Achieving meaningful measurements of ICF concepts

Purpose. This paper reviews the strengths and weaknesses of two different approaches to assessing ICF concepts: coding versus quantitative scales. It illustrates the advantages of an alternative, integrative approach, called functional staging. Method. A prospective cohort study. A total of 516 subjects in the Rehabilitation Outcome Study. Results. ICF codes provide a useful approach for classifying easy-to-interpret health-related information on individuals that can be incorporated into administrative records and databases. By minimizing measurement error, quantitative scales are well suited for synthesizing health-related data that can be used to compare the health states of groups of individuals across studies, conditions, and countries as well as to detect clinically meaningful change. A functional staging approach combines the attractive features of ICF coding and quantitative scales to help the user interpret the clinical meaningfulness of summary scores while retaining measurement reliability, validity and precision. Conclusions. A functional staging approach to assessing ICF concepts holds promise as a useful technique for measuring and interpreting the core concepts in the ICF framework.