Towards comprehensive and transparent reporting: context-specific additions to the ICF taxonomy for medical evaluations of work capacity involving claimants with chronic widespread pain and low back pain

BMC Health Services Research

Bruno Trezzini³  Alarcos Cieza²  Wout De Boer¹  Mirjam Brach³  Andrea Glässel³  Jessica Anner¹  Urban Schwegler⁴ 

[1] asim, Academy of Swiss Insurance Medicine, University Hospital Basel, Basel, Switzerland;Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton S017 1BJ, UK;Swiss Paraplegic Research (SPF), Nottwil, Switzerland;Department of Health Sciences and Health Policy, University of Lucerne and SPF, Nottwil, Switzerland

关键词: Context-specific additions;    Low back pain;    Chronic widespread pain;    Disability evaluation;    Medical evaluation of work capacity;    Disability and Health (ICF);    International Classification of Functioning;   

Others  :  1126628
DOI  :  10.1186/1472-6963-14-361

 received in 2013-11-18, accepted in 2014-08-20,  发布年份 2014

【 摘 要 】

Background

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).

Methods

A retrospective content analysis of Swiss medical reports was conducted by using the ICF for data coding. Concepts not appropriately classifiable with ICF categories were labeled as specification categories (i.e. context-specific additions) and were assigned to predefined specification areas (i.e. precision, coverage, personal factors, and broad concepts). Relevant specification categories for medical evaluations of work capacity involving CWP and LBP were determined by calculating their relative frequency across reports and setting a relevance threshold.

Results

Forty-three specification categories for CWP and fifty-two for LBP reports passed the threshold. In both groups of reports, precision was the most frequent specification area, followed by personal factors.

Conclusions

The ICF taxonomy represents a universally applicable standard for reporting health and functioning information. However, when applying the ICF for comprehensive and transparent reporting in medical evaluations of work capacity involving CWP and LBP context-specific additions are needed. This is particularly true for the documentation of specific pain-related issues, work activities and personal factors. To ensure the practicability of the multidisciplinary evaluation process, the large number of ICF categories and context-specific additions necessary for comprehensive documentation could be specifically allocated to the disciplines in charge of their assessment.

【 授权许可】

   
2014 Schwegler et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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