Content Analysis of Definition and Measurement of Disability: Based on ICF and UN Convention on the Rights of Persons with Disabilities / 中国康复理论与实践

@#Objective To analyze theoretical frameworks, definitions, terminology and measurements of disability using International Classification of Functioning, Disability and Health (ICF), and United Nations Convention on the Rights of Persons with Disabilities (CRPD), to provide a scientific basis for developing definition, classification and measurements to meet international standards.Methods Content analysis had been conducted for the definitions and measurements of disability issued by international organizations using the ICF terminology and code and the definitions of disability and people with disability by CRPD.Results The core concepts and content had been reviewed using the ICF terminology and code, and the definitions of disability and people with disability by CRPD. The contents of definitions of disability proposed by international organizations cover all components of ICF. The contents of standardized disability measurements issued by United Nations or World Health Organization cover all components of ICF and map to CRPD definitions of disability and people with disability as the framework, classification, terminology and coding system had been adopted for the development.Conclusion The definition and measurements had been developed using ICF and CRPD framework, terminology, and coding system of disability. The framework and standard of disability had been constructed. The standard of disability data will implement in the fields of health, rehabilitation, education, employment, community and social services for people with disability to promote data exchange across sectors.

Development and Validation of the Emergency Department Geriatric Readmission Assessment at Yale (ED GRAY): Part 2, Prognostic Accuracy.

Objective: The Emergency Department (ED) Geriatric Readmission Assessment (ED-GRAY) is a 16-item questionnaire we developed that can be used to evaluate the prognostic ability to determine if geriatric patients will recidivate to the ED, be admitted or die within 30 days. Methods: We conducted an observational prospective cohort study at a single academic urban university-affiliated hospital. Subjects (n=250) were consenting, non-critically ill, English-speaking adults older than 65 years and receiving care in the ED. Multivariable logistic regression and receiver operating characteristic (ROC) curves were used to evaluate the ability to accurately predict the likelihood of a 30-day event: subsequent ED visit, hospitalization, or death. Results: 56 participants (22%) experienced at least one 30-day return visit or death. Greater disability as measured by the ED GRAY global disability was associated with an increased likelihood of an event (OR=1.7 for each 1-point worsening in severity; 95% CI 1.2, 2.5). In the multivariable model, prior ED visits (OR=2.7, 95% CI=1.4, 5.2), ED GRAY global score (OR=1.4, 95% CI=1.0, 2.1), and age (OR=1.03, 95% CI=0.99, 1.07) were associated with a greater likelihood of a 30-day event. The fit of the multivariable model was good (Hosmer-Lemeshow Goodness of Fit test, p=0.85) and it provided good discrimination between those having and not having a 30-day event (AUROC=0.70). The predicted probability of a return visit ranged from 3–56%. Conclusions: ED GRAY demonstrated good predictive validity when combined with prior ED visits, poly-pharmacy and age.