TY - JOUR A1 - Prodinger, Birgit A1 - Coenen, Michaela A1 - Hammond, Alison A1 - Küçükdeveci, Ayse A. A1 - Tennant, Alan T1 - Scale-Banking for Patient Reported Outcome Measures (PROMs) Measuring Functioning in Rheumatoid Arthritis: A Daily Activities Metric JF - Arthritis Care & Research N2 - Objective: Functioning is an important outcome for rheumatoid arthritis (RA) management. Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability. Methods: Common Item Non-Equivalent Groups Design (NEAT) with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (incl. UK, Turkey and Germany) to establish a common metric. Other PROMs included are the Physical Function items of the Multidimensional Health Assessment Questionnaire (MDHAQ), Disabilities of Arm, Shoulder and Hand (DASH), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), World Health Organization Disability Assessment Schedule Version 2.0 (WHODAS 2.0), and four short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System (PROMIS). As the HAQ includes mobility, self-care and domestic life items, this study focuses on these three domains. PROMs were described using Standard Error of Measurement (SEM) and Smallest Detectable Difference (SDD). Rasch Measurement model was used to create the common metric. Results: Range of SEM is 0.2 (MDHAQ) to 7.4 (SF36-PF). SDD revealed a range from 9.7 % (WOMAC-RAT) to 33.5 % (WHODAS-PF). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROMs scores. Discussion: Scores between the Daily Activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help determine choice of PROM in clinical practice and research. KW - Common metric KW - DASH KW - HAQ KW - International Classification of Functioning KW - Multidimensional HAQ KW - PROMIS-SF KW - Rasch measurement model KW - Scale banking KW - WHODAS 2.0 KW - WOMAC Y1 - 2020 UR - https://doi.org/10.1002/acr.24503 ER - TY - JOUR A1 - Nicol, R A1 - Yu, H A1 - Selb, M A1 - Prodinger, Birgit A1 - Hartvigsen, J A1 - Côté, P T1 - How does the measurement of disability in low back pain map unto the International Classification of Functioning, Disability and Health (ICF)? A scoping review of the manual medicine literature JF - American Journal of Physical Medicine and Rehabilitation N2 - The objective of this study was to catalogue items from instruments used to measure functioning, disability, and contextual factors in patients with low back pain (LBP) treated with manual medicine (manipulation and mobilization) according to the International Classification of Functioning, Disability and Health (ICF). This catalogue will be used to inform the development of an ICF-based assessment schedule for LBP patients treated with manual medicine. In this scoping review we systematically searched MEDLINE, Embase, PsycINFO and CINAHL. We identified instruments (questionnaires, clinical tests, single questions) used to measure functioning, disability and contextual factors, extracted the relevant items and then linked these items to the ICF. We included 95 articles and identified 1510 meaningful concepts. All but 70 items were linked to the ICF. Of the concepts linked to the ICF, body functions accounted for 34.7%, body structures accounted for 0%, activities and participation accounted for 41%, environmental factors accounted for 3.6%, and personal factors accounted for 16%. Most items used to measure functioning and disability in LBP patient treated with manual medicine focus on body functions, and activities and participation. The lack of measures that address environmental factors warrants further investigation. KW - Low back pain , International Classification of Functioning , Disability and Health , Musculoskeletal Manipulations , Disability Evaluation Y1 - 2020 UR - https://doi.org/10.1097/PHM.0000000000001636 VL - Online ahead of print. ER - TY - JOUR A1 - Prodinger, Birgit A1 - Coenen, M A1 - Hammond, A A1 - Küçükdeveci, AA A1 - Tennant, A T1 - Scale-Banking for Patient Reported Outcome Measures (PROMs) Measuring Functioning in Rheumatoid Arthritis: A Daily Activities Metric JF - Arthritis Care & Research N2 - Objective: Functioning is an important outcome for rheumatoid arthritis (RA) management. Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability. Methods: Common Item Non-Equivalent Groups Design (NEAT) with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (incl. UK, Turkey and Germany) to establish a common metric. Other PROMs included are the Physical Function items of the Multidimensional Health Assessment Questionnaire (MDHAQ), Disabilities of Arm, Shoulder and Hand (DASH), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), World Health Organization Disability Assessment Schedule Version 2.0 (WHODAS 2.0), and four short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System (PROMIS). As the HAQ includes mobility, self-care and domestic life items, this study focuses on these three domains. PROMs were described using Standard Error of Measurement (SEM) and Smallest Detectable Difference (SDD). Rasch Measurement model was used to create the common metric. Results: Range of SEM is 0.2 (MDHAQ) to 7.4 (SF36-PF). SDD revealed a range from 9.7 % (WOMAC-RAT) to 33.5 % (WHODAS-PF). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROMs scores. Discussion: Scores between the Daily Activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help determine choice of PROM in clinical practice and research. Keywords: Common metric; DASH; Disability and Health; HAQ; International Classification of Functioning; Multidimensional HAQ; PROMIS-SF; Rasch measurement model; Scale banking; WHODAS 2.0; WOMAC. KW - Common metric; DASH; Disability and Health; HAQ; International Classification of Functioning; Multidimensional HAQ; PROMIS-SF; Rasch measurement model; Scale banking; WHODAS 2.0; WOMAC. Y1 - 2020 UR - https://doi.org/10.1002/acr.24503 VL - Online ahead of print ER - TY - JOUR A1 - Stanley, Mandy A1 - Rogers, Sandra A1 - Forwell, Sue A1 - Hocking, Clare A1 - Nayar, Shoba A1 - Laliberte Rudman, Debbie A1 - Prodinger, Birgit A1 - Farias Vera, Lisette A1 - Townsend, Elizabeth A1 - Magalhães, Lilian A1 - Simaan, Juman A1 - Reid, Heleen A1 - Pols, Vee T1 - A Pledge to Mobilize Against Racism JF - Journal of Occupational Science KW - against racism Y1 - 2020 N1 - Position statement VL - 27 IS - s1 SP - 294 EP - 295 ER - TY - JOUR A1 - Maritz, Roxanne A1 - Tennant, Alan A1 - Fellinghauer, Carolina A1 - Stucki, Gerold A1 - Prodinger, Birgit T1 - Creating a common metric based on existing activities of daily living tools to enable standardized reporting of functioning outcomes achieved during rehabilitation JF - Journal of Rehabilitation Medicine N2 - Objective: Many different assessment tools are used to assess functioning in rehabilitation; this limits the comparability and aggregation of respective data. The aim of this study was to outline the development of an International Classification of Functioning, Disability and Health (ICF)-based interval-scaled common metric for 2 assessment tools assessing activities of daily living: the Functional Independence Measure (FIMTM) and the Extended Barthel Index (EBI), used in Swiss national rehabilitation quality reports. Methods: The conceptual equivalence of the 2 tools was assessed through their linking to the ICF. The Rasch measurement model was then applied to create a common metric including FIMTM and EBI. Subjects: Secondary analysis of a sample of 265 neurological patients from 5 Swiss clinics. Results: ICF linking found conceptual coherency of the tools. An interval-scaled common metric, including FIMTM and EBI, could be established, given fit to the Rasch model in the related analyses. Conclusion: The ICF-based and interval-scaled common metric enables comparison of patients and clinics functioning outcomes when different activities of daily living tools are used. The common metric can be included in a Standardized Assessment and Reporting System for functioning information in order to enable data aggregation and comparability. Keywords: Barthel Index; Functional Independence Measure; Rasch Measurement Model; activities of daily living; outcome assessment (healthcare); psychometrics; quality in healthcare; rehabilitation. KW - Barthel Index; Functional Independence Measure; Rasch Measurement Model; activities of daily living; outcome assessment (healthcare); psychometrics; quality in healthcare; rehabilitation. Y1 - 2020 UR - https://doi.org/10.2340/16501977-2711 VL - 52 IS - 7 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Küçükdeveci, AA A1 - Kutlay, S A1 - Elhan, AH A1 - Kreiner, S A1 - Tennant, A T1 - Cross-diagnostic scale-banking using Rasch analysis: Developing a common reference metric for generic and health condition-specific scales in people with rheumatoid arthritis and stroke. JF - Journal of Rehabilitation Medicine N2 - Abstract Objectives: To develop a common reference metric of functioning, incorporating generic and health condition-specific disability instruments, and to test whether this reference metric is invariant across 2 health conditions. Design: Psychometric study using secondary data analysis. Firstly, the International Classification of Functioning, Disability and Health (ICF) Linking Rules were used to examine the concept equivalence between the World Health Organization Disability Assessment Schedule (WHODAS 2.0), Health Assessment Questionnaire (HAQ), and Functional Independence Measure (FIMTM). Secondly, a scale-bank was developed using a reference metric approach to test-equating, based on the Rasch measurement model. Participants: Secondary analysis was performed on data from 487 people; 61.4% with rheumatoid arthritis and 38.6% with stroke. Results: Three sub-domains of the WHODAS 2.0 and all items of the HAQ and FIMTM motor mapped on to the ICF chapters d4 Mobility, d5 Self-care and d6 Domestic life. Test-equating of these scales resulted in good model fit, indicating that a scale bank and associated reference metric across these 3 instruments could be created. Conclusion: This study provides a transformation table to enable direct comparisons among instruments measuring physical functioning commonly used in rheumatoid arthritis (HAQ) and stroke (FIMTM motor scale), as well as in people with disability in general (WHODAS 2.0). Keywords: FIM; Functional Independence Measure; HAQ; Health Assessment Questionnaire; WHODAS 2.0; World Health Organization Disability Assessment Schedule; outcome assessment; rheumatoid arthritis; stroke; psychometrics. KW - FIM; Functional Independence Measure; HAQ; Health Assessment Questionnaire; WHODAS 2.0; World Health Organization Disability Assessment Schedule; outcome assessment; rheumatoid arthritis; stroke; psychometrics. Y1 - 2020 UR - https://doi.org/10.2340/16501977-2736 ER - TY - JOUR A1 - Dorjbal, D. A1 - Prodinger, Birgit A1 - Zanini, C. A1 - Avirmed, B. A1 - Stucki, G. A1 - Rubinelli, S. T1 - Living with spinal cord injury in Mongolia: A qualitative study on perceived environmental barriers JF - Journal of Spinal Cord Medicine N2 - Context: Environmental factors play a key role in the lives of individuals with a spinal cord injury (SCI). This study identifies environmental barriers and their impacts on daily lives as perceived by individuals living with SCI in Mongolia. Design: A qualitative study with semi-structured interviews was conducted. A topic guide for the interviews was structured around the components of the International Classification of Functioning, Disability, and Health. Setting: Urban and rural areas of Mongolia. Participants: A purposive sample of 16 persons with traumatic SCI. Interventions: Not applicable. Outcome Measures: Not applicable. Results: Seven categories of environmental barriers were mentioned, such as poor access to the physical environment, absence of wheelchair-friendly transportation, negative societal attitudes, inadequate health and rehabilitation services, lack of access to assistive devices and medicines, limited financial resources for healthcare, and inaccurate categorization of disabilities in laws. These barriers were claimed to have an impact on physical and psychological health, limit activities, and restrict participation in almost all areas of life. Conclusion: This study contributes to the identification of targets for interventions aimed at improving the lived experience of persons with SCI in a low-resource context. The findings reveal that while the Mongolian government already has laws and policies in place to improve access to the physical environment, transportation, assistive devices and employment, much more has to be done in terms of enforcement. Specialized SCI care and rehabilitation services are highly demanded in Mongolia. KW - Lived experience KW - Developing country KW - International Classification of Functioning, Disability, and Health KW - Semi-structured interviews KW - Person-centeredness KW - Rehabilitation services Y1 - 2020 UR - https://doi.org/10.1080/10790268.2019.1565707 VL - 43 IS - 4 SP - 518 EP - 531 ER - TY - JOUR A1 - Mukaino, M. A1 - Prodinger, Birgit A1 - Okouchi, Y. A1 - Mizutani, K. A1 - Senju, Y. A1 - Suzuki, M. A1 - Saitoh, E. T1 - Development and assessment of a home environment checklist to evaluate mismatch between patients' ability and home environment JF - Annals of Physical and Rehabilitation Medicine N2 - Background Modification of the home environment, together with rehabilitative interventions, is important for maximizing the level of functioning after an individual with disability undergoes rehabilitation in the hospital. Objectives We developed a simple screening scale – the home environment checklist (HEC) – to identify any mismatch between an individual's abilities and their home environment to help clinicians monitor the appropriateness of the home environment to which individuals with disability will be discharged. We also examined the psychometric properties of the HEC. Methods The HEC was developed by a multidisciplinary panel of rehabilitation experts using information routinely collected in rehabilitation clinics before discharge. The reliability of the checklist was assessed in 60 individuals undergoing rehabilitation. The inter-rater agreement and internal consistency of the scale were assessed by weighted kappa statistics and Cronbach's alpha, respectively. Rasch analysis was performed with 244 rehabilitation individuals to evaluate the internal construct validity, and the known-groups validity was confirmed by a comparison of the daily activity levels of 30 individuals with disabilities under rehabilitation to the HEC score. Results The HEC was developed as a simple, 10-item checklist. The weighted kappa statistics ranged from 0.73 to 0.93, indicating excellent inter-rater reliability. Cronbach's alpha was 0.92, indicating high internal consistency. Rasch analysis with a testlet approach on 3 subscales demonstrated a good fit with the Rasch model (χ2 = 13.2, P = 0.153), and the demonstrated unidimensionality and absence of differential item functioning supported the internal construct validity of the HEC. HEC scores were significantly different (P < .01) among individuals with disability and 3 levels of restrictions in their activities (no limitation, home-bound, and bed-bound), which demonstrates the known-groups validity of the HEC. Conclusions The HEC has good reliability and validity, which supports its utility in rehabilitation clinics. KW - ICF KW - Environmental factors KW - Activities of daily living Y1 - 2020 UR - https://doi.org/10.1016/j.rehab.2019.09.004 VL - 63 IS - 4 SP - 288 EP - 295 ER - TY - JOUR A1 - Devi, N. A1 - Prodinger, Birgit A1 - Pennycott, A. A1 - Sooben, R. A1 - Bickenbach, J. T1 - Investigating Supported Decision‐Making for Persons With Mild to Moderate Intellectual Disability Using Institutional Ethnography JF - Journal of Policy and Practice in Intellectual Disabilities N2 - Making one's own choices is an important part of leading a fulfilling life within society. However, people with IDs often face significant obstacles when making their own decisions. Article 12 (Equal recognition before the law) of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) aims to ensure firstly that people with IDs and others with compromised capacity are nonetheless recognized as legal individuals, and secondly that assistance is provided in the form of supported decision‐making in order to exercise this resulting legal capacity. It is unclear whether current national legislation in any country satisfies these requirements in practice. This study utilizes institutional ethnography to reveal how decision‐making is coordinated in practice for people with mild to moderate IDs living in supported residential environments in England, and to determine whether these processes are compliant with Article 12 of the CRPD. Data collection was based on observations, semi‐structured interviews, and documentary analysis, involving 29 participants including people with mild to moderate IDs. The results point to the complexity of supported decision‐making and identify three main categories of decision‐making: spontaneous decisions, mid‐term decisions, and strategic decisions. The data also show that people with mild to moderate IDs are able to exercise their legal capacity through support decision‐making in their everyday life. Immediate and informal supported decision‐making exists in daily practice for people with mild to moderate IDs living in supported residential environments. Although there are structures in place for implementing supported decision‐making, various barriers persist that limit the overall efficacy and consistency of the realization of supported decision‐making, for example, multiple use of mental capacity assessments. Such practices move away from the supported decision‐making model toward substituted decision‐making. KW - Institutional Ethnography KW - Intellectual Disability Y1 - 2020 UR - https://doi.org/10.1111/jppi.12314 VL - 17 IS - 2 SP - 143 EP - 156 ER - TY - JOUR A1 - Mukaino, M. A1 - Prodinger, Birgit A1 - Yamada, S. A1 - Senju, Y. A1 - Izumi, S. I. A1 - Sonoda, S. A1 - Selb, M. A1 - Saitoh, E. A1 - Stucki, G. T1 - Supporting the clinical use of the ICF in Japan - development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 set, its operationalization through a rating reference guide, and interrater reliability study JF - BMC Health Services Research N2 - Background The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) in 2001 and has been in the process of implementing it in clinics since then. Current international efforts to implement ICF in rehabilitation clinics include the implementation of ICF Core Sets and the development of simple, intuitive descriptions for the ICF Generic-30 Set (also called Rehabilitation Set). The present study was designed to operationalize these ICF tools for clinical practice in Japan. This work included 1) the development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set, 2) the development of a rating reference guide for Activity and Participation categories, and 3) the examination of the interrater reliability of rating Activity and Participation categories. Methods The Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set was developed following the process employed to develop the Chinese and Italian versions. For further operationalization of this ICF Set in practice, a rating reference guide was developed. The development of the rating reference guide involved the following steps: 1) a trial of rating patients by several raters, 2) cognitive interviewing of the raters to analyse the thinking process involved in rating, 3) drafting of the rating reference guide, and 4) review by ICF specialists to confirm consistency with the original ICF concepts. After the rating reference guide was developed, interrater reliability of the rating with the reference guide was determined. Interrater reliability was examined using weighted kappa statistics with linear weight. Results Through the pre-defined process, the Japanese version of the simple, intuitive descriptions for 30 categories of the ICF Generic-30 Set and the rating reference guides for 21 Activity and Participation categories were successfully developed. The weighted kappa statistics ranged from 0.61 to 0.85, showing substantial to excellent agreement of the ratings between raters. Conclusions The present study demonstrates that ICF categories can be translated into clinical practice. Collaboration between clinicians and researchers would further enhance the implementation of the ICF in Japan. KW - ICF KW - ICF rehabilitation set KW - Simple, intuitive descriptions KW - Interrater reliability Y1 - 2020 UR - https://doi.org/10.1186/s12913-020-4911-6 VL - 20 IS - 1 SP - 66 ER -