Uhlig T, Moe R, Reinsberg S, Kvien T K, Cieza A, Stucki G
National Resource Center for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Ann Rheum Dis. 2009 Jun;68(6):879-84. doi: 10.1136/ard.2008.088708. Epub 2008 Jul 14.
The comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis (RA) is a selection of 96 categories from the ICF, representing relevant aspects in the functioning of patients with RA.
To study the responsiveness of the ICF Core Set for RA in rheumatological practice.
A total of 46 patients with RA (72% women, mean (SD) age 53.6 (12.6) years, disease duration 6.3 (8.0) years) were interviewed at baseline and again after 6 months treatment with a disease-modifying antirheumatic drug (DMARD), applying the ICF Core Set for RA with qualifiers for problems on a modified three-point scale (no problem, mild/moderate, severe/complete). Patient-reported outcomes included Modified Health Assessment Questionnaire (MHAQ) and Short-Form 36 (SF-36) health survey, and disease activity was calculated. Responsiveness was measured as change in qualifiers in ICF categories, and was also compared with change in patient-reported outcomes.
After 6 months of DMARD treatment, improvement by at least one qualifier was seen in 20% of patients (averaged across all ICF categories), 71% experienced no change and 9% experienced worsening symptoms. Findings were similar across the different aspects of functioning. Mainly moderate effect sizes were seen for 6-month changes in the ICF Core Set for RA, especially in patients with improved health status, with similar effect size for disease activity. The components in the ICF Core Set for RA were only weakly associated with patient-reported outcomes and disease activity.
The ICF Core Set for RA demonstrated moderate responsiveness in this real-life setting of patients where minor changes occurred during treatment with DMARDs.
类风湿关节炎（RA）的综合国际功能、残疾和健康分类（ICF）核心集是从ICF中选取的96个类别，代表了RA患者功能方面的相关内容。
研究ICF RA核心集在风湿病实践中的反应性。
共有46例RA患者（72%为女性，平均（标准差）年龄53.6（12.6）岁，病程6.3（8.0）年）在基线时接受访谈，并在使用改善病情抗风湿药物（DMARD）治疗6个月后再次接受访谈，采用带有问题限定词的ICF RA核心集，使用改良的三点量表（无问题、轻度/中度、重度/完全）。患者报告的结局包括改良健康评估问卷（MHAQ）和简明健康调查问卷（SF - 36），并计算疾病活动度。反应性通过ICF类别中限定词的变化来衡量，并与患者报告结局的变化进行比较。
DMARD治疗6个月后，20%的患者（所有ICF类别平均）至少有一个限定词得到改善，71%无变化，9%症状恶化。不同功能方面的结果相似。RA的ICF核心集6个月变化的效应量主要为中等，尤其是在健康状况改善的患者中，疾病活动度的效应量相似。RA的ICF核心集各组成部分与患者报告结局和疾病活动度的关联较弱。
在DMARD治疗期间发生轻微变化的患者实际情况中，RA的ICF核心集显示出中等反应性。
