments. p values based on the χ 2 test were calculated for assessments used in both paraplegic and tetraplegic patients. Results One hundred and nineteen patients were screened. Forty-one assessments were administered, of which 10 on average more than once per patient. The most frequently used assessments were Spinal Cord Independence Measure III (7.7 times per patient), Skin Assessment (3.6 times), and Manual Muscle Test (3.2 times for Lower Extremities; 2.5 times for Upper Extremities). The American Spinal Injury Association Impairment Scale was administered on average 1.9 times per patient. More variation in the number of assessments per patient was observed in patients with complete and incomplete lesions compared to patients with paraplegia and tetraplegia. Conclusion Assessments covering neurological functioning, mobility, and self-care are used in clinical practice during first rehabilitation of patients with SCI, while others covering autonomic functioning, pain, participation, or quality of life are still missing. Based on these observations and national and international requirements, a meaningful standard for an assessment toolkit, applicable in general and in specific subgroups, needs to be defined and implemented.}, language = {en} } @article{ShawProdingerJacobsetal.2010, author = {Shaw, L. and Prodinger, Birgit and Jacobs, K. and Shaw, N.}, title = {WORK: A historical evaluation of the impact and evolution of its editorial board}, series = {Work}, volume = {35}, journal = {Work}, number = {3}, pages = {247 -- 255}, year = {2010}, abstract = {Objectives: A historical review of the editorial board and the founding editor of WORK: A Journal of Prevention, Assessment and Rehabilitation was conducted to examine the understanding of the editorship and contributions of this team to the knowledge in WORK. Participants: The team of four authors worked together to identify an approach to evaluate the contributions and impact of WORK's editorial board (EB) on the journal's scholarship. The editor-in-chief (EIC) and editorial board members were participants in this evaluation. Methods: Informative and formative evaluations were used to investigate how knowledge was shaped through the development of an epistemic community of scholars in the field of work. Metrics of the EB composition and participation in the journal as well as surveys and interviews with the board and the editor-in-chief were analyzed. Results: The EB represents an international community of scholars with a common interest in work and who contribute academically both within WORK and beyond. The epistemic community that has evolved through the editorial board represents a pluralistic perspective on work that is needed to inform practice, and knowledge. Conclusion: Future directions to continue to advance knowledge through WORK's editorial board and EIC are elaborated.}, language = {en} } @article{ShawCampbellJacobsetal.2010, author = {Shaw, L. and Campbell, H. and Jacobs, K. and Prodinger, Birgit}, title = {Twenty years of Assessment in WORK: A narrative review}, series = {Work}, volume = {35}, journal = {Work}, number = {3}, pages = {257 -- 267}, year = {2010}, abstract = {Introduction: The aim of this review was to gain an understanding of the first 20 years of contributions to WORK within the assessment domain and to reflect on the perspectives underscoring this knowledge base. Method: A narrative review of assessment articles using the WORK ARTicle database was conducted. Assessment articles were searched using issues from 1990 to 2009. Descriptive data was analyzed to examine historical trends of the specific types and dimensions of articles, the regional location of the contributions, and the methodological accordance. A reflective process was used by an editorial board member of WORK to inductively interpret perspectives and contextual issues that underpinned the evolution of the assessment domain in WORK. Results: Over half of N= 108 of the articles on assessment in WORK focused on establishing or reporting reliability and validity of assessments used in clinical practice or evaluation research. The majority of the assessment articles were predominantly focused on the person. Contributions of articles were from 5 regions: North America, Europe, Australia, Asia and Africa. Conclusions: Assessment articles in WORK have contributed to the development of evidence to support assessment of the worker. These articles represent a knowledge base that emphasizes evidence-based assessments to evaluate what a person can and cannot do to participate in work. Efforts are needed to expand knowledge generation in assessment to include more evaluations on the workplace and occupation dimensions, and that also considers the worker in context.}, language = {en} } @article{ProdingerMagalhaes2010, author = {Prodinger, Birgit and Magalhaes, L.}, title = {Advancing knowledge in work-related rehabilitation - Review of research published in the journal of WORK}, series = {Work}, volume = {35}, journal = {Work}, number = {3}, pages = {301 -- 318}, year = {2010}, abstract = {Objective: Many studies published in the journal WORK in the recent decades have discussed work and employment trends. However, the dimensions of these contributions over time have not been reviewed. The main objective of this study was to investigate the knowledge development in regard to work-related rehabilitation in WORK over the last two decades. Methods: A scoping review was conducted using the following five stages: (i) identifying research question, (ii) identifying relevant studies, (iii) study selection, (iv) charting, summarizing, and collating the data, and (v) reporting the results. Studies were selected from the WORK Article Database. Results: Seventy-five relevant studies were identified. The findings reflect that WORK has published papers from across the world, with most of the studies from the United States, Sweden, Canada, and Hong Kong. The complexity and multi-factorial nature of work-related rehabilitation was reflected in the application of quantitative, qualitative, and mixed method research approaches, as well as case studies. Study participants were characterized by work, and non-work related injuries, systematic diseases/chronic illness, fulfilled certain socio-demographic characteristic, and represented various stakeholders. Fewer studies drew on secondary resources. In the findings one re-occurring theme has been noted: 'maintaining/obtaining/returning to secure and stable employment/work'. Conclusions: Four key-reflections evolved from this scoping review that provide potential avenues for future research. These key-reflections include (i) the national, transnational and international dimension of the reviewed studies, (ii) the various societal levels informing work-related rehabilitation practices, (iii) the diversity of methodologies applied in current research, and (iv) the variability of terminology used within the reviewed studies. The journal WORK has published a variety of research over the last two decades and contributed significantly to our current understanding of work-related rehabilitation. However, further research in these reflective areas would expand the current knowledge base.}, 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{StammVanderGiesenThorstenssonetal.2009, author = {Stamm, T. and Van der Giesen, F. and Thorstensson, C. and Steen, E. and Birrell, F. and Bauernfeind, B. and Marshall, N. and Prodinger, Birgit and Machold, K. and Smolen, J. and Kloppenburg, M.}, title = {Patient perspective of hand osteoarthritis in relation to concepts covered by instruments measuring functioning: a qualitative European multicentre study}, series = {Annals of the Rheumatic Diseases}, volume = {68}, journal = {Annals of the Rheumatic Diseases}, number = {9}, pages = {1453 -- 1460}, year = {2009}, abstract = {Objective: To explore whether the concepts important to patients with hand osteoarthritis (OA) are covered by the most commonly used instruments measuring functioning. Method: A qualitative multicentre study using a focus group technique was performed in five European countries: Austria, The Netherlands, Norway, Sweden and the United Kingdom. The qualitative data analysis followed a modified form of "meaning condensation" and used the International Classification of Functioning, Disability and Health (ICF) as a theoretical framework. Finally, the concepts from the focus groups were compared with the content of the most commonly used instruments which had been identified in an earlier theoretical analysis. Results: Fifty-six people (51 women, mean (SD) age 62.7 (7.9) years) with hand OA participated in this study in two focus groups per centre. 63 concepts were extracted from the focus groups. Twenty-one (33\%) of the 63 concepts were covered by at least one instrument. Psychological consequences, different qualities of pain, aesthetic changes and leisure activities are important concepts from the focus groups which were not covered by the instruments. The qualitative analysis revealed detailed descriptions of pain-concerning sensations, levels and a certain relation to activity, none of which were fully represented in the instruments routinely used. Conclusion: It was possible to combine the concepts of the focus groups from each centre into a common qualitative analysis. The concepts important to people with hand OA are not fully represented in the most commonly used instruments.}, language = {en} } @article{DuerSteinerStofferetal.2016, author = {D{\"u}r, M. and Steiner, G. and Stoffer, M.A. and Fialka-Moser, V. and Kautky-Willer, A. and Dejaco, C. and Ekmekcioglu, C. and Prodinger, Birgit and Binder, A. and Smolen, J. and Stamm, T. A.}, title = {Initial evidence for the link between activities and health: Associations between a balance of activities, functioning and serum levels of cytokines and C-reactive protein}, series = {Psychoneuroendocrinology}, volume = {65}, journal = {Psychoneuroendocrinology}, pages = {138 -- 148}, year = {2016}, abstract = {Growing evidence shows interrelations of psychological factors, neurological and immunological processes. Therefore, constructs like a balance of activities, the so called "occupational balance", could also have biological correlates. The aim of this study was to investigate potential associations between occupational balance, functioning, cytokines and C-reactive protein (CRP) in patients suffering from a chronic inflammatory disease like rheumatoid arthritis (RA) and healthy people. Moreover, we wanted to explore potential differences in gender and employment status. A descriptive study in patients with RA and healthy people was conducted using the Occupational Balance-Questionnaire (OB-Quest) and the Short-Form 36 Health Survey (SF-36). Serum levels of cytokines, such as interleukin 6 (IL-6) and 8 (IL-8), interferon alpha (INFα), tumour necrosis factor alpha (TNFα), rheumatoid factor (RF) and of CRP were measured. Descriptive statistics, as well as Mann-Whitney U tests and Spearmen's rank correlation coefficients (rs) were calculated. One-hundred-thirty-two patients with RA and 76 healthy people participated. Occupational balance was associated with functioning, cytokines and CRP. The strongest associations were identified in the unemployed healthy-people sample with cytokines and CRP being within the normal range. For example, the OB-Quest item challenging activities was associated with IL-8 (rs = - 0.63, p = 0.04) and the SF-36 sub-scale bodily pain was associated with IFNα (rs = - 0.69, p = 0.02). The items rest and sleep (rs = - 0.71, p = 0.01) and variety of different activities (rs = - 0.74, p < 0.01) correlated with the SF-36 sub-scale social functioning. Employed and unemployed people differed in their age and CRP levels. Additionally, gender differences were found in two OB-Quest items in that fewer women were able to adapt their activities to changing living conditions and fewer men were overstressed. In conclusion, we found preliminary biological evidence for the link between occupation and health in that the concepts encompassed in the construct of occupational balance were associated with functioning, cytokines and CRP.}, language = {en} } @article{HopfeStuckiMarshalletal.2016, author = {Hopfe, M. and Stucki, G. and Marshall, R. and Twomey, C. and {\"U}st{\"u}n, T.B. and Prodinger, Birgit}, title = {Capturing patients' needs in casemix: a systematic literature review on the value of adding functioning information in reimbursement systems}, series = {BMC Health Services Research}, volume = {16}, journal = {BMC Health Services Research}, pages = {40}, year = {2016}, abstract = {Background Contemporary casemix systems for health services need to ensure that payment rates adequately account for actual resource consumption based on patients' needs for services. It has been argued that functioning information, as one important determinant of health service provision and resource use, should be taken into account when developing casemix systems. However, there has to date been little systematic collation of the evidence on the extent to which the addition of functioning information into existing casemix systems adds value to those systems with regard to the predictive power and resource variation explained by the groupings of these systems. Thus, the objective of this research was to examine the value of adding functioning information into casemix systems with respect to the prediction of resource use as measured by costs and length of stay. Methods A systematic literature review was performed. Peer-reviewed studies, published before May 2014 were retrieved from CINAHL, EconLit, Embase, JSTOR, PubMed and Sociological Abstracts using keywords related to functioning ('Functioning', 'Functional status', 'Function*, 'ICF', 'International Classification of Functioning, Disability and Health', 'Activities of Daily Living' or 'ADL') and casemix systems ('Casemix', 'case mix', 'Diagnosis Related Groups', 'Function Related Groups', 'Resource Utilization Groups' or 'AN-SNAP'). In addition, a hand search of reference lists of included articles was conducted. Information about study aims, design, country, setting, methods, outcome variables, study results, and information regarding the authors' discussion of results, study limitations and implications was extracted. Results Ten included studies provided evidence demonstrating that adding functioning information into casemix systems improves predictive ability and fosters homogeneity in casemix groups with regard to costs and length of stay. Collection and integration of functioning information varied across studies. Results suggest that, in particular, DRG casemix systems can be improved in predicting resource use and capturing outcomes for frail elderly or severely functioning-impaired patients. Conclusion Further exploration of the value of adding functioning information into casemix systems is one promising approach to improve casemix systems ability to adequately capture the differences in patient's needs for services and to better predict resource use.}, language = {en} } @article{ProdingerBallertCieza2016, author = {Prodinger, Birgit and Ballert, C. S. and Cieza, A.}, title = {Setting up a cohort study of functioning: From classification to measurement}, series = {Journal of Rehabilitation Medicine}, volume = {48}, journal = {Journal of Rehabilitation Medicine}, number = {2}, pages = {131 -- 140}, year = {2016}, abstract = {Objective: Cohort studies are an appropriate method for the collection of population-based longitudinal data to track people's health and functioning over time. However, describing and understanding functioning in its complexity with all its determinants is one of the biggest challenges faced by clinicians and researchers. Design: This paper focuses on the development of a cohort study on functioning, outlining the relevant steps and related methods, and illustrating these with reference to the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Methods and results: In setting up a cohort study the initial step is to specify which variables are to be included, i.e. what to assess. The International Classification of Functioning, Disability and Health (ICF) is valuable in this process. The second step is to identify how to assess the specified ICF categories. Existing instruments and assessments can then be linked to the ICF. Conclusion: The methods outlined here enable the development of a cohort study to be based on a comprehensive perspective of health, operationalized through functioning as conceptualized and classified in the ICF, yet to remain efficient and feasible to administer.}, language = {en} } @article{HinrichsProdingerBrinkofetal.2016, author = {Hinrichs, T. and Prodinger, Birgit and Brinkof, M.W. and Gemperli, A.}, title = {Subgroups in epidemiological studies on spinal cord injury: Evaluation of international recommendations in the Swiss Spinal Cord Injury Cohort Study}, series = {Journal of Rehabilitation Medicine}, volume = {48}, journal = {Journal of Rehabilitation Medicine}, number = {2}, pages = {141 -- 148}, year = {2016}, abstract = {Objective: To test subgroups of a community-based sample of individuals with spinal cord injury, categorized by the application of current recommendations by the International Spinal Cord Society. Design: Community survey. Participants: Individuals with traumatic and non-traumatic spinal cord injury residing in Switzerland. Methods: Recommended subgroups of age, gender, years since injury, severity of injury and aetiology were tested against the following criteria: (i) distribution of participants across categories; (ii) within- and between-group variability with regard to selected outcomes of functioning and quality of life. Results: Data-sets for 1,549 participants (28.5\% women; mean age 52 ± 15 years) were available for analyses. There was a number of participants in every subgroup, yet numbers were relatively small in the group with the shortest time since injury (< 1 year; n = 23) and in the oldest age group (≥76; n = 94). A high variability in some outcomes was detected between categories. All variables were predictive for most of the endpoints investigated. Conclusion: Recommended categorization could well fit the present sample. A minor concern was the low numbers of participants in some subgroups.}, language = {en} } @article{ProdingerBallertBrinkofetal.2016, author = {Prodinger, Birgit and Ballert, C.S. and Brinkof, M. W. G. and Tennant, A. and Post, M. W. M.}, title = {Metric properties of the Spinal Cord Independence Measure - Self Report in a community survey}, series = {Journal of Rehabilitation Medicine}, volume = {48}, journal = {Journal of Rehabilitation Medicine}, number = {2}, pages = {149 -- 164}, year = {2016}, abstract = {Objective: The Spinal Cord Independence Measure - Self Report (SCIM-SR) is a self-report instrument for assessing functional independence of persons with spinal cord injury. This study examined the internal construct validity and reliability of the SCIM-SR, when administered in a community survey, using the Rasch measurement model. Methods: Rasch analysis of data from 1,549 individuals with spinal cord injury who completed the SCIM-SR. Results: In the initial analysis no fit to the Rasch model was achieved. Items were grouped into testlets to accommodate the substantial local dependency. Due to the differential item functioning for lesion level and degree, spinal cord injury-specific sub-group analyses were conducted. Fit to the Rasch model was then achieved for individuals with tetraplegia and complete paraplegia, but not for those with incomplete paraplegia. Comparability of ability estimates across sub-groups was attained by anchoring all sub-groups on a testlet. Conclusion: The SCIM-SR violates certain assumptions of the Rasch measurement model, as shown by the local dependency and differential item functioning. However, an intermediate solution to achieve fit in 3 out of 4 spinal cord injury sub-groups was found. For the time being, therefore, it advisable to use this approach to compute Rasch-transformed SCIM-SR scores.}, language = {en} } @article{ProdingerBallertBrachetal.2016, author = {Prodinger, Birgit and Ballert, C. S. and Brach, M. and Brinkhof, M. W. G. and Cieza, A. and Hug, K. and Jordan, X. and Post, M. W. M. and Scheel-Sailer, A. and Schubert, M. and Tennant, A. and Stucki, G.}, title = {Toward standardized reporting for a cohort study on functioning: The Swiss Spinal Cord Injury Cohort Study}, series = {Journal of Rehabilitation Medicine}, volume = {48}, journal = {Journal of Rehabilitation Medicine}, number = {2}, pages = {189 -- 196}, year = {2016}, abstract = {Objective: Functioning is an important outcome to measure in cohort studies. Clear and operational outcomes are needed to judge the quality of a cohort study. This paper outlines guiding principles for reporting functioning in cohort studies and addresses some outstanding issues. Design: Principles of how to standardize reporting of data from a cohort study on functioning, by deriving scores that are most useful for further statistical analysis and reporting, are outlined. The Swiss Spinal Cord Injury Cohort Study Community Survey serves as a case in point to provide a practical application of these principles. Methods and Results: Development of reporting scores must be conceptually coherent and metrically sound. The International Classification of Functioning, Disability and Health (ICF) can serve as the frame of reference for this, with its categories serving as reference units for reporting. To derive a score for further statistical analysis and reporting, items measuring a single latent trait must be invariant across groups. The Rasch measurement model is well suited to test these assumptions. Conclusion: Our approach is a valuable guide for researchers and clinicians, as it fosters comparability of data, strengthens the comprehensiveness of scope, and provides invariant, interval-scaled data for further statistical analyses of functioning.}, language = {en} }