Identifying the concepts contained in outcome measures of clinical trials on stroke using the International Classification of Functioning, Disability and Health as a reference

Objectives: To systematically identify and quantify the concepts contained in outcome measures in stroke trials using the International Classification of Functioning, Disability and Health (ICF) as a reference.Methods: Randomized controlled trials between 1992 and 2001 were located in MEDLINE and selected according to predefined criteria. Outcome measures were extracted and concepts contained in the outcome measures were linked to the ICF.Results: A random sample of 160 (50%) of 320 eligible studies was included. A total of 148 standardized health status measures were identified. Of 11,283 extracted concepts, 91% could be linked to the ICF. The most used ICF categories for each component were d450 walking (70%) for activities and participation, b525 defecation functions (62%) for body functions, and e399 support and relationships, unspecified (30%) for environmental factors.Conclusion: The ICF provides a useful reference to identify and quantify the concepts contained in outcome measures used in stroke trials. Outcome measurement in stroke refers to an enormous variety of concepts; for comparability of research findings agreement on what should be measured is needed

Identifying the concepts contained in outcome measures of clinical trials on depressive disorders using the International Classification of Functioning, Disability and Health as a reference

Objectives: First, to systematically identify the concepts contained in outcome measures of trials on depressive disorders using the International Classification of Functioning, Disability and Health (ICF) as a reference. Secondly, to explore differences in the use of ICF categories across different intervention types. Thirdly, to examine which and how often health status measures have been applied in trials on depressive disorders.Methods: Randomized controlled trials between 1991 and 2000 were located in MEDLINE and selected according to predefined criteria. The outcome measures were extracted and the concepts contained in the outcome measures were linked to the ICF.Results: A random sample of 203 (50%) of 406 eligible studies were included. The 5 most used ICF categories (range 88-94%) were sleep functions (b134), emotional functions (b152), energy and drive functions (b130), thought functions (b160) and higher-level cognitive functions (b164), all belonging to the body functions component. The use of ICF categories did not vary across different intervention types. A total of 126 different health status measures were extracted. The Hamilton Rating Scale for Depression was the most used health status measure applied in 80% of the studies.Conclusion: Concepts about execution of tasks/actions, participation in life situations, and the influence of the environment were under-represented in the outcome assessment of trials on depressive disorders. These observations indicate that most trials were limited in their ability to assess more global individual outcomes

Development of the Saxon Health Target "active aging - Aging in health, autonomy, and participation" [Entwicklung des Sachsischen Gesundheitsziels "Aktives Altern - Altern in Gesundheit, Autonomie und Mitverantwortlichkeit"]

Die Folgen der demografischen Alterung sind bereits heute in Sachsen spürbar. Zur Bewältigung der Auswirkungen auf den Gesundheitssektor beschloss der Steuerungskreis Gesundheitsziele Sachsen im März 2008 die Entwicklung des Gesundheitsziels „Aktives Altern – Altern in Gesundheit, Autonomie und Mitverantwortlichkeit“. Die Ausgestaltung des neuen Gesundheitsziels basierte auf einem Siebenstufen-Modell (Handlungsfelder, Oberziele, Zielbereiche, Teilziele, Umsetzungsstrategien, Maßnahmen, Indikatoren für die Evaluation). Mittels einer quantitativen Inhaltsanalyse wurden zehn potenziell relevante Handlungsfelder identifiziert, von denen drei für die Ziele-Entwicklung ausgewählt wurden. Die Ziele wurden von 53 Akteuren in multiprofessionell besetzten Arbeitsgruppen erarbeitet. Zur Gewährleistung von wissenschaftlicher Evidenz und Umsetzbarkeit wurden Kriterienanalysen durchgeführt. In neun Monaten wurden 24 Teilziele entwickelt, die den Oberzielen bedarfsgerechte Versorgungsstrukturen, multiprofessionelle Qualifizierung, subjektive Gesundheit und intergenerationale Solidarität zugeordnet sind. 13 Teilziele wurden bis zu Maßnahmenvorschlägen spezifiziert. Die Maßnahmenvorschläge fokussieren auf eine Stärkung gesundheitsrelevanter Strukturen sowie psychosozialer Gesundheitsdeterminanten im Alter. Die besten Vorschläge sollen in Kooperation mit interessierten Entscheidungsträgern umgesetzt werden