Bibliographische Angaben zur Publikation
Health measurement using the ICF: Test-retest reliability study of ICF codes and qualifiers in geriatric care
Okuchi, Jiro; Utsunomiya, Sakiko; Takahashi, Takahashi
Health and Quality of Life Outcomes, 2005, 3:46, London: BioMed Central, ISSN: 1477-7525 (online)
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The International Classification of Functioning, Disability and Health (ICF
) was published by the World Health Organization (WHO
) to standardize descriptions of health and disability. Little is known about the reliability and clinical relevance of measurements using the ICF
and its qualifiers. This study examines the test-retest reliability of ICF
codes, and the rate of immeasurability in long-term care settings of the elderly to evaluate the clinical applicability of the ICF
and its qualifiers, and the ICF
Reliability of 85 body function (BF) items and 152 activity and participation (AP) items of the ICF
was studied using a test-retest procedure with a sample of 742 elderly persons from 59 institutional and at home care service centers. Test-retest reliability was estimated using the weighted kappa statistic. The clinical relevance of the ICF
was estimated by calculating immeasurability rate. The effect of the measurement settings and evaluators' experience was analyzed by stratification of these variables. The properties of each item were evaluated using both the kappa statistic and immeasurability rate to assess the clinical applicability of WHO
checklist in the elderly care setting.
The median of the weighted kappa statistics of 85 BF and 152 AP items were 0.46 and 0.55 respectively. The reproducibility statistics improved when the measurements were performed by experienced evaluators. Some chapters such as genitourinary and reproductive functions in the BF domain and major life area in the AP domain contained more items with lower test-retest reliability measures and rated as immeasurable than in the other chapters. Some items in the ICF
checklist were rated as unreliable and immeasurable.
The reliability of the ICF
codes when measured with the current ICF
qualifiers is relatively low. The result in increase in reliability according to evaluators' experience suggests proper education will have positive effects to raise the reliability. The ICF
checklist contains some items that are difficult to be applied in the geriatric care settings. The improvements should be achieved by selecting the most relevant items for each measurement and by developing appropriate qualifiers for each code according to the interest of the users.
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Zeitschriftenbeitrag / Forschungsergebnis / Online-Publikation
Health and Quality of Life Outcomes
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