Leiden University Medical Center, Departmentof Orthopaedics, P.O. Box 9600, 2300RC Leiden, the Netherlands.
Bone Joint Res. 2013 Jun 20;2(6):116-21. doi: 10.1302/2046-3758.26.2000153. Print 2013.
Symptoms of obstetric brachial plexus injury (OBPI) vary widely over the course of time and from individual to individual and can include various degrees of denervation, muscle weakness, contractures, bone deformities and functional limitations. To date, no universally accepted overall framework is available to assess the outcome of patients with OBPI. The objective of this paper is to outline the proposed process for the development of International Classification of Functioning, Disability and Health (ICF) Core Sets for patients with an OBPI.
The first step is to conduct four preparatory studies to identify ICF categories important for OBPI: a) a systematic literature review to identify outcome measures, b) a qualitative study using focus groups, c) an expert survey and d) a cross-sectional, multicentre study. A first version of ICF Core Sets will be defined at a consensus conference, which will integrate the evidence from the preparatory studies. In a second step, field-testing among patients will validate this first version of Core Sets for OBPI.
The proposed method to develop ICF Core Sets for OBPI yields a practical tool for multiple purposes: for clinicians to systematically assess and evaluate the individual's functioning, for researchers to design and compare studies, and for patients to get more insight into their health problems and their management.
产科臂丛神经损伤(OBPI)的症状在不同个体和不同时间内变化很大,可能包括不同程度的去神经支配、肌肉无力、挛缩、骨畸形和功能受限。迄今为止,尚无普遍接受的整体框架来评估 OBPI 患者的预后。本文旨在概述制定用于评估 OBPI 患者的国际功能、残疾和健康分类(ICF)核心集的建议流程。
第一步是进行四项预备研究,以确定与 OBPI 相关的重要 ICF 类别:a)系统文献综述以确定结局测量指标,b)使用焦点小组的定性研究,c)专家调查,以及 d)横断面多中心研究。将在共识会议上定义 ICF 核心集的第一个版本,该版本将整合预备研究的证据。在第二步中,将在患者中进行现场测试,以验证用于 OBPI 的该核心集的第一个版本。
为 OBPI 制定 ICF 核心集的建议方法提供了一种实用工具,可用于多种目的:为临床医生提供系统评估和评估个体功能的工具,为研究人员设计和比较研究提供工具,以及为患者提供更多了解他们的健康问题和管理方法。