Bickton Fanuel M, Manifield James R, Limbani Felix, Dixon Justin, Holland Anne E, Taylor Rod S, Calderwood Claire, Wittich Walter, Gregson Celia L, Heine Martin, Ahmed Zahira, Roos Ronel, Singh Sally J
Lung Health Research Group, Malawi-Liverpool-Wellcome Programme, Blantyre, Malawi.
Department of Rehabilitation Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Blantyre, Malawi.
J Multimorb Comorb. 2025 May 20;15:26335565251343923. doi: 10.1177/26335565251343923. eCollection 2025 Jan-Dec.
Core outcome sets for people with multiple long-term conditions (multimorbidity) intervention studies offer an opportunity to compare data across studies and countries. However, a key research gap remains: the development of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) Core Set for multimorbidity rehabilitation. ICF Core Sets are a selection of essential categories from the full ICF classification that are considered most relevant for describing the functioning of a person with a specific health condition or in a specific healthcare context. This study aims to develop and validate an ICF Core Set for exercise-based multimorbidity rehabilitation. Unlike system- or disease-specific rehabilitation, multimorbidity rehabilitation entails using a modified structure that accommodates all conditions that an individual with multimorbidity has.
The three-phase, multi-method process created by the WHO and ICF Research Branch will be followed. The process will involve conducting four preparatory studies (phase 1), including (i) a systematic literature review (to examine researcher perspectives), (ii) a qualitative study (to examine patient perspectives), (iii) an expert survey (to examine health professional perspectives), and (iv) an empirical study (to examine clinical perspectives). This will be followed by an international consensus conference (phase 2) where lists of ICF categories resulting from phase 1 studies will be consolidated into a first version of an ICF Core Set for multimorbidity rehabilitation, which will be validated using an international comparative data analysis (phase 3).
An ICF Core Set created for multimorbidity rehabilitation will (1) benefit patients with multimorbidity who are often excluded from clinical trials of single-disease rehabilitation programs, (2) ensure precise and comprehensive assessment and documentation of functioning and disability relevant to this patient population, (3) help rehabilitation providers and their patients and/or caregivers when setting rehabilitation goals and planning rehabilitative interventions to achieve those goals, (4) help researchers in the synthesis of evidence for multimorbidity rehabilitation and facilitate the comparability of data across studies and countries, and (5) provide the scientific basis from which assessment tools can be derived for use in clinical and research settings and health care administration.
COMET database (https://www.comet-initiative.org/Studies/Details/3266).
针对患有多种长期病症（共病）的人群开展干预研究的核心结局集，为跨研究和跨国家比较数据提供了契机。然而，一个关键的研究空白依然存在：世界卫生组织（WHO）针对共病康复的《国际功能、残疾和健康分类》（ICF）核心集的制定。ICF核心集是从完整的ICF分类中挑选出的基本类别，被认为与描述特定健康状况的人或特定医疗环境中的人的功能最为相关。本研究旨在开发并验证一个针对基于运动的共病康复的ICF核心集。与特定系统或疾病的康复不同，共病康复需要采用一种经过修改的结构，以适应患有共病的个体所患的所有病症。
将遵循世界卫生组织和ICF研究处创建的三阶段、多方法流程。该流程将包括开展四项预备研究（第1阶段），其中包括：（i）系统文献综述（以审视研究者的观点），（ii）定性研究（以审视患者的观点），（iii）专家调查（以审视卫生专业人员的观点），以及（iv）实证研究（以审视临床观点）。随后将召开一次国际共识会议（第2阶段），会上将把第1阶段研究得出的ICF类别清单整合为共病康复ICF核心集的第一版，并通过国际比较数据分析进行验证（第3阶段）。
为共病康复创建的ICF核心集将：（1）使经常被排除在单一疾病康复计划临床试验之外的共病患者受益；（2）确保对与该患者群体相关的功能和残疾进行精确且全面的评估和记录；（3）在设定康复目标和规划实现这些目标的康复干预措施时，帮助康复提供者及其患者和/或护理人员；（4）帮助研究人员综合共病康复的证据，并促进跨研究和跨国家的数据可比性；（5）提供科学依据，据此可衍生出用于临床和研究环境以及医疗保健管理的评估工具。
COMET数据库（https://www.comet-initiative.org/Studies/Details/3266）。
