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Valadkevičienė D, Jatužis D, Žukauskaitė I, Danylaitė Karrenbauer V, Bileviciute-Ljungar I. Revision of the brief international classification of functioning, disability and health core set for multiple sclerosis: a study of the comprehensive icf core set for multiple sclerosis with participants referred for work ability assessment. J Rehabil Med 2024; 56:jrm19671. [PMID: 38450443 PMCID: PMC10938140 DOI: 10.2340/jrm.v56.19671] [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: 09/27/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE To evaluate the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for multiple sclerosis with regard to the Brief ICF Core Set for multiple sclerosis. DESIGN Descriptive cross-sectional single-centre study. SUBJECTS A total of 151 participants (99 females/52 males, mean age 49 years) referred for work ability assessment. METHODS Data were collected from clinical recordings and by telephone interview. RESULTS Among 33 Body Functions, 14 were impaired in over 60% of the participants, and 6 in over 75%. These 6 most impaired functions were related to exercise tolerance (b455), urination (b620), muscle power (b730), motor reflex (b750), control of voluntary movement (b760) and gait pattern (b770). Among 54 Activities and Participation categories, 8 were impaired in over 60% of the participants, and 3 were impaired in over 75%. The latter activities were related to walking (d450), moving around (d455) and moving around using equipment (d465). Among the 36 Environmental categories, most were facilitators, except for temperature (e2250) and employment (e590). The latter category was both a facilitator and a barrier. CONCLUSION These results suggest additional categories that should be included into the Brief ICF Core Set, to improve its representation of the complex disability of multiple sclerosis.
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Affiliation(s)
- Daiva Valadkevičienė
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Disability and Working Capacity Assessment Office under the Ministry of Social Security and Labour of the Republic of Lithuania, Vilnius, Lithuania
| | - Dalius Jatužis
- Clinic of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Irena Žukauskaitė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Virginija Danylaitė Karrenbauer
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Medical Unit Neuro, Karolinska University Hospital, Stockholm, Sweden
| | - Indre Bileviciute-Ljungar
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden; Multidisciplinary Pain Clinic, St Göran Hospital, Stockholm, Sweden.
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Alsubiheen AM, Alzain NA, Albishi AM, Shaheen AAM, Aldaihan MM, Almurdi MM, Alqahtani AS, Alderaa AA, Alnahdi AH. Measurement Properties' Evaluation of the Arabic Version of the Patient-Specific Functional Scale in Patients with Multiple Sclerosis. Healthcare (Basel) 2023; 11:healthcare11111560. [PMID: 37297700 DOI: 10.3390/healthcare11111560] [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: 02/23/2023] [Revised: 03/23/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Purpose: The aim of this study was to assess the reliability and validity of the Arabic version of the patient-specific functional scale (PSFS-Ar) in patients with multiple sclerosis (MS) disorder. Materials and Methods: Reliability and validity were examined in patients with multiple sclerosis using a longitudinal cohort study design. One hundred (N = 100) patients with MS were recruited to examine the PSFS-Ar, test-retest reliability (using the interclass correlation coefficient model 2,1 (ICC2,1)), construct validity (using the hypothesis testing method), and floor-ceiling effect. Results: A total of 100 participants completed the PSFS-Ar (34% male, 66% female). The PSFS-Ar showed an excellent test-retest reliability score (ICC2,1 = 0.87; 95% confidence interval, 0.75-0.93). The SEM of the PSFS-Ar was 0.80, while the MDC95 was 1.87, indicating an acceptable measurement error. The construct validity of the PSFS-Ar was 100% correlated with the predefined hypotheses. As hypothesized, the correlation analysis revealed positive correlations between the PSFS-Ar and the RAND-36 domains of physical functioning (0.5), role limitations due to physical health problems (0.37), energy/fatigue (0.35), and emotional well-being (0.19). There was no floor or ceiling effect in this study. Conclusions: The study results showed that the PSFS-Ar is a self-reported outcome measure that is useful for detecting specific functional difficulties in patients with multiple sclerosis. Patients are able to express and report a variety of functional limitations easily and effectively, as well as to measure their response to physical therapy. The PSFS-Ar is, therefore, recommended for use in Arabic-speaking countries for clinical practice and research for patients with multiple sclerosis.
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Affiliation(s)
- Abdulrahman M Alsubiheen
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Nawaf A Alzain
- Department of Rehabilitation, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia
| | - Alaa M Albishi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Afaf A M Shaheen
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Mishal M Aldaihan
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Muneera M Almurdi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Abdulfattah S Alqahtani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Asma A Alderaa
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Ali H Alnahdi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
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Karlsson E, Gustafsson J. Validation of the international classification of functioning, disability and health (ICF) core sets from 2001 to 2019 - a scoping review. Disabil Rehabil 2021; 44:3736-3748. [PMID: 33535017 DOI: 10.1080/09638288.2021.1878562] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To investigate and summarize the literature on the validation of International classification of functioning, disability and health (ICF) core sets from 2001 to 2019 and explore what research methods have been used when validating ICF core sets.Methods: The current study is a scoping review using a structured literature search.Results: In total, 66 scientific articles were included, of which 23 ICF core sets were validated. Most validation studies were conducted in Europe using a quantitative methodology and were validated from the perspective of patients. Analysis methods differed considerably between the studies, and most ICF core sets were validated only once for a single target population or from a single perspective. The comprehensive core sets were validated more often than the brief core sets, and core sets for stroke and low back pain were validated most often.Conclusion: The results of the current study show that only 66% of the existing ICF core sets are validated. Many of the validation studies are conducted in a European context and from a single perspective. More validation studies of ICF core sets from the perspective of both patients and professionals are needed.Implications for rehabilitationICF core sets aim to facilitate assessments in clinical settings and research.Validation studies indicate in general that the ICF core sets are valid and relevant for patients and professionals in the specific areas explored and thus can be used in rehabilitation settings.To improve the quality of ICF core sets, more validation studies are needed for ICF core sets not yet tested and for ICF core sets that have been validated only in one study or for one specific population or target group.
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Affiliation(s)
- Elin Karlsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
| | - Johanna Gustafsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
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Botulinum toxin for the management of spasticity in multiple sclerosis: the Italian botulinum toxin network study. Neurol Sci 2020; 41:2781-2792. [PMID: 32281038 DOI: 10.1007/s10072-020-04392-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 04/01/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Botulinum toxin (BT) is an effective and safe treatment for spasticity, with limited evidence in multiple sclerosis (MS). We aim to describe the use of BT for the management of MS spasticity in the clinical practice, its combination with other anti-spastic treatments in MS and possible MS clinical correlates. METHODS This is a multicentre cross-sectional observational study including 386 MS patients, receiving BT for spasticity in 19 Italian centres (age 53.6 ± 10.9 years; female 228 (59.1%); disease duration 18.7 ± 9.2 years; baseline Expanded Disability Status Scale (EDSS) 6.5 (2.0-9.0)). RESULTS BT was used for improving mobility (n = 170), functioning in activities of daily living (n = 56), pain (n = 56), posturing-hygiene (n = 63) and daily assistance (n = 41). BT formulations were AbobotulinumtoxinA (n = 138), OnabotulinumtoxinA (n = 133) and IncobotulinumtoxinA (n = 115). After conversion to unified dose units, higher BT dose was associated with higher EDSS (Coeff = 0.591; p < 0.001), higher modified Ashworth scale (Coeff = 0.796; p < 0.001) and non-ambulatory patients (Coeff = 209.382; p = 0.006). Lower BT dose was used in younger patients (Coeff = - 1.746; p = 0.009), with relapsing-remitting MS (Coeff = - 60.371; p = 0.012). BT dose was higher in patients with previous BT injections (Coeff = 5.167; p = 0.001), and with concomitant treatments (Coeff = 43.576; p = 0.022). Three patients (0.7%) reported on post-injection temporary asthenia/weakness (n = 2) and hypophonia (n = 1). CONCLUSION BT was used for spasticity and its consequences from the early stages of MS, without significant adverse effects. MS-specific goals and injection characteristics can be used to refer MS patients to BT treatment, to decide for the strategy of BT injections and to guide the design of future clinical trials and observational studies.
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Swart EC, Neilson LM, Good CB, Shrank WH, Henderson R, Manolis C, Parekh N. Determination of Multiple Sclerosis Indicators for Value-Based Contracting Using the Delphi Method. J Manag Care Spec Pharm 2019; 25:753-760. [PMID: 31232201 PMCID: PMC10397620 DOI: 10.18553/jmcp.2019.25.7.753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Value-based contracts link medication payments to performance measures with the ultimate goal of lowering costs while improving patient outcomes. Previous multiple sclerosis (MS) value-based contracts have focused on indicators easily collected from claims or electronic health record data as their value-based outcomes, even though numerous other MS clinical indicators of interest exist. Uncertainty remains regarding which MS indicators are most meaningful to all stakeholders affected by a value-based contract. OBJECTIVE To identify meaningful MS indicators among key stakeholders for the purpose of informing a value-based contract for MS medications. METHODS Using a modified Delphi method, we surveyed 26 diverse stakeholders, including 8 patients and caregivers; 9 providers (neurologists, nurses, physician assistants, and specialty pharmacists); 2 pharmaceutical company representatives; 5 payers; and 2 pharmacy benefits managers. A list of 12 MS indicators was created from subject matter expert consultation and a literature review. All stakeholders reported on the meaningfulness and value of these 12 indicators through a 5-point Likert scale and forced selection of the 3 most meaningful indicators. All nonpatient stakeholders were additionally surveyed on collection feasibility of the same 12 indicators using a 5-point Likert scale. We defined consensus as ≥ 75% agreement on the meaningfulness and feasibility of an indicator (Likert scores 4 or 5). We performed a Fisher's exact test to assess differences between nonpatient and patient stakeholder rankings of indicators. RESULTS Consensus was reached for at least 1 indicator for all questions after 2 rounds. "Worsening physical disability" and "functional impairment" achieved 92% agreement on a Likert-scale question assessing indicator value, and 100% of participants selected "worsening physical disability" when asked to choose the 3 most meaningful indicators. "MS flares requiring an emergency department visit" and "MS flares requiring inpatient admission" were rated as the 2 most feasibly collected indicators (both received 89% agreement). CONCLUSIONS Using the Delphi method, we identified that disability and functional impairment are meaningful MS indicators to diverse stakeholders. These findings support the incorporation of important patient-reported outcomes into value-based contracts for MS medications. DISCLOSURES This study was supported by a grant from Express Scripts Holding Company, which provided research funding to the UPMC Center for Value-Based Pharmacy Initiatives for work on this study. Swart, Neilson, Good, and Parekh are employed by the UPMC Center for Value-Based Pharmacy Initiatives. Manolis is the Chief Pharmacy Officer of UPMC Health Plan, and Shrank was the Chief Medical Officer of UPMC Insurance Services Division at the time of this study. Henderson is employed by Express Scripts Holding Company.
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Affiliation(s)
- Elizabeth C.S. Swart
- Center for Value-Based Pharmacy Initiatives, UPMC Health Plan, Pittsburgh, Pennsylvania
| | - Lynn M. Neilson
- Center for Value-Based Pharmacy Initiatives, UPMC Health Plan, Pittsburgh, Pennsylvania
| | - Chester B. Good
- Center for Value-Based Pharmacy Initiatives, UPMC Health Plan, Pittsburgh, Pennsylvania, and Division of General Internal Medicine, University of Pittsburgh
| | - William H. Shrank
- Center for Value-Based Pharmacy Initiatives, UPMC Health Plan, Pittsburgh, Pennsylvania
| | | | - Chronis Manolis
- Center for Value-Based Pharmacy Initiatives and Pharmacy Division, UPMC Health Plan, Pittsburgh, Pennsylvania
| | - Natasha Parekh
- Center for Value-Based Pharmacy Initiatives, UPMC Health Plan, Pittsburgh, Pennsylvania, and Division of General Internal Medicine, University of Pittsburgh
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Meca-Lallana V, Arroyo-González R, Meca-Lallana J, Martín-Hernández J, Sánchez-de la Rosa R. A consensus initiative for the assessment of patients newly diagnosed with multiple sclerosis in Spain: the eXamina Project. Neurodegener Dis Manag 2016; 6:363-74. [DOI: 10.2217/nmt-2016-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To create a national consensus checklist to assess newly diagnosed multiple sclerosis patients when considering treatment initiation in Spain. Materials & methods: The Delphi consensus method was used. A scientific committee drafted items/domains, 52 experts evaluated their inclusion in the project checklist and 47 experts assessed checklist use in clinical practice. Results: Forty-eight items from seven dimensions were selected: sociodemographics, n = 3; medical history, n = 10; multiple sclerosis clinical factors, n = 14; laboratory/MRI, n = 8; multiple sclerosis signs affecting treatment, n = 4; multiple sclerosis signs affecting management, n = 1; treatment-related features, n = 8. Understanding, acceptance, ease of use, effectiveness and suitability of checklist use were favorably rated by ≥75.5% of experts. Conclusion: This project provides a consensus checklist gathering necessary information when considering multiple sclerosis treatment in newly diagnosed patients.
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Affiliation(s)
- Virginia Meca-Lallana
- Neurology Department, Demyelinating Disease Unit, Hospital Universitario La Princesa, Diego de León, 62, 28006 Madrid, Spain
| | - Rafael Arroyo-González
- Neurology Department, Hospital Universitario Quirón Madrid, Diego de Velázquez, 1, 28223 Pozuelo de Alarcón, Spain
| | - José Meca-Lallana
- Neurology Department, Multiple Sclerosis Unit, Hospital Clínico Universitario Virgen de la Arrixaca (IMIB-Arrixaca), Carretera Madrid-Cartagena, S/N, 30120 Murcia, Spain
- Department of Clinical Neuroimmunology & Multiple Sclerosis, UCAM Universidad Católica San Antonio de Murcia, Avenida Jerónimos, 135, 30107 Guadalupe, Spain
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Renom M, Conrad A, Bascuñana H, Cieza A, Galán I, Kesselring J, Coenen M. Content validity of the Comprehensive ICF Core Set for multiple sclerosis from the perspective of speech and language therapists. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2014; 49:672-686. [PMID: 25134658 DOI: 10.1111/1460-6984.12086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 01/16/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) is a comprehensive framework to structure the information obtained in multidisciplinary clinical settings according to the biopsychosocial perspective of the International Classification of Functioning, Disability and Health (ICF) and to guide the treatment and rehabilitation process accordingly. It is now undergoing validation from the user perspective for which it has been developed in the first place. AIMS To validate the content of the Comprehensive ICF Core Set for MS from the perspective of speech and language therapists (SLTs) involved in the treatment of persons with MS (PwMS). METHODS & PROCEDURES Within a three-round e-mail-based Delphi Study 34 SLTs were asked about PwMS' problems, resources and aspects of the environment treated by SLTs. Responses were linked to ICF categories. Identified ICF categories were compared with those included in the Comprehensive ICF Core Set for MS to examine its content validity. OUTCOMES & RESULTS Thirty-four SLTs named 524 problems and resources, as well as aspects of environment. Statements were linked to 129 ICF categories (60 Body-functions categories, two Body-structures categories, 42 Activities-&-participation categories, and 25 Environmental-factors categories). SLTs confirmed 46 categories in the Comprehensive ICF Core Set. Twenty-one ICF categories were identified as not-yet-included categories. CONCLUSIONS & IMPLICATIONS This study contributes to the content validity of the Comprehensive ICF Core Set for MS from the perspective of SLTs. Study participants agreed on a few not-yet-included categories that should be further discussed for inclusion in a revised version of the Comprehensive ICF Core Set to strengthen SLTs' perspective in PwMS' neurorehabilitation.
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Affiliation(s)
- Marta Renom
- Unitat de Neurorehabilitació and Unitat de Neuroimmunologia Clínica, Centre d'Esclerosi Múltiple de Catalunya (CEM-Cat), Barcelona, Spain
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Conrad A, Coenen M, Kesselring J, Cieza A. What explains functioning from the perspective of people with multiple sclerosis? J Neurol 2014; 261:2283-95. [PMID: 25209852 DOI: 10.1007/s00415-014-7467-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/05/2014] [Accepted: 08/06/2014] [Indexed: 12/01/2022]
Abstract
The Brief International Classification of Functioning, Disability and Health (ICF) Core Set for MS was developed to capture functioning in people with multiple sclerosis (pwMS). This study examined whether categories in the Brief ICF Core Set for MS best capture different levels of functioning in pwMS. We used data of a multicenter cross-sectional study collected from 205 pwMS using the ICF categories of the MS-specific WHO ICF Checklist and the individual rating of functioning. ICF categories to be entered in an initial regression model were selected following a systematic procedure in accordance with the ICF structure. Based on the initial regression model using stepwise Ordinary Least-Squares regression analyses, additional models were designed by substituting the ICF categories in final model. The selected set of categories was compared with the Brief ICF Core Set for MS. Eleven ICF categories were identified that best differentiate among different levels of functioning. Four were part of the Brief ICF Core Set. ICF categories identified in this study may be used as outcome measures in further study, parameters to monitor functioning along the continuum of health care and lifespan, and to define different subgroups of pwMS.
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Affiliation(s)
- Andrea Conrad
- Department of Medical Informatics, Biometry and Epidemiology-IBE, Pettenkofer School of Public Health (PSPH LMU), Research Unit for Biopsychosocial Health, Ludwig-Maximilians University (LMU), Marchioninistr. 17, 81377, Munich, Germany
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Alford VM, Ewen S, Webb GR, McGinley J, Brookes A, Remedios LJ. The use of the International Classification of Functioning, Disability and Health to understand the health and functioning experiences of people with chronic conditions from the person perspective: a systematic review. Disabil Rehabil 2014; 37:655-66. [DOI: 10.3109/09638288.2014.935875] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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