title: Reliability, construct validity and measurement potential of the ICF comprehensive core set for osteoarthritis.
abstract: BACKGROUND
  This study aimed to investigate the reliability and construct validity of the International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for osteoarthritis (OA) in order to test its possible use as a measuring tool for functioning.
  
  
  METHODS
  100 patients with OA (84 F, 16 M; mean age 63 yr) completed forms including demographic and clinical information besides the Short Form (36) Health Survey (SF-36®) and the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC). The ICF Comprehensive Core Set for OA was filled by health professionals. The internal construct validities of "Body Functions-Body structures" (BF-BS), "Activity" (A), "Participation" (P) and "Environmental Factors" (EF) domains were tested by Rasch analysis and reliability by internal consistency and person separation index (PSI). External construct validity was evaluated by correlating the Rasch transformed scores with SF-36 and WOMAC.
  
  
  RESULTS
  In each scale, some items showing disordered thresholds were rescored, testlets were created to overcome the problem of local dependency and items that did not fit to the Rasch model were deleted. The internal construct validity of the four scales (BF-BS 16 items, A 8 items, P 7 items, EF 13 items) were good [mean item fit (SD) 0.138 (0.921), 0.216 (1.237), 0.759 (0.986) and -0.079 (2.200); person item fit (SD) -0.147 (0.652), -0.241 (0.894), -0.310 (1.187) and -0.491 (1.173) respectively], indicating a single underlying construct for each scale. The scales were free of differential item functioning (DIF) for age, gender, years of education and duration of disease. Reliabilities of the BF-BS, A, P, and EF scales were good with Cronbach's alphas of 0.79, 0.86, 0.88, and 0.83 and PSI's of 0.76, 0.86, 0.87, and 0.71, respectively. Rasch scores of BF-BS, A, and P showed moderate correlations with SF-36 and WOMAC scores where the EF had significant but weak correlations only with SF36-Social Functioning and SF36-Mental Health.
  
  
  CONCLUSIONS
  Since the four different scales derived from BF-BS, A, P, and EF components of the ICF core set for OA were shown to be valid and reliable through a combination of Rasch analysis and classical psychometric methods, these might be used as clinical assessment tools.
authors: Ankara University Faculty of Medicine, Department of Physical Medicine & Rehabilitation, Ankara, Turkey.
authors: Yeşim
authors: Y
authors: Kurtaiş
authors: Derya
authors: D
authors: Oztuna
authors: Ayşe A
authors: AA
authors: Küçükdeveci
authors: Sehim
authors: S
authors: Kutlay
authors: Meliha
authors: M
authors: Hafiz
authors: Alan
authors: A
authors: Tennant
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D004777:Environment; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000503:physiopathology* / Q000534:rehabilitation; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards