Candice L. Osborne

IP173. Content Assessment of Health Status Measures for Intermittent Claudication Using the International Classification of Functioning, Disability and Health

Methods: Complex TAAA without a feasible conventional surgical repair were prospectively evaluated by expert vascular surgeons of the same health public provider (National Health System) dislocated in a huge area of 22,994 km with 3.7 million of inhabitants and 11 tertiary hospitals. Surgeons evaluated computed tomography scans and clinical details, which were placed on a Web platform (Google Drive, Calif) and shared to all surgeons. Patients give informed consent for the teleconsultation. The surgeon who submitted a case discusses in detail his or her case and prospects for a possible therapeutical strategy. The other surgeons suggest other solutions and options in terms of grafts, techniques, or access to be used. Angiographic and clinical outcomes of cases are then presented at the following telemeetings, and a final agreement of the operative strategy is evaluated. Teleconsultation is performed using a Web conference service (web.conference.com; Avaya Inc, Basking Ridge, NJ) with a monthly appointment. Results: The rate of participation was constant (mean surgeons, 11 [range, 9-15]). Twenty-four complex TAAAs were discussed for the difficult planning and/or operation during the study period. The concordance for planning and therapeutic strategy among all participants was complete in 16 cases; in one case, the consultation was decisive for creating an innovative therapeutic strategy, while in the remaining five cases, the strategy proposed by the patient’s tutor was changed completely following the discussion. A surgical team composed by surgeons from different centers performed two of the 24 procedures. Conclusions: Such a regional service of teleconsulation may be of value in standardizing the treatment and derived costs of complex TAAAs in a huge region under the same health provider. The shared decision-making strategy may be of medical legal value as well.

The Burn Model Systems outcome measures : a content analysis using the International Classification of Functioning, Disability, and Health

Abstract Background: The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Burn Injury Model Systems (BMS) is a nationwide database that uses patient-reported outcome measures to collect data. Though the outcome measures demonstrate good psychometric properties, the question remains whether or not these measures collect data that encompass the entire experience of burn patients over time. Methods: Each meaningful concept included in the BMS assessments was linked to the International Classification of Functioning, Disability and Health (ICF) in order to classify and describe the content of each measure. The linking was completed by two experienced coders. The perspective of each assessment was also determined. Results: The body function component was most frequently addressed overall followed by the activities and participation component. The component body structures and environmental factors are not extensively covered in the BMS assessments. ICF chapter and category distribution varied greatly between assessments. The assessments were of the health status perspective. Conclusion: This study suggests a need to revisit the item composition of the BMS assessments to more evenly distribute ICF topics and subtopics that are pertinent to burn injury which will ensure a broader but more precise understanding of burn injury recovery. Implications for Rehabilitation A better understanding of the data collected through the Burn Model Systems (BMS) project may contribute to improve data collection tools and ultimately lead to clinical practice innovations and improvements. Clinicians interested in using BMS data for research purposes can better understand what topics are included and excluded in the collection and what perspectives are addressed. This study highlights the need for burn clinicians around the world to lend their expertise to the WHO for the development of a much needed burn injury International Classification of Functioning, Disability and Health Core Set.

A content analysis of peripheral arterial disease patient-reported outcome measures using the International Classification of Functioning, Disability and Health

Abstract Background: The purpose of this study was to link, classify and describe the content of peripheral arterial disease (PAD)-specific patient-reported outcome measures using the International Classification of Functioning. The results were then analyzed to determine if these assessments provide clinicians and researchers with a comprehensive understanding of the lived experience of patients with PAD. Methods: Each meaningful concept in identified PAD assessments was linked to the International Classification of Functioning, Disability and Health to determine included and excluded content areas. An overall perspective was assigned to each assessment item. Inter-rater reliability was established using a kappa statistic. Results: The body functions component is most frequently addressed overall followed by the activities and participation component. International Classification of Functioning chapter and category distribution vary greatly between assessments and no assessment comprehensively examines community participation and relationships. The majority of the assessment items are of the health status-disability and quality of life perspectives. Conclusions: The results of this study suggest the need for the development of a comprehensive PAD assessment that includes a more even distribution of International Classification of Functioning topics and subtopics. A more comprehensive assessment would better capture the lived experience of this patient population. Implications for Rehabilitation A better understanding of the data collected using the current peripheral arterial disease-specific patient-reported outcome measures may contribute to the development of more comprehensive assessment tools that will ultimately lead to improved patient care. This study contributes to the preliminary foundation for the development of a peripheral arterial disease International Classification of Functioning, Disability and Health Core Set. Clinicians and researchers interested in using peripheral arterial disease-specific patient-reported outcome measures for clinical and research purposes can better understand what topics are included and excluded in the collection and what perspectives are addressed.

The multicenter benchmarking study of burn injury: A content analysis of the outcome measures using the international classification of functioning, disability and health

OBJECTIVE To link, classify and describe the content of the Multicenter Benchmarking Study Burn Outcomes Questionnaires (BOQ) using the International Classification of Functioning, Disability and Health (ICF) to determine if the information garnered provides researchers with the data necessary to develop a comprehensive understanding of life after burns. METHODS Two ICF linking experts used a standardized linking technique endorsed by the World Health Organization to link all BOQ concepts to the ICF. Linking results were analyzed to determine the comprehensiveness of each of the five measures. RESULTS The activities and participation component was most frequently addressed followed by the body functions component. Environmental factors are not extensively covered and body structures are not addressed. ICF chapter and category distribution were skewed and varied between assessments. The majority of BOQ items are of the health status perspective. CONCLUSION BOQ item composition could be improved with a more even distribution of pertinent ICF topics. Assessment authors may consider addressing the impact of environmental factors on participation. Including body structure concepts would allow investigators to track structural deformation and/or developmental delay. Generally speaking, this data should not be used to examine quality of life outcomes.