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Costa ACGD, Martins TF, da Silva VZM, Leite CF, Castro SSD, Cipriano G, Cipriano GFB. Standardization use of the international classification of functioning, disability and health in the determination of health status in patients with post-acute COVID-19 syndrome. Disabil Rehabil 2024:1-13. [PMID: 38835177 DOI: 10.1080/09638288.2024.2358897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/10/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE To propose a standardized method for the use of the International Classification of Functioning, Disability and Health (ICF) to describe the health status in Post-Acute COVID-19 Syndrome (PACS) and investigate interrater agreement in the linking process in instruments and clinical exams using the ICF categories. MATERIALS AND METHODS Cross-sectional and interrater agreement study that followed the Guidelines for Reporting Reliability and Agreement Studies. Two raters performed the linking coding process in instruments of quality of life, anxiety and depression, fatigue and pulmonary function, inspiratory muscle strength and cardiopulmonary exercise testing. The codes were qualified by standards defined to each instrument and exams. RESULTS The instrument with the lowest Cohen's Kappa coefficient was anxiety and depression (k = 0.57). Forty ICF codes were linked to clinical instruments and exams. The fatigue instrument presented a higher degree of disability by the qualification process, from severe to complete, in the linked codes. CONCLUSION The study presents a standardized method for the assessment of the health status of patients with PACS through ICF. Restriction in work performance, socialization and family relationships as well as disabilities in physical endurance, fatigue and exercise tolerance were found in the sample. The agreement between the raters was moderate to perfect, demonstrating that the method can be reproducible.
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Affiliation(s)
| | | | - Vinicius Zacarias Maldaner da Silva
- Physiotherapy department, University of Brasília, Brazil
- Postgraduate Program in Human Moviment and Rehabilitation, UniEVANGÉLICA, Anápolis, Brazil
| | - Camila Ferreira Leite
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Brazil
| | | | - Gerson Cipriano
- Postgraduate Program in Health Sciences and Technologies, University of Brasília, Brazil
- Postgraduate Program in Rehabilitation Science, University of Brasília, Brazil
- Physiotherapy department, University of Brasília, Brazil
- Postgraduate Program in Human Moviment and Rehabilitation, UniEVANGÉLICA, Anápolis, Brazil
| | - Graziella França Bernardelli Cipriano
- Postgraduate Program in Health Sciences and Technologies, University of Brasília, Brazil
- Postgraduate Program in Rehabilitation Science, University of Brasília, Brazil
- Physiotherapy department, University of Brasília, Brazil
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Umemori S, Ogawa M, Yamada S, Komatsu M, Oikawa E, Okamoto Y, Katoh M, Shirasaka T, Abiko K, Moriizumi S, Matsuo Y, Tohyama H, Mukaino M. Development of a Conversion Table Linking Functional Independence Measure Scores to International Classification of Functioning, Disability, and Health Qualifiers: Insights from a Survey of Healthcare Professionals. Healthcare (Basel) 2024; 12:831. [PMID: 38667593 PMCID: PMC11049898 DOI: 10.3390/healthcare12080831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
In clinical practice, patient assessments rely on established scales. Integrating data from these scales into the International Classification of Functioning, Disability, and Health (ICF) framework has been suggested; however, a standardized approach is lacking. Herein, we tested a new approach to develop a conversion table translating clinical scale scores into ICF qualifiers based on a clinician survey. The survey queried rehabilitation professionals about which functional independence measure (FIM) item scores (1-7) corresponded to the ICF qualifiers (0-4). A total of 458 rehabilitation professionals participated. The survey findings indicated a general consensus on the equivalence of FIM scores with ICF qualifiers. The median value for each item remained consistent across all item groups. Specifically, FIM 1 had a median value of 4; FIM 2 and 3 both had median values of 3; FIM 4 and 5 both had median values of 2; FIM 6 had a median value of 1; and FIM 7 had a median value of 0. Despite limitations due to the irreconcilable differences between the frameworks of existing scales and the ICF, these results underline the ICF's potential to serve as a central hub for integrating clinical data from various scales.
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Affiliation(s)
- Shu Umemori
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo 060-8648, Japan; (S.U.); (M.O.)
- Department of Rehabilitation Medicine, Sapporo Azabu Neurosurgical Hospital, Sapporo 065-0022, Japan
| | - Mao Ogawa
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo 060-8648, Japan; (S.U.); (M.O.)
| | - Shin Yamada
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Mitaka 181-8611, Japan;
| | - Masayo Komatsu
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan;
| | - Emiko Oikawa
- General Incorporated Association, Japan ICF Association, Tama 206-0012, Japan;
| | - Yasuyo Okamoto
- Department of Rehabilitation, Hanakawa Hospital, Ishikari 061-3207, Japan;
| | - Masaki Katoh
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake 470-1192, Japan;
| | - Tomohide Shirasaka
- Department of Rehabilitation Medicine, Hokuto Social Medical Corporation Tokachi Rehabilitation Center, Obihiro 080-0833, Japan;
| | - Kagari Abiko
- Department of Rehabilitation Medicine, Sapporo Azabu Neurosurgical Hospital, Sapporo 065-0022, Japan
| | - Shigehiro Moriizumi
- Department of Rehabilitation Medicine, Moriyama Memorial Hospital, Asahikawa 070-0832, Japan;
| | - Yuichiro Matsuo
- Department of Rehabilitation Medicine, National Hospital Organization Hokkaido Medical Center, Sapporo 063-0005, Japan;
| | - Harukazu Tohyama
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan;
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo 060-8648, Japan; (S.U.); (M.O.)
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Kim HJ, Kim W, Cho K, Kim J, Koo MJ, Yu J, Kwon I, Kim H. Development of a Korean version of simple, intuitive descriptions for clinical use of the generic functioning domains in the ICD-11 Chapter V. Disabil Rehabil 2024:1-7. [PMID: 38319047 DOI: 10.1080/09638288.2024.2307388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/27/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE To develop a Korean version of simple, intuitive descriptions (SIDs) for clinical use of the generic functioning domains in the International Classification of Disease 11th revision (ICD-11) Chapter V. METHODS The initial Korean SID version proposal for the International Classification of Functioning, Disability, and Health (ICF) Rehabilitation set was translated following the Italian version. The remaining 17 codes were developed using original ICF descriptions; WHO Disability Assessment Schedule, Model Disability Survey, Korean Classification of Functioning, Disability, and Health; and previous studies. The final proposal for the Korean version of SIDs was selected through virtual conferences and three rounds of voting. RESULTS This study developed SIDs for the 47 generic functioning domains in the Chapter V of ICD-11. However, the SID for 20 of the 47 codes was confirmed in vote A, for 23 codes in vote B and for the remaining 4 in the final vote. All experts agreed with the final SID proposal. CONCLUSIONS This is the first study in South Korea to attempt the development of SIDs for ICD-11 Chapter V. Therefore, the findings of this study could be used to evaluating of disability, functioning when ICD-11 is adopted for use in Korean clinical settings.
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Affiliation(s)
- Hyun-Jin Kim
- National Rehabilitation Center, Seoul, South Korea
| | - Wanho Kim
- National Rehabilitation Center, Seoul, South Korea
| | - Kyeyeob Cho
- National Rehabilitation Center, Seoul, South Korea
- National Center for Mental Health, Seoul, South Korea
| | - Jiin Kim
- National Rehabilitation Center, Seoul, South Korea
| | - Mi Jung Koo
- National Rehabilitation Center, Seoul, South Korea
| | - Jeonga Yu
- National Rehabilitation Center, Seoul, South Korea
| | - Ilho Kwon
- National Rehabilitation Center, Seoul, South Korea
| | - Hogene Kim
- National Rehabilitation Center, Seoul, South Korea
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Liguori S, Selb M, Moretti A, Paoletta M, Invernizzi M, Fiore P, Iolascon G, Gimigliano F. Characterization of an Italian population with neurological disorders in a rehabilitation setting using ClinFIT. J Rehabil Med 2024; 56:jrm18262. [PMID: 38236003 PMCID: PMC10809999 DOI: 10.2340/jrm.v56.18262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE To examine the functioning profile of people with neurological disorders who access rehabilitation services through ClinFIT Generic-30. METHODS The functioning profile of people with neurological disorders accessing rehabilitation services was examined using the ClinFIT Generic-30, and the results compared with existing core set (neurological health conditions acute and post-acute,stroke, Multiple Sclerosis, Traumatic Brain Injury,Spinal Cord Injury). RESULTS Data for 364 people were analysed. The 10 most commonly impaired ICF categories included 3 for Body Functions (exercise tolerance functions (b455), mobility of joint functions (b710), and muscle power functions (b730)) and 7 for Activities and Participation (carrying out daily routine (d230), handling stress and other psychological demands (d240), changing basic body position (d410), maintaining a body position (d415), transferring oneself (d420), walking (d450), and moving around (d455)), while the ICF categories that were severely impaired (ICF qualifiers 3 and 4) in more than 30% of the study cohort were: muscle power functions (b730), carrying out daily routine (d230), walking (d450), moving around (d455), doing housework (d640), and assisting others (d660). DISCUSSION The current study data suggests that ClinFIT Generic-30 appears to effectively identify impairments and/or restrictions, as perceived by individuals affected by selected health conditions. CONCLUSION ClinFIT Generic-30 is a tool that can be used to characterize functioning profile in people with different neurological disorders and to collect important information not addressed by the disease-specific core sets (neurological health conditions acute and post-acute,stroke, Multiple Sclerosis, Traumatic Brain Injury,Spinal Cord Injury).
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Affiliation(s)
- Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy.
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland; ICF Research Branch, Nottwil, Switzerland
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy; Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Pietro Fiore
- Neurological Rehabilitation and Spinal Unit, Bari, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
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Zhang M, Zhang Y, Sui M, Wang L, Lin Z, Shen W, Yu J, Yan T. Agreement Between Single Raters and Team Rating When Applying the International Classification of Functioning, Disability and Health's Rehabilitation Set. J Rehabil Med 2023; 55:jrm14737. [PMID: 38047475 DOI: 10.2340/jrm.v55.14737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/26/2023] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVE To quantify the agreement between functional assessments by a single rater and a team using the Chinese version of the International Classification of Functioning, Disability and Health Rehabilitation Set in a clinical situation. DESIGN Inter-rater, multi-centre agreement study. SUBJECTS A total of 193 adult inpatients admitted to 5 rehabilitation centres at 5 hospitals in China Methods: The Chinese version of the International Classification of Functioning, Disability and Health Rehabilitation Set was used by either a single rater or a team to assess 193 patients at 5 Chinese hospitals. Percentage of agreement and quadratic-weighted kappa coefficients were computed. Evaluation times were compared with paired t-tests. RESULTS The mean team and individual evaluation times were not significantly different. The percentage of agreement ranged from 46.1% to 94.2% depending on the item, and the quadratic-weighted kappas ranged from 0.43 to 0.92. Eight categories (26.6%) showed a weighted kappa exceeding 0.4, 11 others (36.7%) exceeded 0.6, and another 11 (36.7%) produced kappas of more than 0.8. CONCLUSION Either a single rater or a team of raters can produce valid and consistent ratings when using the Chinese version of the International Classification of Functioning, Disability and Health Rehabilitation Set to assess patients in a rehabilitation department. The team rating approach is suitable for clinical application.
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Affiliation(s)
- Malan Zhang
- Department of Exercise Rehabilitation, College of Exercise and Health, Guangzhou Sport University, Guangzhou, China
| | - Yun Zhang
- Department of Rehabilitation, The Fifth Hospital of Xiamen, Xiamen, China
| | - Minghong Sui
- Department of Rehabilitation, Shenzhen Nanshan People's Hospital, Shenzhen, China
| | - Liyin Wang
- Department of Rehabilitation, Clifford Hospital, Guangzhou, China
| | - Ziling Lin
- Department of Rehabilitation, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Wei Shen
- Department of Rehabilitation, GuangDong 999Brain Hospital, Guangzhou, China
| | - Jiani Yu
- Department of Rehabilitation, GuangDong Province Hospital of Chinese Medicine, Guangzhou, China
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou , China; Guangdong Engineering Technology Research Center for Rehabilitation and Elderly Care.
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Zhang L, Tashiro S, Mukaino M, Yamada S. Use of artificial intelligence large language models as a clinical tool in rehabilitation medicine: a comparative test case. J Rehabil Med 2023; 55:jrm13373. [PMID: 37691497 PMCID: PMC10501385 DOI: 10.2340/jrm.v55.13373] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/05/2023] [Indexed: 09/12/2023] Open
Abstract
OBJECTIVE To explore the potential use of artificial intelligence language models in formulating rehabilitation prescriptions and International Classification of Functioning, Disability and Health (ICF) codes. Design: Comparative study based on a single case report compared to standard answers from a textbook. SUBJECTS A stroke case from textbook. Methods: Chat Generative Pre-Trained Transformer-4 (ChatGPT-4)was used to generate comprehensive medical and rehabilitation prescription information and ICF codes pertaining to the stroke case. This information was compared with standard answers from textbook, and 2 licensed Physical Medicine and Rehabilitation (PMR) clinicians reviewed the artificial intelligence recommendations for further discussion. RESULTS ChatGPT-4 effectively formulated rehabilitation prescriptions and ICF codes for a typical stroke case, together with a rationale to support its recommendations. This information was generated in seconds. Compared with standard answers, the large language model generated broader and more general prescriptions in terms of medical problems and management plans, rehabilitation problems and management plans, as well as rehabilitation goals. It also demonstrated the ability to propose specified approaches for each rehabilitation therapy. The language model made an error regarding the ICF category for the stroke case, but no mistakes were identified in the ICF codes assigned. Conclusion: This test case suggests that artificial intelligence language models have potential use in facilitating clinical practice and education in the field of rehabilitation medicine.
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Affiliation(s)
- Liang Zhang
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Japan
| | - Syoichi Tashiro
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Japan
| | - Shin Yamada
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Japan.
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Wiśniowska-Szurlej A, Ćwirlej-Sozańska A, Wilmowska-Pietruszyńska A, Sozański B. Development of a clinical tool for rating categories of the ICF Rehabilitation Set in Polish practice. Sci Rep 2023; 13:1359. [PMID: 36693982 PMCID: PMC9873704 DOI: 10.1038/s41598-023-28441-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
Rehabilitation is considered a key health strategy in the 21st century. The aim of rehabilitation is to optimize the functioning of patients. The International Classification of Functioning, Disability and Health (ICF) is a framework for describing and organizing information on functioning and disability. Current international efforts to implement ICF in rehabilitation practise include the implementation of ICF Core Sets and operationalize ICF tools for clinics. The aim of the study is to create simple, intuitive descriptions and an initial reference guide for the assessment of the ICF Rehabilitation Set in Polish practice. The development of the Polish version of ICF Rehabilitation Set involved the following steps: (1) identification of ICF Rehabilitation Set categories; (2) development simple, intuitive descriptions; (3) the drafting of the rating reference guide by a multidisciplinary panel following the process employed to develop the Japanese version. The Polish version of ICF Rehabilitation Set, the simple, intuitive descriptions for 29 categories and the rating reference guides were successfully developed. The Polish version of ICF Rehabilitation Set proposed by us is a reference framework for the harmonization of existing information on the functioning and disability of people participating in the rehabilitation process.
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Affiliation(s)
- Agnieszka Wiśniowska-Szurlej
- Institute of Health Sciences, Medical College of Rzeszow University, 35-310, Rzeszow, Poland. .,Rehabilitation Center Donum Corde, Budy Głogowskie, 36-060, Głogów Małopolski, Poland.
| | | | | | - Bernard Sozański
- Institute of Medicine, Medical College of Rzeszow University, 35-310, Rzeszow, Poland
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Ćwirlej-Sozańska A, Sozański B, Wilmowska-Pietruszyńska A, Kizowska-Lepiejza B, Wiśniowska-Szurlej A. Development of the Polish Version of the ICF Core Set for the Environment of Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16341. [PMID: 36498407 PMCID: PMC9738278 DOI: 10.3390/ijerph192316341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The percentage of older people in Polish society increases every year. The interaction between the individual health condition and the barriers in the environment of the elderly leads to the development of disability and the limitation of activity and participation in daily activities. AIM This study was aimed at selecting the category of the International Classification of Functioning, Disability, and Health (ICF) to assess the environment of older adults in Poland in the context of their daily functioning. MATERIALS AND METHODS The study was designed to develop a user-friendly tool collecting ICF-based data on the living environment of older people, consisting of five phases: (1) the systematic review of the literature, (2) the empirical multicenter study, (3) the qualitative study based on interviews conducted among the elderly, (4) the experts' study-an assessment of selected codes from the perspective of experts, (5) the consensus conference. RESULTS Consensus was reached for 20 ICF categories, creating a comprehensive core set for the assessment of the living environment of older people, which included six codes from chapter 1, Products and technology, three codes from chapter 2, Natural environment and human-made changes to the environment, four codes from chapter 3, Support and relationships, four codes from Chapter 4, Attitudes, and three codes from Chapter 5, Services, systems, and policies. CONCLUSIONS The core set for the assessment of the living environment of older people living in Poland is a comprehensive and important set of 20 ICF codes that reflect the most important elements of the environment affecting the health and functioning of the elderly. This set can contribute to the optimal management of care services and support in the area of adapting the environment to the older population. The core set for environmental assessment was developed for use by medical and care facilities, as well as by social workers, who should also pay attention to the elements of the environment that affect the level of functioning of older people. In the future, it may also form the basis of national surveys and screening tests for the assessment of the living environment of older people. Optimizing and enhancing the surrounding environment can contribute to a greater degree of independence, even with existing health problems in the older population.
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Affiliation(s)
- Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland
- Laboratory of Geronto-prophylaxis, Center for Innovative Research in Medical and Natural Sciences, Rzeszow of University, Warzywna Street 1A, 35-310 Rzeszow, Poland
| | - Bernard Sozański
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland
| | | | - Beata Kizowska-Lepiejza
- Center for Foreign Language Studies, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland
| | - Agnieszka Wiśniowska-Szurlej
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland
- Laboratory of Geronto-prophylaxis, Center for Innovative Research in Medical and Natural Sciences, Rzeszow of University, Warzywna Street 1A, 35-310 Rzeszow, Poland
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Shiota S, Kitagawa T, Goto N, Fujisita H, Tamekuni Y, Nakayama S, Mio N, Kanai K, Naka M, Yamaguchi M, Mochizuki M, Ochikubo H, Hidaka T, Yasunobu Y, Nakano Y, Kihara Y, Kimura H. Development and appropriateness of a scoring method for International Classification of Functioning, Disabilities, and Health assessment in older patients with heart failure: a Delphi survey of expert panel in Japan. BMJ Open 2022; 12:e060609. [PMID: 36115681 PMCID: PMC9486326 DOI: 10.1136/bmjopen-2021-060609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The number of older patients with heart failure (HF) is increasing in Japan and has become a social problem. There is an urgent need to develop a comprehensive assessment methodology based on the common language of healthcare; the International Classification of Functioning, Disability and Health (ICF). The purpose of this study was to develop and confirm the appropriateness of a scoring methodology for 43 ICF categories in older people with HF. DESIGN Cross-sectional survey. We applied the RAND/University of California at Los Angeles (UCLA) Appropriateness Method with a modified Delphi method. SETTING AND PARTICIPANTS We included a panel of 26 multidisciplinary experts on HF care consisting of home physicians, cardiovascular physicians, care managers, nurses, physical therapists, a pharmacist, occupational therapist, nutritionist and a social worker. MEASURES We conducted a literature review of ICF linking rules and developed a questionnaire on scoring methods linked to ICF categories in older people with HF. In the Delphi rounds, we sent the expert panel a questionnaire consisting of three questions for each of the 43 ICF categories. The expert panel responded to the questionnaire items on a 1 (very inappropriate) - 9 (very appropriate) Likert scale and repeated rounds until a consensus of 'Appropriate' and 'Agreement' was reached on all items. RESULTS A total of 21 panel members responded to all the Delphi rounds. In the first Delphi round, six question items in four ICF categories did not reach a consensus of 'Agreement', but the result of our modifications based on panel members' suggestions reached to a consensus of 'Appropriate' and 'Agreement' on all questions in the second Delphi round. CONCLUSION The ICF-based scoring method for older people with HF developed in this study was found to be appropriate. Future work is needed to clarify whether comprehensive assessment and information sharing based on ICF contributes to preventing readmissions.
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Affiliation(s)
- Shigehito Shiota
- Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshiro Kitagawa
- Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Naoya Goto
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan
| | - Hironori Fujisita
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan
| | - Yurika Tamekuni
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Naoki Mio
- Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan
| | - Kana Kanai
- Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan
| | - Makiko Naka
- Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Mizuho Yamaguchi
- Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan
| | | | | | - Takayuki Hidaka
- Department of Cardiovascular Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Yuji Yasunobu
- Department of Cardiovascular Medicine, Miyoshi Medical Association Hospital, Miyoshi, Japan
| | - Yukiko Nakano
- Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yasuki Kihara
- Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroaki Kimura
- Heart Failure Center, Hiroshima University Hospital, Hiroshima, Japan
- Department of Rehabilitation Medicine, Hiroshima City General Rehabilitation Center, Hiroshima, Japan
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Li J, Qiu H, Zhang X, Jin J, Zhao Y, Yan J, Xie H, Liu S, Li J. Validation of a Disability Assessment Tool Based on the International Classification of Functioning, Disability, and Health in the Chinese Context. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:855502. [PMID: 36189056 PMCID: PMC9397936 DOI: 10.3389/fresc.2022.855502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022]
Abstract
Background:The common standards of disability assessment for long-term care (LTC) insurance are currently absent. The International Classification of Functioning, Disability and Health (ICF) was designed for a better description of health and functioning, which could fill the demand gap for the standards of disability assessment and be a promising tool for the development of LTC insurance system.ObjectivesTo validate a disability assessment scale for disabled elderly individuals based on the ICF for LTC in the Chinese context.MethodsThe present study is a cross-sectional study. A disability assessment tool based on the ICF was developed by referring to other assessment tools and an expert consensus meeting in the initial phase of the study. The developed tool was used to evaluate 1,610 elderly individuals in the LTC institutions. The Cronbach's α coefficient and split-half reliability were applied to test the internal consistency of the tool, while the Interclass correlation coefficients (ICCs) were used to evaluate the interrater reliability (IRR). Factor analysis was performed to verify the construct validity of the tool. The scores from the Medical Outcomes Short Form-12 (SF-12) were correlated with that from the disability assessment tool, to assess the criterion-related validity.ResultsThe Cronbach's α coefficient and split-half reliability of the disability assessment tool were 0.969 and 0.877, respectively. The ICCs of the sum scale was 0.85, and the ICCs of each of the 20 items in the scale ranged from 0.78 to 0.94. The items were divided into three factors through analysis, which is consistent with the structure expectation. The scores of each item and the sum score of the disability assessment scale were negatively correlated with the scores of the physical and psychological fields in SF-12 (p < 0.001). Overall, the data indicated that the tool was characterized by good internal consistency, IRR, construct validity, and criterion-related validity.ConclusionsThe disability assessment tool based on the ICF is a reliable and valid tool for the collection of information on functioning across various LTC settings. The information of disability provided evidence for the distribution of LTC service and guided the development of LTC insurance standards.
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Affiliation(s)
- Jiahui Li
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huaide Qiu
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | | | - Juan Jin
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuanping Zhao
- School of Nursing, Peking University, Beijing, China
| | - Juan Yan
- China Association of Social Security, Beijing, China
| | - Hong Xie
- School of Nursing, Peking University, Beijing, China
- Hong Xie
| | - Shouguo Liu
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Shouguo Liu
| | - Jianan Li
- Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Jianan Li
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AMATYA B, ELMALIK A, SONG K, LEE SY, GALEA MP, KHAN F. Responsiveness of the International Classification of Functioning, Disability And Health (ICF) Clinical Functioning Information Tool (ClinFIT) in Routine Clinical Practice in an Australian Inpatient Rehabilitation Setting. J Rehabil Med 2022; 54:jrm00268. [PMID: 35174870 PMCID: PMC9131197 DOI: 10.2340/jrm.v54.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine the responsiveness of the International Classification of Functioning, Disability and Health (ICF) Clinical Functioning Information Tool (ClinFIT) in routine clinical practice in an Australian context. METHODS A prospective observational study with consecutive recruitment of inpatients at a tertiary rehabilitation facility. The assessments were at admission (T0), discharge (T1) and 3-month postdischarge (T2), using the following questionnaires: ClinFIT, Functional Independence Measure (FIM) and European Quality of Life (EQ-5D-5L). Extension Indices (EI) were calculated for the ClinFIT set, and responsiveness measured as a change in scores over time. The association between FIM and ClinFIT scores was explored. RESULTS Participants (n = 91, mean age 66.8±13.0 years, 52% male, 48% following stroke) reported ≥ 1 issue related to ClinFIT categories. ClinFIT total raw scores improved significantly across all health conditions compared with T0 (median (interquartile range): 196 (110, 228)) at both T1: 69 (37, 110); p < 0.001 and T2: 46.5 (20.8, 77); p < 0.001, with a medium effect size (r = 0.61 for both). There were significant changes in EI in the entire ClinFIT set from T0 to T1, and from T0 to T2 (p < 0.001 for both), with small to medium effect sizes. Analyses confirmed significant correlation in improvements between ClinFIT and FIM scores. CONCLUSION ClinFIT is useful in evaluating patient functioning and can detect changes in functioning over time and across different health conditions.
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Affiliation(s)
- Bhasker AMATYA
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville
| | - Alaeldin ELMALIK
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville
| | - Krystal SONG
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville
| | - Su Yi LEE
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville
| | - Mary P. GALEA
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville
| | - Fary KHAN
- Department of Rehabilitation Medicine, Royal Melbourne Hospital
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville
- Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Parkville
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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12
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Developing an International Classification of Functioning, Disability and Health Core Set for Pediatric Brain Tumor Survivors in Chinese Clinical Settings. Cancer Nurs 2022:00002820-990000000-00013. [DOI: 10.1097/ncc.0000000000001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Integrating a New Dietetic Care Process in a Health Information System: A System and Process Analysis and Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052491. [PMID: 35270184 PMCID: PMC8909013 DOI: 10.3390/ijerph19052491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/04/2022]
Abstract
Managing routinely collected data in health care and public health is important for evaluation of interventions and answering research questions using “real life” and ”big data”. In addition to the technical requirements of information systems, both standardized terminology and standardized processes are needed. The aim of this project was to analyse and assess the integration of standardized terminology and document templates for a dietetic care process (DCP) into the health information system (HIS) in a hospital in Austria. Using an action research approach, the DCP was analysed through four expert interviews and the integration into the HIS through two expert interviews with observations. Key strengths and weaknesses for the main criteria (“integration of the ICF catalogue”, “adaption of the document templates”, “adaption of the DCP”, and the “adaption of the user authorizations”) were presented and proposals for improvement given. The system and process integration of the DCP is possible, and the document templates can be adapted with the software currently in use. Although an increase in resources and finances required is to be expected initially, the integration of a standardized dietetic terminology in combination with a standardized process is likely to improve the quality of care and support outcomes management and research.
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Amatya B, Elmalik A, Lee SY, Song K, Galea M, Khan F. A process evaluation of patient care needs using the Post- Stroke Checklist: a prospective study. J Rehabil Med 2022; 54:jrm00259. [PMID: 35001136 PMCID: PMC8892296 DOI: 10.2340/jrm.v53.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To assess the utility of the modified Post-Stroke Checklist (mPSC) to identify impairments and care needs of patients with stroke (PwS) in an inpatient rehabilitation setting. Methods Prospective observational design with consecutive admission of PwS (n = 44) at a tertiary rehabilitation facility. The post-stroke checklist was administered at hospital discharge (T1) and 3 months post-discharge (T2). Furthermore, validated questionnaires assessed function and participation, including the Clinical Functioning Information Tool (ClinFIT) on admission (T0), T1 and T2. Results Participants’ mean age was 67.7 years (standard deviation; SD) 14.6), 58% of participants were female, and the mean length of inpatient stay was 32.7 days (SD 22.4). At T1, 80% and at T2 only 60% of participants reported ≥1 strokerelated problem (mean 5.3 (SD 3.3) and 3.6 (SD 2.8), respectively). Half of participants were referred to physiotherapy/occupational therapy, and 36% to specialist clinics following discharge. The most prevalent problems included: life after stroke (62.2%), fatigue (55.6%), activities of daily living, and mobility (51.1% each). Compared with T1, at T2 there was an observed reduction in all mPSC items, except pain and incontinence. Participants showed improved function at T1 and T2 (Extension Index, ClinFIT set), from T0 to T1 and T0 to T2 (p<0.001, with large effect sizes). Conclusion The mPSC is feasible to implement in an inpatient rehabilitation setting and community. It can identify relevant stroke-related problems, and hence facilitate targeted intervention.
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Affiliation(s)
- Bhasker Amatya
- Department of Rehabilitation, Royal Melbourne Hospital, Parkville, Victoria.
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15
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Ibsen C, Maribo T, Nielsen CV, Hørder M, Schiøttz-Christensen B. ICF-Based Assessment of Functioning in Daily Clinical Practice. A Promising Direction Toward Patient-Centred Care in Patients With Low Back Pain. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:732594. [PMID: 36188866 PMCID: PMC9397761 DOI: 10.3389/fresc.2021.732594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022]
Abstract
Background: Patient-centred care has received increased attention in recent years. Patient-Reported Outcomes (PROs) and shared decision-making are key components of Patient-Centred care. Low back pain (LBP) is a complex symptom affected by multiple, interacting factors. Therefore, evidence strongly recommend a biopsychosocial and patient-centred approach in the assessment and management. The International Classification of Functioning, Disability and Health (ICF) provide a biopsychosocial model for describing functioning and disability. ICF is widely acknowledged, but implementation into clinical practice is lacking. To support the use of a biopsychosocial and patient-centred approach in daily clinical practice among patients with LBP we developed a practice-friendly tool based on ICF; the LBP assessment tool. Objective: To compare an ICF-based assessment facilitated by the LBP assessment tool with standard care in terms of the use of PROs and shared decision-making in order to promote patient-centred care in patients with LBP. Methods: A non-randomized controlled design was used. Eligible patients were allocated to one of two groups: the ICF group, assessed with the LBP assessment tool or the control group, assessed with a conventional LBP assessment. Primary outcome includes use of PROs. Secondary outcomes include use of a graphical overview displaying the patient profile and shared decision-making. A patient evaluation questionnaire was used to collect data. Results: Seven hundred ten patients were assessed for eligibility of whom 531 were allocated to the ICF group (n = 299) or the control group (n = 232). A significantly higher use of PRO data (p < 0.00) and the patient profile (p < 0.00) was reported in favor of the ICF group. Patients in the ICF group also experienced being more involved in decision-making (p = 0.01). Conclusions: This study showed that a functioning assessment, by means of the LBP assessment tool, increased use of PROs and shared decision-making when compared to a conventional LBP assessment. Additionally, this study demonstrated that routine use of ICF-based PRO data and shared decision-making promoted patient-centred care in patients with LBP. The LBP assessment tool may be a strong candidate for a user-friendly ICF-based tool with the potential to support health professionals in a shift toward a biopsychosocial and patient-centred approach to patients with LBP.
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Affiliation(s)
- Charlotte Ibsen
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- *Correspondence: Charlotte Ibsen
| | - Thomas Maribo
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Claus Vinther Nielsen
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Regional Hospital West Jutland, Herning, Denmark
| | - Mogens Hørder
- Department of Public Health, Research Unit of User Perspectives, University of Southern Denmark, Odense, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Senju Y, Mukaino M, Prodinger B, Selb M, Okouchi Y, Mizutani K, Suzuki M, Yamada S, Izumi SI, Sonoda S, Otaka Y, Saitoh E, Stucki G. Development of a clinical tool for rating the body function categories of the ICF generic-30/rehabilitation set in Japanese rehabilitation practice and examination of its interrater reliability. BMC Med Res Methodol 2021; 21:121. [PMID: 34126940 PMCID: PMC8204586 DOI: 10.1186/s12874-021-01302-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
Background The International Classification of Functioning, Disability, and Health (ICF) Generic-30 (Rehabilitation) Set is a tool used to assess the functioning of a clinical population in rehabilitation. The ICF Generic-30 consists of nine ICF categories from the component “body functions” and 21 from the component “activities and participation”. This study aimed to develop a rating reference guide for the nine body function categories of the ICF Generic-30 Set using a predefined, structured process and to examine the interrater reliability of the ratings using the rating reference guide. Methods The development of the first version of the rating reference guide involved the following steps: (1) a trial of rating patients by several raters; (2) cognitive interviews with each rater to analyze the thought process involved in each rating; (3) the drafting of the rating reference guide by a multidisciplinary panel; and (4) a review by ICF specialists to confirm consistency with the ICF. Subsequently, we conducted a first field test to gain insight into the use of the guide in practice. The reference guide was modified based on the raters’ feedback in the field test, and an inter-rater reliability test was conducted thereafter. Interrater agreement was evaluated using weighted kappa statistics with linear weights. Results The first version of the rating reference guide was successfully developed and tested. The weighted kappa coefficient in the field testing ranged from 0.25 to 0.92. The interrater reliability testing of the rating reference guide modified based on the field test results yielded an improved weighted kappa coefficient ranging from 0.53 to 0.78. Relative improvements in the weighted kappa coefficients were observed in seven out of the nine categories. Consequently, seven out of nine categories were found to have a weighted kappa coefficient of 0.61 or higher. Conclusions In this study, we developed and modified a rating reference guide for the body function categories of the ICF Generic-30 Set. The interrater reliability test using the final version of the rating reference guide showed moderate to substantial interrater agreement, which encouraged the use of the ICF in rehabilitation practice.
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Affiliation(s)
- Yuki Senju
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Birgit Prodinger
- Faculty of Applied Health and Social Sciences, Technical University of Applied Sciences Rosenheim, Rosenheim, Germany.,Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland
| | - Yuki Okouchi
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Kouji Mizutani
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Megumi Suzuki
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Shin Yamada
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shigeru Sonoda
- Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Mie, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Selb M, Stucki G, Li J, Mukaino M, Li L, Gimigliano F. Developing clinfit COVID-19: An initiative to scale up rehabilitation for COVID-19 patients and survivors across the care continuum. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2021. [DOI: 10.4103/jisprm-000128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Toward implementation of the International Classification of Functioning Generic-30 (Rehabilitation) Set into clinical and research settings in Croatia. Int J Rehabil Res 2020; 43:287-288. [PMID: 32769586 DOI: 10.1097/mrr.0000000000000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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