@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} } @article{SelbGimiglianoProdingeretal.2017, author = {Selb, M. and Gimigliano, F. and Prodinger, Birgit and Stucki, G. and Pestelli, G. and Iocco, M. and Boldrini, P.}, title = {Toward an International Classification of Functioning, Disability and Health clinical data collection tool: The Italian experience of developing simple, intuitive descriptions of the Rehabilitation Set categories}, series = {European Journal of Physical and Rehabilitation Medicine}, volume = {53}, journal = {European Journal of Physical and Rehabilitation Medicine}, number = {2}, pages = {290 -- 298}, year = {2017}, abstract = {As part of international efforts to develop and implement national models including the specification of ICF-based clinical data collection tools, the Italian rehabilitation community initiated a project to develop simple, intuitive descriptions of the ICF Rehabilitation Set, highlighting the core concept of each category in user-friendly language. This paper outlines the Italian experience in developing simple, intuitive descriptions of the ICF Rehabilitation Set as an ICF-based clinical data collection tool for Italy.Consensus process.Expert conference. Multidisciplinary group of rehabilitation professionals.The first of a two-stage consensus process involved developing an initial proposal for simple, intuitive descriptions of each ICF Rehabilitation Set category based on descriptions generated in a similar process in China. Stage two involved a consensus conference. Divided into three working groups, participants discussed and voted (vote A) whether the initially proposed descriptions of each ICF Rehabilitation Set category was simple and intuitive enough for use in daily practice. Afterwards the categories with descriptions considered ambiguous i.e. not simple and intuitive enough, were divided among the working groups, who were asked to propose a new description for the allocated categories. These proposals were then voted (vote B) on in a plenary session. The last step of the consensus conference required each working group to develop a new proposal for each and the same categories with descriptions still considered ambiguous. Participants then voted (final vote) for which of the three proposed descriptions they preferred.Nineteen clinicians from diverse rehabilitation disciplines from various regions of Italy participated in the consensus process. Three ICF categories already achieved consensus in vote A, while 20 ICF categories were accepted in vote B. The remaining 7 categories were decided in the final vote.The findings were discussed in light of current efforts toward developing strategies for ICF implementation, specifically for the application of an ICF-based clinical data collection tool, not only for Italy but also for the rest of Europe. Promising as minimal standards for monitoring the impact of interventions and for standardized reporting of functioning as a relevant outcome in rehabilitation.}, language = {en} } @article{MuellerGrillStierJarmeretal.2011, author = {M{\"u}ller, Martin and Grill, E. and Stier-Jarmer, M. and Strobl, R. and Gutenbrunner, C. and Fialka-Moser, V. and Stucki, G.}, title = {Validation of the comprehensive ICF Core Sets for patients receiving rehabilitation interventions in the acute care setting}, series = {Journal of rehabilitation medicine}, journal = {Journal of rehabilitation medicine}, number = {43(2)}, editor = {Foundation of Rehabilitation Information,}, year = {2011}, abstract = {Objective: To examine the relevance and completeness of the comprehensive International Classification of Functioning, Disability and Health (ICF) Core Sets for patients with rehabilitation needs in acute hospital care. Design: Multi-centre cohort study. Patients: A total of 391 patients (50.1\% female, mean age 63.4 years) from 4 university hospitals in Austria, Germany and Switzerland and one Austrian general hospital. Methods: Data on functioning were collected using the respective comprehensive acute ICF Core Sets. Data were extracted from patients' medical record sheets and interviews with health professionals and patients. Results: Most of the categories of the comprehensive ICF Core Sets describing impairments, limitations or restrictions occurred in a considerable proportion of the study population. The most outstanding limitations and restrictions of the patients were problems with sleep and blood vessel functions, walking and moving and self-care. Thirty-eight aspects of functioning not previously covered by the comprehensive ICF Core Sets were ranked as relevant. Conclusion: Categories of the comprehensive ICF Core Sets for the acute hospital situation were confirmed. Some additional categories not covered by the Set in its present version emerged from the interviews, and should be considered for inclusion in a finalized version.}, language = {en} } @article{GrillStroblMuelleretal.2011, author = {Grill, E. and Strobl, R. and M{\"u}ller, Martin and Quittan, M. and Kostanjsek, N. and Stucki, G.}, title = {ICF Core Sets for early post-acute rehabilitation facilities}, series = {Journal of rehabilitation medicine}, journal = {Journal of rehabilitation medicine}, number = {43(2)}, editor = {Foundation of Rehabilitation Information,}, year = {2011}, abstract = {Objective: To identify candidate categories for International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and measurement of functioning in patients in early post-acute rehabilitation facilities. Design: Prospective multi-centre cohort study. Patients: Patients receiving rehabilitation interventions for musculoskeletal, neurological or cardiopulmonary injury or disease in early post-acute rehabilitation facilities. Methods: Functioning was coded using the ICF. The criterion for selecting candidate categories for the ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables. Results: A total of 165 patients were included in the study (67 neurological, 37 cardiopulmonary, 61 musculoskeletal), mean age 67.5 years, 46.1\% female. Selection yielded 38 categories for neurological, 32 for cardiopulmonary, and 31 for musculoskeletal. Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the issues most relevant for the assessment and monitoring of functioning in patients undergoing early post-acute rehabilitation for neurological, cardiopulmonary, and musculoskeletal conditions.}, 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{ProdingerSalzbergerStuckietal.2011, author = {Prodinger, Birgit and Salzberger, T. and Stucki, G. and Stamm, T. and Cieza, A.}, title = {Measuring Functioning in People with Fibromyalgia (FM) Based on the International Classification of Functioning, Disability and Health (ICF)—A Psychometric Analysis}, series = {Pain Practice}, volume = {12}, journal = {Pain Practice}, number = {4}, pages = {255 -- 265}, year = {2011}, abstract = {Objectives: Instruments to assess functioning in patients with FM vary considerably in their content and are often symptom-specific. This study aimed to examine whether it is feasible to construct a psychometric-sound clinical instrument to measure functioning in FM based on the Brief ICF-Core-Set for chronic widespread pain (CWP). Methods: Two hundred and fifty six people with FM completed the Brief ICF-Core-Set. The Rasch model was used for analysis. Once ordering of response options of ICF categories was ensured, the following properties were studied: fit of the ICF categories to the Rasch model, the targeting between ICF categories and a person's abilities, unidimensionality, and reliability. Results: Six ICF categories were rescored due to disordered thresholds. Five ICF categories were removed due to high model-misfit and differential item functioning (DIF) for gender. Scores from 46 participants were excluded due to extreme scores. The ICF categories included display consistency with an underlying unidimensional construct, are free of DIF for age, disease duration and gender, display excellent overall reliability, and cover a range of functioning difficulties. Conclusions: This study illustrates that it is possible to measure functioning as a unidimensional construct based on selected ICF categories from the components body functions, as well as activities and participation of the Brief ICF-Core-Set for CWP in patients with FM.}, language = {en} } @article{GrillMuellerQuittanetal.2011, author = {Grill, E. and M{\"u}ller, Martin and Quittan, M. and Fialka-Moser, V. and Strobl, R. and Kostanjsek, N. and Stucki, G.}, title = {Brief ICF Core Sets for the acute hospital}, series = {Journal of Rehabilitation Medicine}, journal = {Journal of Rehabilitation Medicine}, editor = {Medical Journals Limited,}, year = {2011}, abstract = {Objective: To identify candidate categories for brief International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and measurement of functioning in patients in the acute hospital. Design: Prospective multi-centre cohort study. Patients: Patients receiving rehabilitation interventions for musculoskeletal, neurological or cardiopulmonary injury or disease in acute hospitals. Methods: Functioning and contextual factors were coded using the ICF. The criterion for selecting candidate categories for the brief ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables. Results: A total of 391 patients were included in the study (91 neurological, 109 cardiopulmonary, 191 musculoskeletal), mean age 63.4 years, 50.1\% female. Selection yielded 33 categories for neurological, 31 for cardiopulmonary, and 30 for musculoskeletal. Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the ICF categories most relevant for the practical assessment and monitoring of functioning in patients with acute neurological, cardiopulmonary, and musculoskeletal conditions.}, language = {en} } @article{MuellerGrillQuittanetal.2011, author = {M{\"u}ller, Martin and Grill, E. and Quittan, M. and Strobl, R. and Kostanjsek, N. and Stucki, G.}, title = {ICF Core Set for patients in geriatric post-acute rehabilitation facilities}, series = {Journal of Rehabilitation Medicine}, journal = {Journal of Rehabilitation Medicine}, editor = {Medical Journals Limited,}, year = {2011}, abstract = {Objective: To identify candidate categories for International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and clinical measurement of functioning in older patients in early post-acute rehabilitation facilities. Design: Prospective multi-centre cohort study. Patients: Older patients receiving rehabilitation interventions in early post-acute rehabilitation facilities. Methods: Functioning was coded using the ICF. The criterion for selecting candidate categories for the brief ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables. Results: A total of 209 patients were included in the study, mean age 80.4 years, 67.0\% female. Selection yielded a total of 29 categories for the functioning part and 9 categories for the contextual part of the ICF. Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the issues most relevant for the clinical assessment and monitoring of functioning in older patients undergoing early post-acute rehabilitation.}, language = {en} } @article{ProdingerO'ConnorStuckietal.2017, author = {Prodinger, Birgit and O'Connor, R.J. and Stucki, G. and Tennant, A.}, title = {Establishing score equivalence of the Functional Independence Measure (FIM™) motor scale and the Barthel Index, utilising the International Classification of Functioning, Disability and Health (ICF) and Rasch Measurement Theory}, series = {Journal of Rehabilitation Medicine}, volume = {49}, journal = {Journal of Rehabilitation Medicine}, number = {5}, pages = {416 -- 422}, year = {2017}, abstract = {Introduction: Two widely used outcome measures to assess functioning in neurological rehabilitation are the Functional Independence Measure (FIM™) and the Barthel Index. The current study aims to establish the equivalence of the total score of the FIM™ motor scale and the Barthel Index through the application of the International Classification of Functioning, Disability and Health, and Rasch measurement theory. Methods: Secondary analysis of a large sample of patients with stroke, spinal cord injury, and multiple sclerosis, undergoing rehabilitation was conducted. All patients were assessed at the same time on both the FIM™ and the Barthel Index. The International Classification of Functioning, Disability and Health Linking Rules were used to establish conceptual coherency between the 2 scales, and the Rasch measurement model to establish an exchange of the total scores. Results: Using the FIM™ motor scale, items from both scales linked to the International Classification of Functioning, Disability and Health d4 Mobility or d5 Self-care chapters. Their co-calibration satisfied the assumptions of the Rasch model for each of 3 diagnostic groups. A ceiling effect was observed for the Barthel Index when contrasted against the FIM™ motor scale. Conclusion: Having a Rasch interval metric to transform scores between the FIM™ motor scale and Barthel Index is valuable for monitoring functioning, meta-analysis, quality audits and hospital benchmarking.}, language = {en} } @article{ProdingerScheelSailerEscorpizoetal.2017, author = {Prodinger, Birgit and Scheel-Sailer, A. and Escorpizo, R. and Stucki, G.}, title = {UEMS-PRM ICF workshop moderators and rapporteurs. (2017) European initiative for the application of the International Classification of Functioning, Disability and Health: Development of Clinical Assessment Schedules for specified rehabilitation services}, series = {European Journal of physical and rehabilitation medicine}, volume = {53}, journal = {European Journal of physical and rehabilitation medicine}, number = {2}, pages = {319 -- 332}, year = {2017}, abstract = {Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. UEMS PRM Workshop in Nottwil, Switzerland, January 2016.PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds.Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services. The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted. All groups deliberated on this topic; however, no conclusive statement was presented yet.The groups recognized a need for a systematic effort to identify data collection tools currently used.CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for improving data collection on people's functioning.}, language = {en} } @article{FeketePostBickenbachetal.2017, author = {Fekete, C. and Post, M. and Bickenbach, J. and Middleton, J. and Prodinger, Birgit and Selb, M. and Stucki, G.}, title = {A structured approach to capture the lived experience of spinal cord injury: Data model and questionnaire of the International Spinal Cord Injury Community Survey (InSCI)}, series = {American Journal of physical and rehabilitation medicine}, volume = {96}, journal = {American Journal of physical and rehabilitation medicine}, number = {2}, pages = {S5 -- S16}, year = {2017}, abstract = {The International Spinal Cord Injury (InSCI) community survey has been developed to collect internationally comparable data on the lived experience of persons with spinal cord injury (SCI) in all 6 WHO regions. The InSCI survey provides a crucial first step to generate evidence on functioning, health maintenance, and subjective well-being in persons with SCI globally. A major challenge in setting up the InSCI community survey was to develop a data model and questionnaire that comprehensively captures what matters to people and, at the same time, is feasible and parsimonious in terms of participant's burden. This paper outlines the components of the InSCI data model and presents the question selection to operationalize the data model along the 4 guiding principles of efficiency, feasibility, comparability, and truth and discrimination. The data model consists of 6 components operationalized with 125 questions including functioning (n = 28 body functions and structures; n = 42 activities and participation), contextual factors (n = 26 environmental; n = 19 personal factors), lesion characteristics (n = 2), and appraisal of health and well-being (n = 8). The InSCI questionnaire presents an efficient and feasible solution with satisfying comparability to other populations; however, its validity and reliability still needs to be confirmed.}, language = {en} } @article{DorjbalCiezaGmuenderetal.2016, author = {Dorjbal, D. and Cieza, A. and Gm{\"u}nder, H.-P- and Scheel-Sailer, A. and Stucki, G. and {\"U}st{\"u}n, T.B. and Prodinger, Birgit}, title = {Strengthening quality of care through standardized reporting based on the World Health Organization's reference classifications}, series = {International Journal of Quality in Health}, volume = {28}, journal = {International Journal of Quality in Health}, number = {5}, pages = {626 -- 633}, year = {2016}, abstract = {Quality issue Responding to person's health and related needs requires the availability of health information that reflects relevant aspects of a health condition and how this health condition impacts on a person's daily life. Initial assessment Health information is routinely collected at different time points by diverse professionals, in different settings for various purposes with varying methods. Consequently, health information is not always comparable, posing a challenge to the regular monitoring of quality. Choice of solution The World Health Organization's (WHO) International Classification of Diseases (ICD), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI; under development) are complementary and serve as meaningful reference classifications for comparing data on persons' health and related interventions across health systems. Implementation We developed a systematic approach of translating routinely collected information into a standardized report based on the three WHO reference classifications and the Rehab-Cycle®. Subsequently, we have demonstrated its application using five random case records of individuals attending a rehabilitation program. Evaluation All identified concepts were able to be linked to WHO's reference classifications. The ICF served as a tool to standardize information on rehabilitation goals and their achievement. The ICHI served as the basis for reporting the interventions that were documented in the case records, including the intervention targets that were derived from the ICF codes. Lessons learned Our experience shows that, it is possible to translate routinely collected information into standardized reports by linking existing narrative records with WHO's reference classifications.}, language = {en} }