System-wide Routine Clinical Assessment Of Functioning Based On The International Classification Of Functioning,Disability And Health(ICF) Generic Set In China

Background:Based on WHO's International Classification of Functioning,Disability and Health(ICF),the ICF Generic-6 is a minimum set of information on functioning to be routinely collected across health conditions and settings.This study aimed to validate the ICF Generic-6 in daily routine clinical practice in Mainland China.Specific objectives were to a)analyse the interrater reliability,b)convergent validity,known group validity,predictive validity,c)feasibility,d)sensitivity to change and e)minimal clinical important difference(MCID)of the ICF Generic.Methods:Data from 4,510 patients with various diagnoses from 50 hospitals located in 20 provinces of Mainland China were collected by nurses who applied a 0(no problem)t 10(complete problem)numeric rating scale to each of six ICF categories of the ICF Generic-6 at admission and study endpoint.Totally 703 patients were rated independently by two investigators.Interrater reliability was evaluated with intraclass correlation coefficient(ICC).Convergent validity was evaluated with Spearman correlation coefficients between ICF Generic set and SF-12 items.Known group-validity was examined by comparing discharge scores between different discharge destinations.Predictive validity was determined by employing ICF Generic set baseline scores for estimating length of hospital stay and cost of in-hospital treatment.Feasibility was determined by evaluating the assessing time.Sensitivity was evaluated by analyzing the score difference of ICF generic set after admission and before discharge.MCID was determined by analyzing the ICF generic set score change before and after treatment of the patients whose health status "improve a little".Results:The interrater reliability of items and score of ICF Generic set was good with ICCs ranging from 0.67 to 0.87.Spearman correlation coefficient analysis showed that ICF Generic-6 items were correlated with respective SF-12 items.Discharge scores of patients differed significantly by discharge destination.ICF Generic admission score was a significant predictor of length of stay and treatment cost.The average time consuming of ICF generic set evaluation was 7.08 minutes.The score of ICF generic set after admission was significant different with the score before discharge(P<0.001).The MCID was 0.79(average score of ICF generic set).Conclusions:The ICF Generic set administered in combination with a 0 to 10 numeric-rating scale is a reliable,valid,feasible,and sensitive tool for the collection of minimal information on functioning across various clinical settings.