Occupational Science and Therapy/Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
Centre of Disability Research and Policy, University of Sydney, Sydney, Australia.
Disabil Rehabil. 2022 Dec;44(25):8022-8028. doi: 10.1080/09638288.2021.2008525. Epub 2021 Dec 6.
To uncover the factors that influence inter-rater agreement when extracting stroke interventions from patient records and linking them to the relevant categories in the Extended International Classification of Functioning, Disability and Health Core Set for Stroke.
Using 10 patient files, two linkers independently extracted interventions and linked the target of the intervention to relevant functions in the ICF. The percentage agreement of extracted interventions and the ICF codes was calculated. Non-matching interventions and codes were further analysed to determine the reasons for poor agreement.
A total of 518 interventions were extracted, with 44.01% agreement between the two linkers. Of the non-agree codes and interventions, 43.79% were due to mismatched ICF codes and 56.20% were due to mismatched interventions. Differences were due to linkers (a) extracting interventions from different parts of the patient note (b) differences in interpreting the target of the intervention, and (c) choosing a different code with similar meaning.
Greater reliability when linking interventions to ICF codes can be achieved by; health services using a consistent progress note that uses ICF language, recording the intervention aim, linkers knowing the aims of each discipline's interventions and using multiple reliability checks and analysis to inform the linking method.Implications for rehabilitationLinking intervention targets to the ICF and to the ICHI is an emerging research field.Development of trustworthy inter-rater reliability methods is needed to achieve its potential to demonstrate the equity, quality and effectiveness of interventions.Independent linking of patient notes to the ICF can identify factors that impact inter-rater reliability.When writing patient notes, health professionals should use a consistent format that identifies the functional target of the intervention using ICF terms.
揭示从病历中提取中风干预措施并将其与中风国际功能、残疾和健康分类核心集扩展版相关类别相联系时，影响评价者间一致性的因素。
使用 10 份病历，两名链接员独立提取干预措施，并将干预措施的目标与 ICF 中的相关功能联系起来。计算提取干预措施和 ICF 代码的百分比一致性。对不匹配的干预措施和代码进行进一步分析，以确定一致性差的原因。
共提取了 518 项干预措施，两名链接员之间的一致性为 44.01%。在不匹配的代码和干预措施中，43.79%是由于 ICF 代码不匹配，56.20%是由于干预措施不匹配。差异归因于链接员 (a) 从病历的不同部分提取干预措施，(b) 对干预目标的解释存在差异，以及 (c) 选择了具有相似含义的不同代码。
通过以下方法可以提高将干预措施与 ICF 代码相联系的可靠性：卫生服务部门使用符合 ICF 语言的一致的进展记录，记录干预措施的目标，链接员了解每个学科干预措施的目标，并使用多个可靠性检查和分析来为链接方法提供信息。
康复的意义将干预措施与 ICF 和 ICHI 相联系是一个新兴的研究领域。需要开发可靠的评价者间一致性方法，以充分发挥其潜力，展示干预措施的公平性、质量和效果。独立地将患者记录与 ICF 相联系可以确定影响评价者间一致性的因素。在写病历时，卫生专业人员应使用一致的格式，使用 ICF 术语识别干预措施的功能目标。
