Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc A systematic review of ICF Core Sets Towards an evidence-based assessment of work capacity Authors: Johan Sengers¹ ², Femke Abma¹ ², Loes Wilming¹ ², Yvonne Heerkens ³, Sandra Brouwer¹ ² ¹ University Medical Center Groningen ² Dutch Research Center for Insurance Medicine ³ HAN University of Applied Sciences Nijmegen, the Netherlands EUMASS conference 2016, Ljubljana 1

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Conflict of interest Disclosure Name: J.H. Sengers I have no potential conflict of interest to report 2

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Background A new assessment Aim is to assess claimant’s abilities to actively participate in the labor market 3

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Aim of present study To identify important ICF factors for assessing abilities for participation or functioning by studying ICF coresets 4

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc What is an ICF core set? selection of essential ICF categories (> 1400) most relevant for describing functioning within a specific health condition or context

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Development of a core set

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Methods Systematic review Search strategy in Medline, PsycInfo and Web of Science Inclusion of papers ICF core sets working age population (18-65 years) broad perspective 7

Search results hits 260 full text 29 core sets 27 disease specific 2 work related

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Core sets on Health Conditions Neurological conditions Cardiovascular and respiratory conditions Musculoskelatal conditions Mental conditions Cancers 9

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Personal factors -- Mental conditions Mental disorder; Bipolar disorder; Depression Participation d710 Basic interpersonal interactions d720 Complex interpersonal interactions d730 Relating with strangers d750 Social relationships d760 Family relationships d770 Intimate relationships d845 Acquiring, keeping and terminating a job d850 Remunerative employment d870 Economic self-sufficiency d910 Community life d920 Recreation and leisure Body functions b126 Temperament and personality functions b130 Energy and drive functions b134 Sleep functions b140 Attention functions b144 Memory functions b147 Psychomotor functions b152 Emotional functions b160 Thought functions b280 Sensation of pain b530 Weight maintenance functions Body structures -- Activities d175 Solving problems d177 Making decisions d210 Undertaking a single task d220 Undertaking multiple tasks d230 Carrying out daily routine d240 Handling stress and other psychological demands d350 Conversation d470 Using transportation d475 Driving d570 Looking after one’s health d620 Acquisition of goods and services d640 Doing housework Environmental factors e110 Products or substances for personal consumption e310 Immediate family e320 Friends e355 Health professionals e410 Individual attitudes of immediate family members e420 Individual attitudes of friends e450 Individual attitudes of health professionals e460 Societal attitudes e570 Social security services, systems and policies e580 Health services, systems and policies 10 E310 Immediate family E320 Friends E355 Health professionals

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Results 11

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Personal factors -- Mental conditions Mental disorder; Bipolar disorder; Depression Participation d710 Basic interpersonal interactions d720 Complex interpersonal interactions d730 Relating with strangers d750 Social relationships d760 Family relationships d770 Intimate relationships d845 Acquiring, keeping and terminating a job d850 Remunerative employment d870 Economic self-sufficiency d910 Community life d920 Recreation and leisure Body functions b126 Temperament and personality functions b130 Energy and drive functions b134 Sleep functions b140 Attention functions b144 Memory functions b147 Psychomotor functions b152 Emotional functions b160 Thought functions b280 Sensation of pain b530 Weight maintenance functions Body structures -- Activities d175 Solving problems d177 Making decisions d210 Undertaking a single task d220 Undertaking multiple tasks d230 Carrying out daily routine d240 Handling stress and other psychological demands d350 Conversation d470 Using transportation d475 Driving d570 Looking after one’s health d620 Acquisition of goods and services d640 Doing housework Environmental factors e110 Products or substances for personal consumption e310 Immediate family e320 Friends e355 Health professionals e410 Individual attitudes of immediate family members e420 Individual attitudes of friends e450 Individual attitudes of health professionals e460 Societal attitudes e570 Social security services, systems and policies e580 Health services, systems and policies 12

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Non specified health condition Vocational Rehabilitation Activities d155 Acquiring skills d160 Focusing attention, thinking, reading d163 Thinking d166 Reading d170 Writing d172 Calculating d175 Solving problems d177 Making decisions d210 Undertaking a single task d220 Undertaking multiple tasks d230 Carrying out daily routine d240 Handling stress and other psychological demands d310 Communicating with- receive- spoken messages d315 Communicating with- receiving- non-verbal messages Body functions b117 Intellectual functions b126 Temperament and personality functions b130 Energy and drive functions b134 Sleep functions b140 Attention functions b144 Memory functions b152 Emotional function b160 Thought functions b164 Higher level cognitive functions b210 Seeing functions b230 Hearing functions b235 Vestibular functions b280 Sensation of pain b455 Excercise tolerance functions b730 Muscle power functions b740 Musle endurance functions b810 Protective functions of the skin Environmental factors e110 Products or substances for personal consumption e115 Products and technology for personal use in daily live e120 Products and technology for personal indoor and outdoor mobility transportation e125 Products and technology for communication e130 Products and technology for education e135 Products and technology for employment e150 Design, construction and building products and technology of buildings for public use e155 Design, construction and building products and technology of buildings for private use Participation d710 Basic interpersonal interactions d720 Complex interpersonal interactions d740 Formal relationships d820 School education d825 Vocational learning d830 Higher education d840 Apprenticeship (work preparation) d845 Acquiring, keeping and terminating a job d850 Remunerative employment d855 Non-renumerative employment d870 Economic self-sufficiency d350 Conversation d360 Using communication devices and techniques d410 Changing basic body position d415 Maintaining a body position d430 Lifting and carrying objects d435 Moving objects with the lower extremities d440 Fine hand use d445 Hand and arm use d450 Walking d455 Moving around d465 Moving around using equipment d470 Using transportation d475 Driving d530 Toileting d540 Dressing d570 Looking after one’s health e310 Immediate family e320 Friends e325 Acquaintances, peers, colleagues e330 People in positions of authority e340 Personal care providers and personal assistants e355 Health Professionals e360 Health related professionals e430 Individual attitudes of people in positions of authority e450 Individual attitudes of health professionals e460 Societal attitudes e465 Social norms e525 Housing services, systems and policies e535 Communication services, systems and policies e540 Transportation services e550 Legal services, systems and policies e555 Associations and organizational services e565 Economic services, systems and policies e570 Social security services e580 Health services e585 Education and training services, systems and policies e590 Labour and employment services, systems and policies 13

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Disability evaluation claimantimpairment benefit disability evaluation No benefit

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Disability Evaluation (DE) Developed for functional assessment in DE Intended for the evaluation of rights to benefits Body functions b164 Higher level cognitive functions b280 Sensation of pain b455 Exercise tolerance functions b710 Mobility of joint functions b730 Muscle power functions Activities d110 Watching d115 Listening d155 Acquiring skills d177 Making decisions d220 Undertaking multiple tasks d240 Handling stress d399 Communication, unspecified d410 Changing body position d415 Maintaining a body position d430 Lifting and carrying objects D440 Fine hand use D445 Hand and arm use D450 Walking D470 Using transportation Participation d720 Complex interpersonal interactions

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Conclusions The disease specific core sets are not work oriented Work related core sets are not sufficient –DE is more oriented on the benefit –VR is too generic to associate with the disease 16

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc An extension in the assessment claimantimpairment remaining abilities disability evaluation participation in work

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Next step To enrich the disease specific core sets, structured by health conditions, with more work related factors

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Johan 19 Thank you for your attention

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Background Shift in focus from assessing disabilities towards promoting active participation in work for claimants in social insurance setting New measures for participation oriented assessments in a social security setting are required ICF as a helpful framework 20

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc 21

Disorder Body functions & Structures Activities Participation External factors Specific Environmental factors Conditions and solutions in work and work environment Personal factors Occupational Assessor Insurance Physician 22

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc Criteria full text Excluded N = 227 Criteria abstract 23

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc 24

Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc 25

Social Security Setting Claimant for a (social) benefit Disability evaluation Inducement is an impairment Limitations in activities Restrictions in participation in work Focus on optimizing abilities for participation of functioning in work 26