Interrater Reliability of the Extended ICF Core Set for Stroke Applied by Physical Therapists

Clinics Schmieder, Allensbach, Germany.
Physical Therapy (Impact Factor: 2.53). 08/2008; 88(7):841-51. DOI: 10.2522/ptj.20070211
Source: PubMed

ABSTRACT The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is gaining recognition in physical therapy. The Extended ICF Core Set for Stroke is a practical tool that represents a selection of categories from the whole classification and can be used along with the ICF qualifier scale to describe patients' functioning and disability following stroke. The application of the ICF qualifier scale poses the question of interrater reliability. The primary objective of this investigation was to study the agreement between physical therapists' ratings of subjects' functioning and disability with the Extended ICF Core Set for Stroke and with the ICF qualifier scale. Further objectives were to explore the relationships between agreement and rater confidence and between agreement and physical therapists' areas of core competence.
A monocentric, cross-sectional reliability study was conducted. A consecutive sample of 30 subjects after stroke participated. Two physical therapists rated the subjects' functioning in 166 ICF categories.
The interrater agreement of the 2 physical therapists was moderate across all judgments (observed agreement=51%, kappa=.41). Interrater reliability was not related to rater confidence or to the physical therapists' areas of core competence.
The present study suggests potential improvements to enhance the implementation of the ICF and the Extended ICF Core Set for Stroke in practice. The results hint at the importance of the operationalization of the ICF categories and the standardization of the rating process, which might be useful in controlling for rater effects and increasing reliability.

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Available from: Mario Prosiegel, Jan 25, 2014
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    • "The functioning profile displays an overall expert rating of the patient's functioning using ICF qualifiers based on clinical data, i.e. findings of the discipline-specific clinical tests, clinical examinations and questionnaires. However, to some extent, the rating is sometimes wrought with reliability and precision concerns (Grill et al., 2007; Uhlig et al., 2007; Starrost et al., 2008; Jette et al., 2009). At a practical level for goal setting, the present case illustrates that ICF qualifiers are sufficiently precise to document a mutually shared, comprehensive overview of the patient's abilities and problems. "
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    Physiotherapy Research International 04/2014; DOI:10.1002/pri.1587
    • "Third, the use of the ICF qualifier scale generally provides comprehensible information about the severity of problems reflected in the ICF categories. However , it may lack reliability and precision [43] [44]. The literature documents that Core Sets define only " what to measure and not how to measure " [18]. "
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    ABSTRACT: Although the incidence of cancer in the United States is high, improvements in early diagnosis and treatment have significantly increased survival rates in recent years. Many survivors of cancer experience lasting, adverse effects caused by either their disease or its treatment. Physical therapy interventions, both established and new, often can reverse or ameliorate the impairments (body function and structure) found in these patients, improving their ability to carry out daily tasks and actions (activity) and to participate in life situations (participation). Measuring the efficacy of physical therapy interventions in each of these dimensions is challenging but essential for developing and delivering optimal care for these patients. This article describes the acute and long-term effects of cancer and its treatment and the use of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) as a basis for selection of assessment or outcome tools and diagnostic or screening tools in this population.
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