Validation of the Comprehensive Core Set for Rheumatoid Arthritis

Objective: The “Comprehensive ICF Core Set for Rheumatoid Arthritis
(RA)” is an application of the International Classification of
Functioning, Disability and Health (ICF) and represents the typical
spectrum of problems in functioning of patients with RA. The
objective of this study was to validate this ICF Core Set from the
perspective of physicians. Methods: Physicians experienced in RA
treatment were asked about the patients’ problems, patients’
resources and aspects of environment from their scope of practice.
This survey was conducted via e-mail in three rounds using the
Delphi technique. The responses were linked to the ICF by two
trained individuals according to empirically tested linking rules.
Consensus of the results was calculated statistically by the
statistical Kappa coefficient. Results: 79 physicians in 41
countries named 512 patients’ problems spanning all ICF components.
227 ICF categories were linked to the physicians’ responses. 16 ICF
categories were not represented in the Comprehensive ICF Core Set
for RA although at least 75% of the participants have rated them as
important. 19 issues were not covered by the ICF classification and
26 answers were linked to the not yet developed ICF component
Personal factors. Conclusion: The validity of the ICF components
Body Structures, Activities and Participation and Environmental
Factors was well supported by the physicians whereas there was less
support for the validity of the component Body Functions. Several
issues arose that are not covered and need to be investigated
further.