Enhanced informed decision-making in the health system: ICF as a standard for reporting functioning information Prodinger B1,2, Tennant A1,2, Brinkhof M1,Bickenbach J1,2, Cieza A1,2,4,5, Stucki G1,2,3 1Swiss Paraplegic Research, Switzerland; 2ICF Research Branch in Cooperation with WHO-FIC Centre (at DIMDI) in Germany, Nottwil, Switzerland; 3Department of Health Sciences & Health Policy, University of Lucerne, Switzerland; 4Faculty of Health and Social Sciences, University of Southampton, UK; 5Institute for Public Health and Health Care Research, Ludwig-Maximilians University, Germany.

Background Optimizing functioning is an important outcome in clinical practice and public health. Availability of functioning information is essential for planning interventions and allocating resources at individual and population level. Functioning information is already collected with various methods in health and its related systems.  A system that builds upon existing data collection processes and integrates existing practices of data collection into a unified framework is needed to ensure comparability of functioning information.

Toward standardized reporting of functioning information Questions to be answered Specification of elements for reporting Relevant tools and methods What to assess? ICF categories ICF Core Sets How to assess? Existing methods and modes for data collection ICF Linking Rules How to report? Standardized units: Range from 0 to 100 Rasch measurement model Questions to be answered Specification of elements for reporting Relevant tools and methods What to assess? ICF categories ICF Core Sets How to assess? Existing methods and modes for data collection ICF Linking Rules How to report? Standardized units: Range from 0 to 100 Rasch measurement model Questions to be answered Specification of elements for reporting Relevant tools and methods What to assess? ICF categories ICF Core Sets How to assess? Existing methods and modes for data collection ICF Linking Rules How to report? Standardized units: Range from 0 to 100 Rasch measurement model Questions to be answered Specification of elements for reporting Relevant tools and methods What to assess? ICF categories ICF Core Sets How to assess? Existing methods and modes for data collection ICF Linking Rules How to report? Standardized units: Range from 0 to 100 Rasch measurement model (Selb et al. 2014) (Cieza et al. 2002; Cieza et al. 2005) (Tennant & Conaghan, 2007)

Swiss Spinal Cord Injury Cohort Study (SwiSCI) as a case in point International Classification of Functioning, Disability and Health (ICF) Existing health instruments Select ICF Core Set(s) ICF Generic and Disability Set Brief ICF Core Set for SCI – Early post-acute Setting Brief ICF Core Set for SCI – Long-term Setting Link information to the ICF ICF Category Item included in SwiSCI Response format b130 Energy and drive functions Fatigue Polytomous (0 insignificant problem to 3 chronic problem) b134 Sleep functions Spinal cord injury secondary condition scale (SCI-SCS) Dichotomous b152 Emotional functions Mental health subscale of the SF-36 Polytomous (1 All of the time to 6 None of the time) Identify ICF categories Co-calibration of items along a common metric while maintaining structure of ICF Rasch Measurement Model Standardized units: Range from 0 to 100 4

Swiss Spinal Cord Injury Cohort Study (SwiSCI) as a case in point Illustration of operationalization of b1 Mental functions by integrating items from various existing instruments

Conclusion We have illustrated one approach toward developing a system for standardized reporting of functioning which builds upon existing methods for data collection. enables comparability of functioning information based on the ICF. enhances comprehensive, reliable and understandable foundation for decision making at all levels of health its related systems. Acknowledgments: The authors would like to acknowledge the extensive support of Carolina Saskia Ballert in this project.

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