Tevfik Bedirhan Ustun

Koc University · School of Medicine

Background The most common treatment for major depressive disorder (MDD) is antidepressant medication (ADM). Results are reported on frequency of ADM use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries. Methods Face-to-face interviews with community samples totaling n = 49 919 respondents in t...

Objective This paper introduces a novel method to evaluate the local impact of behavioral scenarios on disease prevalence and burden with representative individual level data while ensuring that the model is in agreement with the qualitative patterns of global relative risk (RR) estimates. The method is used to estimate the impact of behavioral sce...

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 differe...

Background: Contemporary casemix systems for health services need to ensure that payment rates adequately account for actual resource consumption based on patients' needs for services. It has been argued that functioning information, as one important determinant of health service provision and resource use, should be taken into account when develo...

Objective: To develop a comprehensive set of the International Classification of Functioning, Disability and Health (ICF) categories as a minimal standard for reporting and assessing functioning and disability in clinical populations along the continuum of care. The specific aims were to specify the domains of functioning recommended for an ICF Re...

The World Health Organization (WHO) plans to submit the 11th revision of the International Classification of Diseases (ICD) to the World Health Assembly in 2018. The WHO is working toward a revised classification system that has an enhanced ability to capture health concepts in a manner that reflects current scientific evidence and that is compatib...

Due to fundamental differences in design and editorial policies, semantic interoperability between two de facto standard terminologies in the healthcare domain – the International Classification of Diseases (ICD) and SNOMED CT (SCT), requires combining two different approaches: (i) axiom-based, which states logically what is universally true, using...

Semantic Interoperability, i.e., Preserving the meaning among health related data, is one of the crucial topics of Health Informatics. The International Classification of Diseases by WHO and SNOMED-CT, by IHTSDO, are the most prominent systems currently available for coding health data. In 2010 a collaboration agreement between the maintainers of I...

This is a follow-up of the special report Towards the joint use of ICD and ICF: A call for contribution, published by the Journal of Rehabilitation Medicine in 2012, which introduced an initiative of using the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF) in a complem...

Background: 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. Methods: We analysed representative samples aged 50 to...

The upcoming ICD-11 will be harmonized with SNOMED CT via a common ontological layer (CO). We provide evidence for our hypothesis that this cannot be appropriately done by simple ontology alignment, due to diverging ontological commitment between the two terminology systems. Whereas the common ontology describes clinical situations, ICD-11 lineariz...

The improvement of semantic interoperability between data in electronic health records and aggregated data for health statistics requires efforts to carefully align the two domain terminologies ICD and SNOMED CT. Both represent a new generation of ontology-based terminologies and classifications. The proposed alignment of these two systems and, in...

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, Disabili...

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 C...

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 a...

In the beta phase of the 11th revision of International Classification of Diseases (ICD-11), the World Health Organization (WHO) exposes ICD-11 content through a collection of web services. The emerging Common Terminology Services 2 (CTS2) standard provides a common model and semantics for representation, interchange, and federation of terminologic...

To assess the relationship of posttraumatic stress disorder (PTSD) with health functioning and disability in Vietnam-era Veterans. A cross-sectional study of functioning and disability in male Vietnam-era Veteran twins. PTSD was measured by the Composite International Diagnostic Interview; health functioning and disability were assessed using the V...

This paper outlines the approach that the WHO's Family of International Classifications (WHO-FIC) network is undertaking to create ICD-11. We also outline the more focused work of the Quality and Safety Topic Advisory Group, whose activities include the following: (i) cataloguing existing ICD-9 and ICD-10 quality and safety indicators; (ii) reviewi...

Objective Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it...

To understand the full burden of a health condition, we need the information on the disease and the information on how that disease impacts the functioning of an individual. The ongoing revision of the International Classification of Diseases (ICD) provides an opportunity to integrate functioning information through the International Classification...

In order to support semantic interoperability in eHealth systems, domain terminologies need to be carefully designed. SNOMED CT and the upcoming ICD-11 represent a new generation of ontology-based terminologies and classifications. The proposed alignment of these two systems and, in consequence, the validity of their cross-utilisation requires a th...

Classification revision and update can be defined as a social experience, with the participating community of experts behaving like a social network. ICD11 is being revised using an innovative web based process, for which we envisioned also tools for social platforms integration. The present poster preliminarily describes the Facebook tools develop...

Purpose: How many people with disabilities are in the world? How is disability defined? How can we measure disability in an accurate and comparable way? These are some of the key questions which the recently published World Bank/WHO World Report on Disability (WRD) addresses. Method: Multiple data sources and methods were used by WHO and the Wor...

The methodology commonly used to estimate disease burden, featuring ratings of severity of individual conditions, has been criticized for ignoring co-morbidity. A methodology that addresses this problem is proposed and illustrated here with data from the World Health Organization World Mental Health Surveys. Although the analysis is based on self-r...

Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the World Health Organization World Mental Health S...

A person’s functioning is conceived as a dynamic interaction between the individual’s health condition and contextual factors, according to the World Health Organization’s International Classification of Functioning Disability and Health (ICF) (WHO 2001). For reactive disorders, contextual factors are the sine qua non for establishing a diagnosis o...

Context: Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. Objective: To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the World Health Organization W...

The impact of disease on functioning is the essential information for clinicians when reporting on health problems of individuals. The International Classification of Functioning, Disability and Health (ICF) is a comprehensive and universally accepted model to classify and describe functioning, disability and health in a systematic way. The objecti...

The World Health Organization (WHO) is well under way with the new revision of the International Classification of Diseases (ICD-11). The current revision process is significantly different from past ones: the ICD-11 authoring is now open to a large international community of medical experts, who perform the authoring in a web-based collaborative p...

OBJECTIVE: To describe the development of the World Health Organizatiosn Disability Assessment Schedule 2.0 (WHODAS 2.0) for measuring functioning and disability in accordance with the International Classification of Functioning, Disability and Health. WHODAS 2.0 is a standard metric for ensuring scientific comparability across different population...

Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. National...

To describe the development of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for measuring functioning and disability in accordance with the International Classification of Functioning, Disability and Health. WHODAS 2.0 is a standard metric for ensuring scientific comparability across different populations. A series...

The World Health Organization is currently developing the 11th revision of the International Classification of Diseases (ICD-11). ICD is the standard diagnostic classification used in health care all over the world. In contrast to previous ICD revisions that did not have a formal representation and were mainly available as printed books, ICD-11 use...

This review provides an overview of the literature on the conceptualisation of the Personal Factors (PF) component of the International Classification of Functioning, Disability and Health (ICF). A systematic literature review was carried out. Electronic searches were performed in Pubmed, Embase, PsycINFO, CINAHL and SSCI. Qualitative content analy...

To propose the joint use of the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF) and to illustrate this proposal using musculoskeletal (MSK) conditions. In light of the MSK conditions as classified in the ICD, categories from existing ICF core sets for MSK conditions wer...

People may suffer from diseases and a variety of health conditions, but a full understanding of the experience of their health condition also requires comprehensive information about the impact of the disease or the health condition on the person. This article operationalises the impacts of health conditions as classified in the International Class...

To examine the construct validity of the International Classification of Functioning Disability and Health (ICF) framework using multidimensional item response modelling and data collected in different regions from patients with five chronic health conditions. We assume that the ICF components should represent statistically called dimensions that a...

MHADIE project (Measuring Health and Disability in Europe: Supporting policy development) aimed at developing realistic, evidence-based and effective national policies for persons with disabilities. A preliminary step towards this goal was the demonstration on the feasibility of employing the ICF in clinical, educational and statistical fields, whi...

Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 cou...

The World Health Organization Disability Assessment Schedule (WHODAS 2.0) measures disability due to health conditions including diseases, illnesses, injuries, mental or emotional problems, and problems with alcohol or drugs. The 12 Item WHODAS 2.0 was used in the second Australian Survey of Mental Health and Well-being. We report the overall facto...

In 2005 the National Center for Public Health Informatics (NCPHI) was created and the first five US-based Centers of Excellence in Public Health Informatics were funded by CDC to advance the science of informatics in public health practice and to engage in collaborative development of state-of-the art information systems in partnership with public...

Summary This article reviews the key issues arising in the revision of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) from a mental health perspective, and describes the work of the Disability Working Group of the WHO's Division of Mental Health. The ICIDH, which describes the consequences of disorders at three...

The formulation of disability (or "functional impairment") is currently not operationalized in either the ICD or the DSM. In the DSM system, making a diagnosis depends on a conjoint assessment of symptoms and functioning, whereas the ICD keeps the disability construct separate from the diagnosis of mental disorders. We need an internationally agree...

To explore whether it is possible to construct clinical measures of functioning by integrating information obtained across the categories of the International Classification of Functioning, Disability, and Health (ICF) using the ICF Core Set of osteoarthritis (OA) as a case in point. Psychometric study using data from 437 patients with OA from Germ...

To exemplify the construction of interval scales for specified categories of the International Classification of Functioning, Disability and Health (ICF) by integrating items from a variety of patient-oriented instruments. Psychometric study using data from a convenience sample of 122 patients with rheumatoid arthritis. Patients completed six diffe...

IntroductionRevision of the ICDObjectives of the ICD Revision ProcessMethods Conclusion: Future StepsReferences

The paper reviews recent findings from the WHO World Mental Health (WMH) surveys on the global burden of mental disorders. The WMH surveys are representative community surveys in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, distribution, burden, and unmet need for treatment of...

The paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health polic...

If we aim towards a comprehensive understanding of human functioning and the development of comprehensive programs to optimize functioning of individuals and populations we need to develop suitable measures. The approval of the International Classification, Disability and Health (ICF) in 2001 by the 54th World Health Assembly as the first universal...

Advocates of expanded mental health treatment assert that mental disorders are as disabling as physical disorders, but little evidence supports this assertion. To establish the disability and treatment of specific mental and physical disorders in high-income and low- and middle-income countries. Community epidemiological surveys were administered i...

The purpose of this EU funded project is to describe a short and medium term Research and Deployment Roadmap for Semantic Interoperability in e-health. It started by defining 4 levels and 3 dimensions for Semantic Interoperability. The vision is to reconcile the needs for the direct patient care safety, biomedical and clinical research and for publ...

With the International Classification of Functioning, Disability and Health (ICF), we can now rely on a globally agreed-upon framework and system for classifying the typical spectrum of problems in the functioning of persons given the environmental context in which they live. ICF Core Sets are subgroups of ICF items selected to capture those aspect...

Due to the increasing importance of quality of life assessments in obstructive sleep apnea (OSA) patients and due to an increased use of the International Classification of Functioning, Disability and Health (ICF), for comparative purposes it is essential to understand the relationship between health-related quality of life (HRQOL) instruments and...

Having spent a considerable amount of time thinking about the uses of large-scale descriptive psychiatric epidemiological needs assessment surveys in our capacity as co-directors of the World Health Organization's World Mental Health Survey Initiative, we agree with many of the conclusions of Henderson and Andrews. Most importantly, we agree: ∘ tha...

Data are presented on the lifetime prevalence, projected lifetime risk, and age-of-onset distributions of mental disorders in the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Face-to-face community surveys were conducted in seventeen countries in Africa, Asia, the Americas, Europe, and the Middle East. The combined numbers o...

Data are presented on patterns of failure and delay in making initial treatment contact after first onset of a mental disorder in 15 countries in the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Representative face-to-face household surveys were conducted among 76,012 respondents aged 18 and older in Belgium, Colombia, Franc...

There is limited information that accounts for comorbidity on the impact of role disability associated with a wide range of mental and physical disorders in population-based samples. To estimate the comparative effects of common mental and physical conditions on role disability in the general population using a novel method that accounts for comorb...

Depression is an important public-health problem, and one of the leading causes of disease burden worldwide. Depression is often comorbid with other chronic diseases and can worsen their associated health outcomes. Few studies have explored the effect of depression, alone or as a comorbidity, on overall health status. The WHO World Health Survey (W...

The concept of the Family of International Classifications has been created to have a common framework and language to report, compile, use, and compare health information at the national and international level. The family brings together different health classifications dealing with various dimensions of health and health care so as to present a...

The aim of this article is to review recent epidemiological research on age-of-onset of mental disorders, focusing on the WHO World Mental Health surveys. Median and inter-quartile range (IQR; 25th-75th percentiles) of age-of-onset is much earlier for phobias (7-14, IQR 4-20) and impulse-control disorders (7-15; IQR 4-35) than other anxiety disorde...

This paper discusses the description of attention-deficit/hyperactivity disorder (ADHD) as a possible "disease entity" and the "disabilities" associated with it. It builds on the nosological descriptions of ADHD from International Classification of Disease (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM) perspectives and introd...

To present an overview of the World Health Organization World Mental Health (WMH) Survey Initiative. The discussion draws on knowledge gleaned from the authors' participation as principals in WMH. WMH has carried out community epidemiological surveys in more than two dozen countries with more than 200,000 completed interviews. Additional surveys ar...

Despite growing interest in adult attention deficit hyperactivity disorder (ADHD), little is known about its prevalence or correlates. A screen for adult ADHD was included in a probability subsample (N=3,199) of 18-44-year-old respondents in the National Comorbidity Survey Replication, a nationally representative household survey that used a lay-ad...

The International Classification of Functioning, Disability and Health (ICF) is the framework developed by WHO to describe functioning and disability at both the individual and population levels.While condition-specific ICF Core Sets are useful, a Generic ICF Core Set is needed to describe and compare problems in functioning across health condition...

interventions. The extension of the Finnish Diabetes Prevention Study suggests that the benefi ts of intensive lifestyle intervention are sustained for many years after the intervention period (unpublished data). 13 Overall, despite the impressive risk reduction for progression to diabetes, the lack of data on long-term benefi ts and side-eff ects,...

Outcome research seeks to understand the end results of health services. Researchers use a wide variety of outcome measures including technical, clinical and patient-oriented measures. The International Classification of Functioning, Disability and Health (ICF) as a common reference framework for functioning may contribute to improved outcome resea...