The International Classification of Functioning, Disability
               and Health: a systematic review of observational studies

Castaneda, Luciana; Bergmann, Anke; Bahia, Ligia

doi:10.1590/1809-4503201400020012ENG

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Original Articles • Rev. bras. epidemiol. 17 (02) • June 2014 • https://doi.org/10.1590/1809-4503201400020012ENG copy

The International Classification of Functioning, Disability and Health: a systematic review of observational studies

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To systematically review the use of the International Classification of Functioning, Disability and Health (ICF) in observational studies.

Methods:

This study is a systematic review of articles that use the ICF in observational studies. We took into account the observational design papers available in databases such as PubMed, Lilacs and SciELO, published in English and Portuguese from January 2001 to June 2011. We excluded those in which the samples did not comprise individuals, those about children and adolescents, and qualitative methodology articles. After reading the abstracts of 265 identified articles, 65 met the inclusion criteria. Of these, 18 were excluded. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) adapted Checklist, with 15 items needed for observational studies, was applied to the 47 remaining articles. Any paper that met 12 of these criteria was included in this systematic review.

Results:

29 articles were reviewed. Regarding the ICF application methodology, the checklist was used in 31% of the articles, the core set in 31% and the ICF categories in 31%. In the remaining 7%, it was not possible to define the applied methodology. In most papers (41%), qualifiers were used in their original format. As far as the area of knowledge is concerned, most of the studies were related to Rheumatology (24%) and Orthopedics (21%). Regarding the study design, 83% of the articles used cross-sectional studies.

Conclusion:

Results indicate a wide scientific production related to ICF over the past 10 years. Different areas of knowledge are involved in the debate on the improvement of information on morbidity. However, there are only a few quantitative epidemiological studies involving the use of ICF. Future studies are needed to improve data related to functioning and disability.

International Classification of Functioning, Disability and Health; Chronic disease; Review literature as topic; Data collection; Evidence-based practice

Author, year	Knowledge area	Design of the study	General goal	Population of the study	Sample size	ICF Methodology (Spare cathegories, checklist or core set)	Qualifiers (original or adapted)	Aditional instruments
Almansa et al., 2011¹¹	Not definable	Cross-sectional	To assess whether the validity scales performance and capacity can be developed from the domains of activity and check list participation	Patients with 11 different chronic conditions	1092	Checklist	Original	YRSM, HDRS, MIDAS, EDSS, MIF
Peyrin-Biroulet et al., 2011¹²	Internal Medicine	Cross-sectional	To develop the first disability index for inflammatory bowel disease	Patients with inflammatory bowel disease	192	Checklist	Not definable	x
Gojlar et al., 2011¹³	Neurology	Cohort	To determine whether the ICF model is adequate for capturing the patterns of disability	Patients who had a stroke	197	Checklist	Original	MIF
Pollard et al., 2011¹⁴	Orthopedics	Cross-sectional	To examine the relationship between disability, limiting to activities and restriction to participation	Patients with osteoarthritis in situation prior to the hip and ankle arthroplasty	413	Cathegories	Adapted	x
Virués-Ortega et al., 2011¹⁵	Geriatrics	Cross-sectional	To report the prevalence of disability (mild, moderate, severe and extreme)	Patients with more than 75 years of age	503	Not definable	Original	WHODAS II
Herrmann et al., 2011¹⁶	Neurology	Cross-sectional	To identify and quantify the differences in functionality	Patients with paraplegia and tetraplegia	1048	Not definable	Adapted	x
Gradinger et al., 2011¹⁷	Neurology	Cross-sectional	To identify the most common problems in patients with any degree of disorder of sleep	Patients with sleep disorders	99	Checklist	Adapted	x
Rogers et al., 2010¹⁸	Oncology	Cross-sectional	To develop a self-administered questionnaire in order to obtain the patient’s vision over its content	Patients with head and neck cancer	364	Core set	Adapted	UW-QOL
Rauch et al., 2009¹⁹	Rheumatology	Cross-sectional	To identify similarities and differences in functionality in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS)	Patients with rheumatoid arthritis and ankylosing spondylitis	230	Core set	Original	x
Taylor et al., 2010²⁰	Rheumatology	Cross-sectional	To determine the categories of the checklist and the core set for RA and AS in patients with frequent psoriatic arthritis	Patients with psoriatic arthritis	94	Checklist	Original	WHODAS II, PAR-PRO, SF-36, Psa-QOL, HAQ-DI
Cieza et al., 2009²¹	Orthopedics	Cross-sectional	To explore the possibility of building clinical measures of functionality by integrating information from the categories of core set for osteoarthritis	Patients with Osteoarthritis	437	Core set	Original	X
Tsutsui et al., 2008²²	Nephrology	Cross-sectional	Identify the most common problems in Japanese patients on hemodialysis	Patients on hemodialysis	136	Checklist and cathegories	Not definable	x
Tschiesner et al., 2009²³	Oncology	Cross-sectional	To access the level of functionality in patients with head and neck cancer through the ICF	Patients with head and neck cancer	145	Checklist and cathegories	Original	EORTC
Hilfiker et al., 2009²⁴	Orthopedics	Cohort	To evaluate the inter-rater (two raters) agreement using the core set for low back pain	Patients with low back pain	61	Core set	Adapted	SF-36, SCQ
Rastogi et al., 2008²⁵	Orthopedics	Cohort	To quantify the level of importance on the areas of functionality	Preoperative and postoperative patients	54	Cathegories	Adapted	NPRS, KOOS
Bautz-Holter et al., 2008²⁶	Orthopedics	Cross-sectional	To evaluate the Norwegian version of the core set for low back pain and to investigate the feasibility of application in clinical practice	Patients with low back pain	118	Core set	Original	SF-36, SCQ, ODI
Xie et al., 2008²⁷	Orthopedics	Cross-sectional	To validate the abbreviated core set for osteoarthritis	Patients with Osteoarthritis	122	Core set	Not definable	SF-36, SCQ
Uhlig et al ²⁸	Rheumatology	Cohort	To investigate the responsiveness of the rheumatoid arthritis core set in clinical practice	Patients with rheumatoid arthritis	46	Core set	Adapted	MHAQ, SF-36
Grill e Stucki, 2008²⁹	Not definable	Cross-sectional	To examine whether clinical assessments tomade with the ICF can be integrated into parametric scales	Patients with musculoskeletal conditions	234	Core set	Adapted	X
Gaidhane et al., 2008³⁰	Infectology	Cross-sectional	To verify the perception of self-care in patients with HIV/AIDS	Patients with HIV/AIDS	194	Cathegories	Original	X
Jonsson et al., 2008³¹	Neurology	Cross-sectional	To describe, through the use of environmental factors of the ICF, the social groups that participate in the life of adults with cerebral palsy	Patients with cerebral palsy	16	Cathegories	Original	X
Farin et al., 2007³²	Not definable	Cross-sectional	To develop a self-guided questionnaire for the categories of mobility and self-care based on ICF	Patients with various conditions	1019	Cathegories	Not definable	X
Verhoef et al., 1007³³	Rheumatology	Cohort	To investigate whether the use of an instrument based on ICF improves clinical outcomes and patient satisfaction with the multidisciplinary team	Patients with rheumatoid arthritis	165	Cathegories	Not definable	MACTAR, RaQol, DAS28
Grill et al., 2007³⁴	Not definable	Cross-sectional	To observe an agreement in description and classification using the ICF	Patients with various conditions	25	Cathegories	Adapted	X
Echteld et al., 2006³⁵	Rheumatology	Cross-sectional	To identify the most common problems in patients with ankylosing spondylitis	Patients with ankylosing spondylitis	111	Checklist	Original	SACQ, BASFI
Cieza et al., 2006³⁶	Not definable	Cross-sectional	To propose a method to select ICF categories when a large amount of data must be handled and to identify categories for a generic core set	Not definable	1.039	Checklist	Adapted	SF-36
Zochling et al., 2006³⁷	Rheumatology	Cross-sectional	To identify the most common problems in patients with acute inflammatory arthritis	Patients with acute inflammatory arthritis	130	Cathegories	Adapted	X
Riberto et al³⁸	Rheumatology	Cross-sectional	Description of the results of the application of core sets for chronic widespread pain	Patients with fibromyalgia	29	Core set	Original	X

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[1] Corresponding author: Luciana Castaneda Avenida Brigadeiro Trompowisky s/n Praça da Prefeitura da Cidade Universitária CEP: 21949-900, Rio de Janeiro, RJ, Brasil E-mail: lucianacastaneda@yahoo.com.br