Attributed disability: a spot of local difficulty.
There has been an exponential growth of publications relating to the development and application of health measurement instruments. Condition-specific measures have formed a large part of this trend. This article questions the rationale behind the concept of condition-specific disability, a common domain in such measures, taking musculoskeletal medicine as an example. It argues that physical functions are seldom unique to a specific condition and that measurement specificity therefore relies on attributing functional consequences to the health condition of interest. The presence of multi-morbidity (musculoskeletal and non-musculoskeletal), and the influence of personal and environmental factors, pose problems for attribution that have seldom been empirically investigated. Furthermore, attributing disability to a specific health condition of interest potentially limits insights into important interventions such as managing co-morbid interactions and targeting barriers in the physical, social, and attitudinal environment. Efforts to identify regionally relevant item content and to measure participation in daily life are a step in the right direction. Attribution is not needed for either.
Peat
George
G
Primary Care Sciences Research Centre, Keele University, Keele, Staffordshire, UK. g.m.peat@cphc.keele.ac.uk
D015897:Comorbidity; D004185:Disability Evaluation; D006305:Health Status Indicators; D006801:Humans; D009140:Musculoskeletal Diseases / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D014944:World Health Organization