ICF通用组合在临床应用中的评估者间和评估者内信度研究

The inter-rater and intra-rater agreement of International Classification of Functioning, Disability and Health(ICF) Generic Set as a measure of functioning in clinical practice

目的:探讨ICF通用组合在临床功能评估中的评估者间和评估者内信度,为其临床应用提供依据。方法:来自21个省份、50家医院康复医学科、神经内科、心内科、呼吸科和骨科的4784例患者参与了本研究,其中康复科患者776例。患者在入院时、住院中期、出院3个时间点接受同一名评估者的ICF通用组合功能评估,以进行评估者内信度分析。康复科患者同时接受2名评估者的评估,以进行评估者间信度分析。组内相关系数(ICC)检验评估者间信度和评估者内信度。结果:ICF通用组合的7个条目中除了d850有报酬的就业的ICC为0.40外,其他类目及总分的ICC都在0.70—0.95之间,评估者间信度佳。ICF通用组合的7个类目在入院和住院中期两个时间点之间的ICC要高于入院和出院两个时间点之间的ICC,评估者内信度佳。结论:除了d850有报酬的就业,ICF通用组合的其他条目及总分评估者间信度良好。ICF通用组合的评估者内信度良好。

Objective： To explore the inter-rater and intra-rater reliability of International Classification or Functlonlng, Disability and Health（ICF） generic set as a functioning measure tool in routine clinical practice. Method： Totally 4784 patients from different departments of 50 hospitals in 21 provinces of China's Mainland were enrolled in this study, and 776 of them were from Rehabilitation department. Each patient was assessed by the same rater with ICF generic set at the time of baseline, midterm and discharge. The patients from rehabilitation department were assessed by two raters. Interclass correlation coefficient （ICC） was employed to evaluate the inter-rater and intra-rater reliability. Result： With exception of the item d850 （midterm ICC=0.40）, the inter-rater reliability of items and sum score of ICF generic set exhibit excellent interclass correlation coefficient （ICC） with ranging from 0.70 to 0.95. The ICC of all items of ICF generic set between baseline and midterm were found to be higher than that of baseline and discharge. Conclusion： The inter-rater reliability of all items and sum score of ICF generic set is good, with exception of item d850. The intra-rater reliability of all items of ICF generic set is good.