Alarcos Cieza

University of Southampton, Southampton, England, United Kingdom

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Publications (280)611.56 Total impact

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    ABSTRACT: To examine the relevance of social skills and their different dimensions (i.e. expressivity, sensitivity and control) in relation to social support, depression, participation and quality of life (QoL) in individuals with spinal cord injury (SCI).
    Archives of physical medicine and rehabilitation. 09/2014;
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    ABSTRACT: When comparing the health of two populations, it is not enough to compare the prevalence of chronic diseases. The objective of this study is therefore to propose a metric of health based on domains of functioning to determine whether the English are healthier than the Americans.
    International journal of epidemiology. 09/2014;
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    ABSTRACT: The Brief International Classification of Functioning, Disability and Health (ICF) Core Set for MS was developed to capture functioning in people with multiple sclerosis (pwMS). This study examined whether categories in the Brief ICF Core Set for MS best capture different levels of functioning in pwMS. We used data of a multicenter cross-sectional study collected from 205 pwMS using the ICF categories of the MS-specific WHO ICF Checklist and the individual rating of functioning. ICF categories to be entered in an initial regression model were selected following a systematic procedure in accordance with the ICF structure. Based on the initial regression model using stepwise Ordinary Least-Squares regression analyses, additional models were designed by substituting the ICF categories in final model. The selected set of categories was compared with the Brief ICF Core Set for MS. Eleven ICF categories were identified that best differentiate among different levels of functioning. Four were part of the Brief ICF Core Set. ICF categories identified in this study may be used as outcome measures in further study, parameters to monitor functioning along the continuum of health care and lifespan, and to define different subgroups of pwMS.
    Journal of neurology. 09/2014;
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    ABSTRACT: Medical evaluations of work capacity provide key information for decisions on a claimant's eligibility for disability benefits. In recent years, the evaluations have been increasingly criticized for low transparency and poor standardization. The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive spectrum of categories for reporting functioning and its determinants in terms of impairments and contextual factors and could facilitate transparent and standardized documentation of medical evaluations of work capacity. However, the comprehensiveness of the ICF taxonomy in this particular context has not been empirically examined. In this study, we wanted to identify potential context-specific additions to the ICF for its application in medical evaluations of work capacity involving chronic widespread pain (CWP) and low back pain (LBP).
    BMC Health Services Research 08/2014; 14(1):361. · 1.77 Impact Factor
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    ABSTRACT: AimThe objective of this article is to report on the Core Sets developed for children and youth aged 0 to 18 years, with cerebral palsy (CP) based on the pediatric International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO).MethodA formal decision-making and consensus process integrating evidence gathered from preparatory studies was followed. Preparatory studies included: a systematic literature review; an international expert survey; a qualitative study of children and youth with CP and their caregivers; and a clinical study. Relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. Twenty-six international experts chosen by WHO region with expertise in CP attended the consensus meeting.ResultsOverall, five ICF Core Sets were developed: a Comprehensive Core Set (135 ICF categories); a Common Brief (25 ICF categories); and three age-specific Core Sets: under 6 years (31 ICF categories), from 6 to <14 years (35 ICF categories) and from 14 to 18 years (37 ICF categories).InterpretationThese ICF Core Sets for children and youth with CP are the first ICF-based tools developed for this population. The ICF Core Sets for children and youth with CP can be applied in clinical practice, research, teaching and administration. The application of the ICF Core Sets to this population will standardize the functional assessments of CP worldwide.
    Developmental Medicine & Child Neurology 08/2014; · 2.68 Impact Factor
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    ABSTRACT: Objective: To determine which environmental factors are associated with performance when controlling for capacity, using the International Classification of Functioning, Disability and Health (ICF). Methods: A psychometric study using a sample of 296 persons with musculoskeletal health conditions as a case in point. The following steps were carried out: (i) Rasch analyses created 2 interval measurement scales, capacity and performance, based on 22 Activities and Participation ICF categories that had been rated as capacity and performance. Capacity and performance scores, ranging from 0 (low level) to 100 (high level) were calculated; (ii) group lasso regression was used to identify the environmental factors associated with a person's performance when controlling for capacity. Gender, age and health condition were forced to remain in the model. Results: A capacity scale based on 16 ICF categories (rated as capacity) and a performance scale based on 18 categories (rated as performance) were created. Thirteen environmental factors ICF categories covering the physical, social, attitudinal and political environment were identified as highly associated with patient's performance. Conclusion: Using an exclusively statistical approach this study identified environmental factors associated with a person's performance.
    Journal of Rehabilitation Medicine 07/2014; · 2.13 Impact Factor
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    ABSTRACT: To determine the most robust dimensional structure of the International Classification of Functioning, Disability and Health (ICF) categories relevant to spinal cord injury (SCI) across subgroups of [1] lesion level, [2] health care context, [3] gender, [4] age, and [5] the countries' resources.
    Archives of physical medicine and rehabilitation. 07/2014;
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    ABSTRACT: Background The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) is a comprehensive framework to structure the information obtained in multidisciplinary clinical settings according to the biopsychosocial perspective of the International Classification of Functioning, Disability and Health (ICF) and to guide the treatment and rehabilitation process accordingly. It is now undergoing validation from the user perspective for which it has been developed in the first place.AimsTo validate the content of the Comprehensive ICF Core Set for MS from the perspective of speech and language therapists (SLTs) involved in the treatment of persons with MS (PwMS).Methods & ProceduresWithin a three-round e-mail-based Delphi Study 34 SLTs were asked about PwMS’ problems, resources and aspects of the environment treated by SLTs. Responses were linked to ICF categories. Identified ICF categories were compared with those included in the Comprehensive ICF Core Set for MS to examine its content validity.Outcomes & ResultsThirty-four SLTs named 524 problems and resources, as well as aspects of environment. Statements were linked to 129 ICF categories (60 Body-functions categories, two Body-structures categories, 42 Activities-&-participation categories, and 25 Environmental-factors categories). SLTs confirmed 46 categories in the Comprehensive ICF Core Set. Twenty-one ICF categories were identified as not-yet-included categories.Conclusions & ImplicationsThis study contributes to the content validity of the Comprehensive ICF Core Set for MS from the perspective of SLTs. Study participants agreed on a few not-yet-included categories that should be further discussed for inclusion in a revised version of the Comprehensive ICF Core Set to strengthen SLTs’ perspective in PwMS’ neurorehabilitation.
    International Journal of Language & Communication Disorders 07/2014; · 1.44 Impact Factor
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    ABSTRACT: Study design: Secondary data analysis of a questionnaire-based, cross-sectional survey in persons with spinal cord injury (SCI) in Switzerland. Objective: To describe the frequency of participation in sport (PiS) and to identify correlates for PiS in persons with SCI in Switzerland. Setting: Community sample Methods: Frequency of PiS was assessed retrospectively for the time before the onset of SCI and the time of the survey using a single-item question. A comprehensive set of independent variables was selected from the original questionnaire. Descriptive statistics, bivariate analyses and ordinal regressions were carried out. Results: Data from 505 participants were analyzed. Twenty independent variables were selected for analyses. PiS decreased significantly from the time before the onset of SCI to the time of the survey (P<0.001). Sport levels were significantly lower in women than men for the time of the survey (P<0.001), whereas no difference was observed before onset of SCI (P=0.446). Persons with tetraplegia participated significantly less often in sport than persons with paraplegia (P<0.001). Lesion level, active membership in a club, frequency of PiS before the onset of SCI and the subjective evaluation of the importance of sport correlate with PiS. When controlling for gender differences, only the subjective importance of sport for persons with SCI determines PiS, particularly among women. Conclusions: Persons with tetraplegia and women need special attention when planning interventions to improve PiS. Furthermore, the subjective importance of sport is important for PiS, particularly among women, whereas most other factors were only weakly associated with PiS.
    Spinal Cord 06/2014; · 1.90 Impact Factor
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    ABSTRACT: Study design: Secondary data analysis of a questionnaire-based, cross-sectional survey in persons with spinal cord injury (SCI) in Switzerland. Objective: To describe the frequency of participation in sport (PiS) and to identify correlates for PiS in persons with SCI in Switzerland. Setting: Community sample Methods: Frequency of PiS was assessed retrospectively for the time before the onset of SCI and the time of the survey using a single-item question. A comprehensive set of independent variables was selected from the original questionnaire. Descriptive statistics, bivariate analyses and ordinal regressions were carried out. Results: Data from 505 participants were analyzed. Twenty independent variables were selected for analyses. PiS decreased significantly from the time before the onset of SCI to the time of the survey (P<0.001). Sport levels were significantly lower in women than men for the time of the survey (P<0.001), whereas no difference was observed before onset of SCI (P=0.446). Persons with tetraplegia participated significantly less often in sport than persons with paraplegia (P<0.001). Lesion level, active membership in a club, frequency of PiS before the onset of SCI and the subjective evaluation of the importance of sport correlate with PiS. When controlling for gender differences, only the subjective importance of sport for persons with SCI determines PiS, particularly among women. Conclusions: Persons with tetraplegia and women need special attention when planning interventions to improve PiS. Furthermore, the subjective importance of sport is important for PiS, particularly among women, whereas most other factors were only weakly associated with PiS.
    Spinal Cord 06/2014; · 1.90 Impact Factor
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    ABSTRACT: The aims of the study were (1) to examine the associations between the psychological resources general self-efficacy (GSE) and purpose in life (PIL), appraisals, coping and life satisfaction, and (2) to examine whether the effects of the psychological resources on life satisfaction are mediated by appraisals and coping, as proposed by the spinal cord injury adjustment model (SCIAM).
    Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. 06/2014;
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    ABSTRACT: To determine whether ICF categories relevant to SCI can be integrated in clinical measures and get insights to guide their future operationalization. Specific aims are to find out whether the ICF categories relevant to SCI [1] fit a Rasch model taking into consideration the dimensionality found in previous investigations, [2] show local item dependencies (LID), or [3] differential item functioning (DIF).
    Archives of physical medicine and rehabilitation. 05/2014;
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    ABSTRACT: Visual impairment is associated with important limitations in functioning. The International Classification of Functioning, Disability and Health (ICF) adopted by the World Health Organisation (WHO) relies on a globally accepted framework for classifying problems in functioning and the influence of contextual factors. Its comprehensive perspective, including biological, individual and social aspects of health, enables the ICF to describe the whole health experience of persons with visual impairment. The objectives of this study are (1) to analyze whether the ICF can be used to comprehensively describe the problems in functioning of persons with visual impairment and the environmental factors that influence their lives and (2) to select the ICF categories that best capture self-perceived health of persons with visual impairment.
    Health and Quality of Life Outcomes 05/2014; 12(1):65. · 2.27 Impact Factor
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    ABSTRACT: The Patient-Reported Outcomes Measurement Information System (PROMIS (®) ) is a US National Institutes of Health initiative that has produced self-reported item banks for physical, mental and social health. To describe the content of PROMIS at the item level using the World Health Organization's International Classification of Functioning, Disability and Health (ICF). All PROMIS adult items (publicly available as of 2012) were assigned to relevant ICF concepts. The content of the PROMIS adult item banks was then described using the mapped ICF code descriptors. The 1,006 items in the PROMIS instruments could all be mapped to ICF concepts at the second level of classification, with the exception of three items of global or general health that mapped across the first-level classification of ICF activity and participation component (d categories). Individual PROMIS item banks mapped from 1 to 5 separate ICF codes indicating one-to-one, one-to-many and many-to-one mappings between PROMIS item banks and ICF second-level classification codes. PROMIS supports measurement of the majority of major concepts in the ICF body functions (b) and activity and participation (d) components using PROMIS item banks or subsets of PROMIS items that could, with care, be used to develop customized instruments. Given that the focus of PROMIS is on measurement of person health outcomes, concepts in body structures (s) and some body functions (b), as well as many ICF environmental factor, have minimal coverage in PROMIS. The PROMIS-ICF mapped items provide a basis for users to evaluate the ICF-related content of specific PROMIS instruments and to select PROMIS instruments in ICF-based measurement applications.
    Quality of Life Research 04/2014; · 2.86 Impact Factor
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    ABSTRACT: International Classification of Functioning, Disability and Health (ICF) Core Sets are purposetailored shortlists of ICF categories from the whole ICF classification for describing functioning and disability. Although the 34 ICF Core Sets developed up to now already cover many health conditions, there may still be a need to develop additional ICF Core Sets that tackle other health conditions and address other purposes.This paper provides a detailed description of the standard process for developing ICF Core Sets that will serve as a guide for future ICF Core Sets development projects. ICF Core Sets are developed by means of a threephase, multimethod scientific process. The process involves four preparatory studies-an empirical multicentre study, a systematic literature review, a qualitative study and an expert survey. The results of the preparatory studies serve as the starting point for a structured decisionmaking and consensus process at an international conference, during which participating experts decide on the ICF categories to be included in the Comprehensive and Brief ICF Core Sets. The first version of the ICF Core Sets are then implemented, possibly necessitating modifications for specific applications and settings.
    European journal of physical and rehabilitation medicine 04/2014; · 2.06 Impact Factor
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    ABSTRACT: AimsIn the context of the development of the International Classification of Functioning, Disability and Health (ICF) Core Sets for children and adolescents with cerebral palsy (CP), we investigated the strengths and limitations in functioning important to children with CP, through either child self-reports or caregiver proxy reports, using components of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY).Method We conducted semi-structured interviews with 10 children with CP (children self-reporting), 10 caregivers of children self-reporting (10 child–caregiver dyads), and 12 caregivers of children not self-reporting. Mean age 10y 6mo, range 4–16y. A convenience sample was recruited representing Gross Motor Function Classification System (GMFCS) levels I to V. Interviews were audio-taped and the content covered all of the relevant ICF-CY components. The interviews were then transcribed verbatim and coded in N-Vivo 10 using the ICF-CY coding system.ResultsWe identified 1956 themes that linked to 175 ICF-CY categories. Most of the themes were represented by the ICF-CY components activities and participation and environmental factors. The children interviewed discussed issues related to mobility, self-care, and recreation and leisure, whereas the caregivers focused more on physical limitations and on the environmental factors associated with everyday activities.InterpretationThe children and their caregivers described many of the same areas of functioning but provided unique perspectives. Children talked more frequently about their abilities with CP, whereas the caregivers interviewed talked more about their concern over the limitations and broader issues facing their child. The findings highlight the need to explore the perspectives of both the child and the caregiver when characterizing the functional profile of children with CP.
    Developmental Medicine & Child Neurology 04/2014; · 2.68 Impact Factor
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    ABSTRACT: The World Health Organization (WHO) has argued that functioning, and, more concretely, functioning domains constitute the operationalization that best captures our intuitive notion of health. Functioning is, therefore, a major public-health goal. A great deal of data about functioning is already available. Nonetheless, it is not possible to compare and optimally utilize this information. One potential approach to address this challenge is to propose a generic and minimal set of functioning domains that captures the experience of individuals and populations with respect to functioning and health. The objective of this investigation was to identify a minimal generic set of ICF domains suitable for describing functioning in adults at both the individual and population levels. We performed a psychometric study using data from: 1) the German National Health Interview and Examination Survey 1998, 2) the United States National Health and Nutrition Examination Survey 2007/2008, and 3) the ICF Core Set studies. Random Forests and Group Lasso regression were applied using one self-reported general-health question as a dependent variable. The domains selected were compared to those of the World Health Survey (WHS) developed by the WHO. Seven domains of the International Classification of Functioning, Disability and Health (ICF) are proposed as a minimal generic set of functioning and health: energy and drive functions, emotional functions, sensation of pain, carrying out daily routine, walking, moving around, and remunerative employment. The WHS domains of self-care, cognition, interpersonal activities, and vision were not included in our selection. The minimal generic set proposed in this study is the starting point to address one of the most important challenges in health measurement - the comparability of data across studies and countries. It also represents the first step in developing a common metric of health to link information from the general population to information about sub-populations, such as clinical and institutionalized populations.
    BMC Public Health 03/2014; 14(1):218. · 2.08 Impact Factor
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    ABSTRACT: Lived health is a person's level of functioning in his or her current environment and depends both on the person's environment and biological health. Our study addresses the question whether biological health or lived health is more predictive of self-reported general health (SRGH). This is a psychometric study using cross-sectional data from the Spanish Survey on Disability, Independence and Dependency Situation. Data was collected from 17,739 people in the community and 9,707 from an institutionalized population. The following analysis steps were performed: (1) a biological health and a lived health score were calculated for each person by constructing a biological health scale and a lived health scale using Samejima's Graded Response Model; and (2) variable importance measures were calculated for each study population using Random Forest, with SRGH as the dependent variable and the biological health and the lived health scores as independent variables. The levels of biological health were higher for the community-dwelling population than for the institutionalized population. When technical assistance, personal assistance or both were received, the difference in lived health between the community-dwelling population and institutionalized population was smaller. According to Random Forest's variable importance measures, for both study populations, lived health is a more important predictor of SRGH than biological health. In general, people base their evaluation of their own health on their lived health experience rather than their experience of biological health. This study also sheds light on the challenges of assessing biological health and lived health at the general population level.
    BMC Public Health 02/2014; 14(1):189. · 2.08 Impact Factor
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    ABSTRACT: The Patient Reported Outcomes Measurement Information System (PROMIS (®) ) is a US National Institutes of Health initiative that has produced self-report outcome measures, using a framework of physical, mental, and social health defined by the World Health Organization in 1948 (WHO, in Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 1948). The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is a comprehensive classification system of health and health-related domains that was put forward in 2001. The purpose of this report is to compare and contrast PROMIS and ICF conceptual frameworks to support mapping of PROMIS instruments to the ICF classification system . We assessed the objectives and the classification schema of the PROMIS and ICF frameworks, followed by content analysis to determine whether PROMIS domain and sub-domain level health concepts can be linked to the ICF classification. Both PROMIS and ICF are relevant to all individuals, irrespective of the presence of health conditions, person characteristics, or environmental factors in which persons live. PROMIS measures are intended to assess a person's experiences of his or her health, functional status, and well-being in multiple domains across physical, mental, and social dimensions. The ICF comprehensively describes human functioning from a biological, individual, and social perspective. The ICF supports classification of health and health-related states such as functioning, but is not a specific measure or assessment of health, per se. PROMIS domains and sub-domain concepts can be meaningfully mapped to ICF concepts. Theoretical and conceptual similarities support the use of PROMIS instruments to operationalize self-reported measurement for many body function, activity and participation ICF concepts, as well as several environmental factor concepts. Differences observed in PROMIS and ICF conceptual frameworks provide a stimulus for future research and development.
    Quality of Life Research 02/2014; · 2.86 Impact Factor
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    ABSTRACT: The burden of disease in patients with ankylosing spondylitis (AS) can be considerable. However, no agreement has been reached among expert members of Assessment of SpondyloArthritis International Society (ASAS) to define severity of AS. Based on the International Classification of Functioning, Disability and Health (ICF), a core set of items for AS has been selected to represent the entire spectrum of possible problems in functioning. Based on this, the objective of this study was to develop a tool to quantify health in AS, the ASAS Health Index. First, based on a literature search, experts' and patients' opinion, a large item pool covering the categories of the ICF core set was generated. In several steps this item pool was reduced based on reliability, Rasch analysis and consensus building after two cross-sectional surveys to come up with the best fitting items representing most categories of the ICF core set for AS. After the first survey with 1754 patients, the item pool of 251 items was reduced to 82. After selection by an expert committee, 50 items remained which were tested in a second cross-sectional survey. The results were used to reduce the number of items to a final set of 17 items. This selection showed the best reliability and fit to the Rasch model, no residual correlation, and absence of consistent differential item function and a Person Separation Index of 0.82. In this long sequential study, 17 items which cover most of the ICF core set were identified that showed the best representation of the health status of patients with AS. The ASAS Health Index is a linear composite measure which differs from other measures in the public domain.
    Annals of the rheumatic diseases 01/2014; · 8.11 Impact Factor

Publication Stats

5k Citations
611.56 Total Impact Points

Institutions

  • 2013–2014
    • University of Southampton
      • Faculty of Social and Human Sciences
      Southampton, England, United Kingdom
  • 2002–2014
    • Ludwig-Maximilians-University of Munich
      • • Department of Medical Informatics
      • • Department of Physical Medicine and Rehabilitation
      • • Institute of Medical Psychology (IMP)
      München, Bavaria, Germany
  • 2010–2013
    • University of British Columbia - Vancouver
      • Department of Pediatrics
      Vancouver, British Columbia, Canada
    • Fondazione Don Carlo Gnocchi
      Milano, Lombardy, Italy
    • McGill University
      • School of Physical and Occupational Therapy
      Montréal, Quebec, Canada
  • 2012
    • Oslo University Hospital
      • Department of Physical Medicine and Rehabilitation
      Oslo, Oslo, Norway
    • Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta
      • Division of Neurology IV - Neuro-Immunology and Neuromuscular Diseases
      Milano, Lombardy, Italy
    • Munich University of Applied Sciences
      • Department of Applied Social Sciences
      München, Bavaria, Germany
  • 2008–2012
    • Swiss Paraplegic Research Group
      Nottwil, Lucerne, Switzerland
    • University of Geneva
      Genève, Geneva, Switzerland
  • 2011
    • Swiss Paraplegic Centre
      Nottwil, Lucerne, Switzerland
  • 2010–2011
    • Universidad Autónoma de Madrid
      • Departamento de Psiquiatria
      Madrid, Madrid, Spain
  • 2005–2011
    • Medical University of Vienna
      • Department of Medicine II
      Wien, Vienna, Austria
  • 2004–2011
    • Hannover Medical School
      Hanover, Lower Saxony, Germany
    • Universität Ulm
      Ulm, Baden-Württemberg, Germany
  • 2004–2010
    • Servicio de Salud del Principado de Asturias (SESPA)
      Oviedo, Asturias, Spain
  • 2008–2009
    • Haute école de santé Genève
      Genève, Geneva, Switzerland
  • 2007–2008
    • Diakonhjemmet Hospital (Norway)
      Kristiania (historical), Oslo County, Norway
    • Fondazione Salvatore Maugeri IRCCS
      • Servizio di Psicologia (Nervi)
      Ticinum, Lombardy, Italy
    • Technische Universität München
      • Faculty of Medicine
      München, Bavaria, Germany
  • 2005–2007
    • German Institute Of Medical Documentation And Information
      Köln, North Rhine-Westphalia, Germany