Do patient-reported outcome measures capture functioning aspects and environmental factors important to individuals with injuries or disorders of the hand?

STUDY DESIGN: Qualitative study. INTRODUCTION: Clinical outcome evaluation needs to consider the patient perspective for an in-depth understanding of functioning and disability. PURPOSE OF THE STUDY: To explore whether patient-reported outcome measures (PROMs) used in the field of hand injuries or hand disorders, capture functioning aspects and environmental factors important to the patients. METHODS: We performed a qualitative study and a systematic literature review. The focus group sessions were recorded, transcribed verbatim, and the identified concepts were linked to the ICF. We searched in MEDLINE for reviews, related to injuries or disorders of the hand, reporting on PROMs. We linked the items of the identified PROMs to the ICF and compared the qualitative data with the content of the PROMs. RESULTS: Statements from 45 individuals who participated in eight focus groups were linked to 97 categories of the ICF. From 15 reviews included, eight PROMs were selected. The selected PROMs capture 34 of the categories retrieved from the qualitative data. CONCLUSIONS: PROMs used in the context of hand injuries or hand disorders capture only in parts the functioning aspects important to the patients.

Validation of the Comprehensive International Classification of Functioning, Disability, and Health Core Set for multiple sclerosis from the perspective of physicians.

The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for multiple sclerosis (MS) is an application of the ICF to describe the typical spectrum of functioning in people with MS. The objective of this study was to validate the Comprehensive ICF Core Set for MS from the perspective of physicians. Using a three-round Delphi technique, physicians experienced in the MS treatment were requested to name patients' problems, resources, and aspects of environment. The statements of the first Delphi round were linked to ICF categories based on established linking rules. These categories as well as the results of the second round were reported back to the participants. Eighty-four physicians participated in the study. Totally, 89 categories (64.5%) of the Comprehensive ICF Core Set for MS were confirmed by the participants. Eight ICF categories, which are currently not included in the ICF Core Set, were identified. The validity of the Comprehensive ICF Core Set for MS was largely affirmed by the physicians. However, some additional categories were named, which should be further discussed regarding a revised version of the Comprehensive ICF Core Set for MS.

What is our knowledge of functioning and disability in hand conditions based on?

OBJECTIVES: To analyze the content of published studies on hand conditions using the International Classification of Functioning, Disability and Health (ICF) as a reference, and to highlight the most common aspects of functioning as well as those that deserve more consideration in research on hand conditions. DATA SOURCES: The MEDLINE, Embase, PsycINFO, CINAHL, and PEDro databases were searched for English language studies on hand conditions published between 1998 and 2008. STUDY SELECTION: The identified studies were reviewed by 2 persons independently. Studies reporting firsthand data of patients with diseases/injuries of the hand and with a minimum sample size of 10 patients were included. Reviews, overviews, meta-analyses, and psychometric studies were excluded. DATA EXTRACTION: Peer review strategy was conducted in the data extraction process. Data from a random sample of 15% of the included studies was extracted by 2 reviewers independently. DATA SYNTHESIS: The search identified 18,861 citations. A random sample of 2782 (15%) abstracts was reviewed, leading to the inclusion of 471 publications. Preliminary included publications were reviewed in full-text, resulting in the final inclusion of 188 studies. The information obtained from the included studies was linked to 127 different second-level ICF categories. Second-level categories most frequently addressed in the studies were: health services, systems, and policies; sensation of pain and structure of upper extremity; mobility of joint functions; and muscle power functions. CONCLUSIONS: The ICF provides a valuable reference to systematically analyze the content of published studies on hand conditions. Research activity needs to widen its focus on mental functions, further mobility functioning, self-care, and domestic life aspects, as well as environmental factors to encompass the impact of hand conditions on an individual's health. This would increase our knowledge on patients' needs and would help to ensure patient-oriented care.

Tests of the accuracy and speed of categorizing foods into child vs professional categories using two methods of browsing with children.

This research tested whether children could categorize foods more accurately and speedily when presented with child-generated rather than professionally generated food categories, and whether a graphically appealing browse procedure similar to the Apple iTunes (Cupertino, CA) "cover flow" graphical user interface accomplished this better than the more common tree-view structure. In Fall 2008, 104 multiethnic children ages 8 to 13 were recruited at the Baylor College of Medicine (Houston, TX) and randomly assigned to two browse procedures: cover flow (collages of foods in a category) or tree view (food categories in a list). Within each browse condition children categorized the same randomly ordered 26 diverse foods to both child and professionally organized categories (with method randomly sequenced per child). Acceptance of categorization was determined by registered dietitians. Speed of categorization was recorded by the computer. Differences between methods were determined by repeated measures analysis of variance. Younger children (8 to 9 years old) tended to have lower acceptance and longer speeds of categorization. The quickest categorization was obtained with child categories in a tree structure. Computerized dietary reporting by children can use child-generated food categories and tree structures to organize foods for browsing in a hierarchically organized structure to enhance speed of categorization, but not accuracy. A computerized recall may not be appropriate for children 9 years of age or younger.