ICF linking rules: an update based on lessons learned

TLDR

Outcome research aims to understand health service results, using diverse technical, clinical, and patient‑oriented measures, and the ICF framework may improve such research. The paper updates the 2002 linking rules and demonstrates their application to link technical, clinical, health‑status measures and interventions to the ICF, with potential for operationalizing ICF categories and developing category‑based item banks. The updated rules comprise three linking rules for health‑status measures and one for technical and clinical measures and interventions. The update yields eight linking rules that enable systematic linking and comparison of concepts across outcome measures and interventions, facilitating selection of the most suitable measures for applied interventions.

Abstract

Outcome research seeks to understand the end results of health services. Researchers use a wide variety of outcome measures including technical, clinical and patient-oriented measures. The International Classification of Functioning, Disability and Health (ICF) as a common reference framework for functioning may contribute to improved outcome research. The objective of this paper is to provide an updated version of the linking rules published in 2002 and illustrate how these rules are applied to link technical and clinical measures, health-status measures and interventions to the ICF.Three specific linking rules have been established to link health-status measures to the ICF and one specific linking rule has been created to link technical and clinical measures and interventions. A total of 8 linking rules have been established for use with all different outcome measures and with interventions.The newly updated linking rules will allow researchers systematically to link and compare meaningful concepts contained in them. This should prove extremely useful in selecting the most appropriate outcome measures among a number of candidate measures for the applied interventions. Further possible applications are the operationalization of concrete ICF categories using specific measures or the creation of ICF category-based item bankings.