Department of Otorhinolaryngology, Mayo Clinic, Jacksonville, FL, USA.
These authors contributed equally to this work.
Ear Hear. 2019 Jul/Aug;40(4):858-869. doi: 10.1097/AUD.0000000000000662.
The International Classification of Functioning, Disability, and Health (ICF) Core Sets for Hearing Loss (CSHL) consists of short lists of categories from the entire ICF classification that are thought to be the most relevant for describing the functioning of persons with hearing loss. A comprehensive intake that covers all factors included in the ICF CSHL holds the promise of developing a tailored treatment plan that fully complements the patient's needs. The Comprehensive CSHL contains 117 categories and serves as a guide for multiprofessional, comprehensive assessment. The Brief CSHL includes 27 of the 117 categories and represents the minimal spectrum of functioning of persons with HL for single-discipline encounters or clinical trials. The authors first sought to benchmark the extent to which Audiologist (AUD) and Otorhinolaryngologist (ORL) discipline-specific intake documentation, as well as Mayo Clinic's multidisciplinary intake documentation, captures ICF CSHL categories.
A retrospective study design including 168 patient records from the Department of Otorhinolaryngology/Audiology of Mayo Clinic in Jacksonville, Florida. Anonymized intake documentation forms and reports were selected from patient records filed between January 2016 and May 2017. Data were extracted from the intake documentation forms and reports and linked to ICF categories using pre-established linking rules. "Overlap," defined as the percentage of ICF CSHL categories represented in the intake documentation, was calculated across document types. In addition, extra non-ICF CSHL categories (ICF categories that are not part of the CSHL) and extra constructs (constructs that are not part of the ICF classification) found in the patient records were described.
The total overlap of multidisciplinary intake documentation with ICF CSHL categories was 100% for the Brief CSHL and 50% for the Comprehensive CSHL. Brief CSHL overlap for discipline-specific documentation fell short at 70% for both AUD and ORL. Important extra non-ICF CSHL categories were identified and included "sleep function" and "motor-related functions and activities," which mostly were reported in relation to tinnitus and vestibular disorders.
The multidisciplinary intake documentation of Mayo Clinic showed 100% overlap with the Brief CSHL, while important areas of nonoverlap were identified in AUD- and ORL-specific reports. The ICF CSHL provides a framework for describing each hearing-impaired individual's unique capabilities and needs in ways currently not documented by audiological and otological evaluations, potentially setting the stage for more effective individualized patient care. Efforts to further validate the ICF CSHL may require the involvement of multidisciplinary institutions with commonly shared electronic health records to adequately capture the breath of the ICF CSHL.
国际功能、残疾和健康分类（ICF）听力损失核心集（CSHL）由整个 ICF 分类中认为最能描述听力损失患者功能的简短类别列表组成。全面的评估涵盖了 ICF CSHL 中包含的所有因素，有望制定出完全符合患者需求的个性化治疗计划。综合 CSHL 包含 117 个类别，是多专业综合评估的指南。简要 CSHL 包含 117 个类别的 27 个类别，代表了单学科接触或临床试验中听力损失患者的最低功能谱。作者首先寻求基准，以确定听力学（AUD）和耳鼻喉科（ORL）专科的特定摄入文档以及梅奥诊所的多学科摄入文档在多大程度上捕获了 ICF CSHL 类别。
回顾性研究设计，包括佛罗里达州杰克逊维尔梅奥诊所耳鼻喉科/听力学系的 168 名患者记录。从 2016 年 1 月至 2017 年 5 月期间归档的患者记录中选择匿名的摄入文档表格和报告。从摄入文档表格和报告中提取数据，并使用预先建立的链接规则将其链接到 ICF 类别。通过计算文档类型之间的“重叠”（定义为代表 ICF CSHL 类别的百分比）来衡量重叠度。此外，还描述了患者记录中发现的额外非 ICF CSHL 类别（不属于 CSHL 的 ICF 类别）和额外结构（不属于 ICF 分类的结构）。
多学科摄入文档与 ICF CSHL 类别的总重叠率为简要 CSHL 的 100%，全面 CSHL 的 50%。AUD 和 ORL 的专科文档的简要 CSHL 重叠率均低于 70%。确定了重要的额外非 ICF CSHL 类别，包括“睡眠功能”和“与运动相关的功能和活动”，这些类别主要与耳鸣和前庭障碍有关。
梅奥诊所的多学科摄入文档与简要 CSHL 完全重叠，而在 AUD 和 ORL 特定报告中发现了重要的非重叠领域。ICF CSHL 提供了一个框架，用于以目前未通过听力学和耳科学评估记录的方式描述每个听力受损个体的独特能力和需求，这可能为更有效的个体化患者护理奠定基础。为进一步验证 ICF CSHL 可能需要多学科机构的参与，这些机构具有共同的共享电子健康记录，以充分捕捉 ICF CSHL 的广度。
