TY - JOUR A1 - Fekete, C. A1 - Post, M. A1 - Bickenbach, J. A1 - Middleton, J. A1 - Prodinger, Birgit A1 - Selb, M. A1 - Stucki, G. T1 - 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) JF - American Journal of physical and rehabilitation medicine N2 - 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. KW - International Spinal Cord Injury KW - Comparability of spinal cord injury Y1 - 2017 UR - https://doi.org/10.1097/PHM.0000000000000622 VL - 96 IS - 2 SP - S5 EP - S16 ER - TY - JOUR A1 - Dorjbal, D. A1 - Cieza, A. A1 - Gmünder, H.-P- A1 - Scheel-Sailer, A. A1 - Stucki, G. A1 - Üstün, T.B. A1 - Prodinger, Birgit T1 - Strengthening quality of care through standardized reporting based on the World Health Organization's reference classifications JF - International Journal of Quality in Health N2 - 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. KW - International Classification of Diseases KW - International Classification of Functioning KW - Disability and health KW - Quality improvement KW - Rehabilitation Y1 - 2016 UR - https://doi.org/10.1093/intqhc/mzw078 VL - 28 IS - 5 SP - 626 EP - 633 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Tennant, A. A1 - Stucki, G. A1 - Cieza, A. A1 - Üstün, T.B. T1 - Harmonizing routinely collected health information for strengthening quality management in health systems: requirements and practice JF - Journal of Health Services Research & Policy N2 - Objective Our aim was to specify the requirements of an architecture to serve as the foundation for standardized reporting of health information and to provide an exemplary application of this architecture. Methods The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) served as the conceptual framework. Methods to establish content comparability were the ICF Linking Rules. The Rasch measurement model, as a special case of additive conjoint measurement, which satisfies the required criteria for fundamental measurement, allowed for the development of a common metric foundation for measurement unit conversion. Secondary analysis of data from the North Yorkshire Survey was used to illustrate these methods. Patients completed three instruments and the items were linked to the ICF. The Rasch measurement model was applied, first to each scale, and then to items across scales which were linked to a common domain. Results Based on the linking of items to the ICF, the majority of items were grouped into two domains, Mobility and Self-care. Analysis of the individual scales and of items linked to a common domain across scales satisfied the requirements of the Rasch measurement model. The measurement unit conversion between items from the three instruments linked to the Mobility and Self-care domains, respectively, was demonstrated. Conclusions The realization of an ICF-based architecture for information on patients’ functioning enables harmonization of health information while allowing clinicians and researchers to continue using their existing instruments. This architecture will facilitate access to comprehensive and consistently reported health information to serve as the foundation for informed decision-making. KW - Decision making KW - Health classification KW - Health status measurement KW - Information standards KW - Quality management Y1 - 2016 UR - https://doi.org/10.1177/1355819616636411 VL - 21 IS - 4 SP - 223 EP - 228 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stamm, T. A1 - Petersson, D. A1 - Stucki, G. A1 - Tennant, A. T1 - Toward a standardized reporting of outcomes in hand osteoarthritis: Developing a common metric of outcome measures commonly used to assess functioning. JF - Arthritis Care & Research N2 - Objective Functioning is an important outcome in hand osteoarthritis (OA). The heterogeneity of patient‐reported outcome measures (PROMs) available challenges the direct comparability of information collected by these instruments. This study aimed to examine whether it is possible to achieve metric equivalence of PROMs commonly used to measure functioning in people with hand OA. Methods A secondary analysis of data from 253 persons who participated in the Vienna Hand Osteoarthritis Cohort Study was conducted applying the Rasch measurement model. Participants completed the Health Assessment Questionnaire, the Australian/Canadian Index for Hand Osteoarthritis, the Functional Index for Hand Osteoarthritis (FIHOA), and the Cochin Scale. The assumptions of stochastic ordering, local independence, unidimensionality, and invariance were tested for each scale independently before the scales were co‐calibrated onto a common metric. Results Except for the FIHOA, all measures indicated issues of local dependency in the initial analyses. After accommodating those with testlets, all scales satisfied the assumptions of the Rasch model (χ2 > 0.05). Marginal misfit in 2 items was found in the FIHOA, but this did not disturb person estimates. As the 4 scales form a common metric that satisfies the assumptions of the Rasch model, the scores can be equated. Conclusion The scores of the 4 hand function measures can be transformed to a common 0–100 metric, such that scores can be interchanged. A user‐friendly transformation table enables clinicians and researchers to have access to the common metric by simply adding up the total score for each instrument and identifying the corresponding transformed score on the common metric. KW - Osteoarthritis KW - Outcome measures KW - Cohort study Y1 - 2016 UR - https://doi.org/10.1002/acr.22816 VL - 68 IS - 8 SP - 1115 EP - 1127 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Cieza, A. A1 - Oberhauser, C. A1 - Bickenbach, J. A1 - Üstün, T.B. A1 - Chatterji, S. A1 - Stucki, G. T1 - Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy JF - Archives of Physical Medicine and Rehabilitation KW - Rehabilitation KW - Disability and health KW - ICF Rehabilitation Set Y1 - 2016 UR - https://doi.org/10.1016/j.apmr.2015.12.030 VL - 97 IS - 6 SP - 875 EP - 884 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Reinhard, J.D. A1 - Selb, M. A1 - Stucki, G. A1 - Yan, T. A1 - Zhang, C. A1 - Li, J. T1 - Towards system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in routine practice: Developing simple, intuitive descriptions of ICF categories in the ICF Generic and Rehabilitation Set JF - Journal of Rehabilitation Medicine N2 - Objective: A national, multi-phase, consensus process to develop simple, intuitive descriptions of International Classification of Functioning, Disability and Health (ICF) categories contained in the ICF Generic and Rehabilitation Sets, with the aim of enhancing the utility of the ICF in routine clinical practice, is presented in this study. Methods: A multi-stage, national, consensus process was conducted. The consensus process involved 3 expert groups and consisted of a preparatory phase, a consensus conference with consecutive working groups and 3 voting rounds (votes A, B and C), followed by an implementation phase. In the consensus conference, participants first voted on whether they agreed that an initially developed proposal for simple, intuitive descriptions of an ICF category was in fact simple and intuitive. Results: The consensus conference was held in August 2014 in mainland China. Twenty-one people with a background in physical medicine and rehabilitation participated in the consensus process. Four ICF categories achieved consensus in vote A, 16 in vote B, and 8 in vote C. Discussion: This process can be seen as part of a larger effort towards the system-wide implementation of the ICF in routine clinical and rehabilitation practice to allow for the regular and comprehensive evaluation of health outcomes most relevant for the monitoring of quality of care. KW - Disability and health KW - Health information systems KW - International classification of functioning KW - Practicing standards Y1 - 2016 UR - https://doi.org/10.2340/16501977-2066 VL - 48 IS - 6 SP - 508 EP - 514 ER - TY - JOUR A1 - Li, J. A1 - Prodinger, Birgit A1 - Reinhard, J. D. A1 - Stucki, G. T1 - Toward the system-wide implementation of the International Classification of Functioning, Disability and Health in routine clinical practice: Lessons from a pilot study in China JF - Journal of Rehabilitation Medicine N2 - In 2011 the Chinese leadership in rehabilitation, in collaboration with the International Classification of Functioning, Disability and Health (ICF) Research Branch, embarked on an effort towards the system-wide implementation of the ICF in the healthcare system in China. We report here on the lessons learned from the pilot phase of testing the ICF Generic Set, a parsimonious set of 7 ICF categories, which have been shown to best describe functioning across the general population and people with various health conditions, for use in routine clinical practice in China. The paper discusses whether classification and measurement are compatible, what number of ICF categories should be included in data collection in routine practice, and the usefulness of a functioning profile and functioning score in clinical practice and health research planning. In addition, the paper reflects on the use of ICF qualifiers in a rating scale and the particularities of certain ICF categories contained in the ICF Generic Set when used as items in the context of Chinese rehabilitation and healthcare. Finally, the steps required to enhance the utility of system-wide implementation of the ICF in rehabilitation and healthcare services are set out. KW - Functional status KW - ICF KW - Psychomatrics KW - Rasch analysis KW - Sensitivity to change Y1 - 2016 UR - https://doi.org/10.2340/16501977-2067 VL - 48 IS - 6 SP - 502 EP - 507 ER - TY - JOUR A1 - Reinhardt, J. D. A1 - Zhang, X. A1 - Prodinger, Birgit A1 - Ehrmann-Bostan, C. A1 - Selb, M. A1 - Stucki, G. A1 - Li, J. T1 - Toward the system-wide implementation of the International Classification of Functioning, Disability and Health in routine clinical practice: Empirical findigns of a pilot study from Mainland China JF - Journal of Rehabilitation Medicine N2 - Objective: The aims of this study were to evaluate the feasibility of using the International Classification of Functioning, Disability and Health (ICF) Generic Set in routine clinical practice, and of creating a functioning score based on it, and, subsequently, to examine its sensitivity to change. Methods: In this prospective cohort study, data from 761 adult inpatients from 21 Chinese hospitals were analysed. Each patient was assessed at admission and discharge. Feasibility was evaluated by analysing mean assessment time. The Rasch model was used to create a metric of functioning. Sensitivity to change was analysed with mixed-effects regression and by calculating standardized effect size based on Cohen's f2. Results: Mean duration of assessment was 5.3 min, with a significant decrease between admission and discharge. After removal of the item remunerative employment, the remaining ICF Generic Set categories fitted the Rasch model well. With a mean improvement in functioning of 12.1 (95% confidence interval (95% CI): 11.5–12.6), this metric proved sensitive to change, both in terms of statistical significance (p < 0.001) and standardized effect size (Cohen's f2 = 2.35). Discussion: The ICF Generic Set is feasible for use in routine clinical practice and is promising to serve as the basis for the development of a functioning score that is sensitive to change. KW - Functional status KW - ICF KW - Psychomatrics KW - Rasch analysis Y1 - 2016 UR - https://doi.org/10.2340/16501977-2102 VL - 48 IS - 6 SP - 515 EP - 521 ER - TY - JOUR A1 - Maritz, R. A1 - Ehrmann, C. A1 - Prodinger, Birgit A1 - Tennant, A. A1 - Stucki, G. T1 - The influence and added value of a Standardized Assessment and Reporting System for functioning outcomes upon national rehabilitation quality reports JF - International Journal for Quality in Health Care N2 - Objective To demonstrate the influence and added value of a Standardized Assessment and Reporting System (StARS) upon the reporting of functioning outcomes for national rehabilitation quality reports. A StARS builds upon an ICF-based (International Classification of Functioning, Disability and Health) and interval-scaled common metric. Design Comparison of current ordinal-scaled Swiss national rehabilitation outcome reports including an expert-consensus-based transformation scale with StARS-based reports through descriptive statistical methods and content exploration of further development areas of the reports with relevant ICF Core Sets. Setting Swiss national public rehabilitation outcome quality reports on the clinic level. Participants A total of 29 Swiss rehabilitation clinics provided their quality report datasets including 18 047 patients. Interventions Neurological or musculoskeletal rehabilitation. Main outcome measures Functional Independence Measure™ or Extended Barthel Index. Results Outcomes reported with a StARS tended to be smaller but more precise than in the current ordinal-scaled reports, indicating an overestimation of achieved outcomes in the latter. The comparison of the common metric’s content with ICF Core Sets suggests to include ‘energy and drive functions’ or ‘maintaining a basic body position’ to enhance the content of functioning as an indicator. Conclusions A StARS supports the comparison of outcomes assessed with different measures on the same interval-scaled ICF-based common metric. Careful consideration is needed whether an ordinal-scaled or interval-scaled reporting system is applied as the magnitude and precision of reported outcomes is influenced. The StARS’ ICF basis brings an added value by informing further development of functioning as a relevant indicator for national outcome quality reports in rehabilitation. KW - quality of health care KW - public reporting of healthcare data KW - outcome assessment (health care) KW - rehabilitation KW - international classification of functioning, disability and health KW - psychometrics Y1 - 2020 UR - https://doi.org/10.1093/intqhc/mzaa058 VL - 32 IS - 6 SP - 379 EP - 387 PB - Oxford University Press CY - Oxford 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 -