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Martin Weigl

Publications and source records attributed to Martin Weigl.

7 recordsLinked to original sources

Measuring the outcome of health resort programs.

OBJECTIVE: To evaluate the metric properties and practicability of valid, internationally available outcome instruments in the special setting of health resort programs. METHODS: A cohort study in a convenience sample of patients with low back pain, upper back pain, conditions of the lower extremities, and conditions of the upper extremities was conducted. Their functioning and health were assessed before and after a health resort program by the disease-specific North American Spine Society (NASS) instruments Lumbar NASS and Cervical NASS; WOMAC Osteoarthritis Index; Disabilities of Arm, Shoulder and Hand Questionnaire; and the general instrument, Medical Outcome Study Short Form-36 (SF-36). RESULTS: Completeness on the scale level ranged between 1% and 10%. Criterion validity of condition-specific instruments was confirmed by stronger associations of the pain and function scales to the Physical Health component of the SF-36 (r = -0.59 to -0.79, p < 0.001 for all scales) than to the Mental Health component (r = -0.11, NS, to r = -0.42, p < 0.001). Reliability (Cronbach's alpha coefficient) was higher than 0.8 for all scales of condition-specific instruments and for 6 of 8 SF-36 scales. Floor and ceiling effects ranged between 0% and 7%. The condition-specific instruments demonstrated a good responsiveness with an effect size ranging between 0.28 and 0.55 and with a standardized response mean between 0.32 and 0.94. The responsiveness of most SF-36 scales was similar, but the Physical Function scale showed a lower responsiveness than the condition-specific scales. CONCLUSION: The evaluated instruments can be recommended for use in clinical trials that assess the outcome of health resort programs.

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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.

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

OBJECTIVES: To systematically identify and quantify the concepts contained in outcome measures of clinical breast cancer trials using the International Classification of Functioning, Disability and Health (ICF) as a reference. METHODS: Randomized controlled trials between 1991 and 2000 were located in MEDLINE and selected according predefined criteria. The outcome measures were extracted and the concepts contained in the outcome measures were linked to the ICF. RESULTS: A total of 640 trials were included. Ninety-four different health status questionnaires were extracted. Three questionnaires were breast cancer-specific and 12 cancer-specific. Of 19,692 extracted concepts, 88% could be linked to the ICF. The most used ICF categories within the components body structures, body functions, and activities and participation were structure of the reproductive system (s630), sensations associated with the digestive system (b535), and looking after one's health (d570) with frequencies of 64%, 46% and 14%, respectively. No category of the environmental factors component reached a frequency of 10%. CONCLUSION: The ICF provides a useful reference to identify and quantify the concepts contained in outcome assessment used in clinical breast cancer trials. There seems to be a lack of health concepts evaluating specific aspects of disability and participation in breast cancer. Similarly, environmental factors with an impact on individual life of breast cancer survivors seem to be poorly represented.

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Identification of relevant ICF categories in patients with chronic health conditions: a Delphi exercise.

OBJECTIVES: To identify the most typical and relevant categories of the International Classification of Functioning, Disability and Health (ICF) for patients with low back pain, osteoporosis, rheumatoid arthritis, osteoarthritis, chronic generalized pain, stroke, depression, obesity, chronic ischaemic heart disease, obstructive pulmonary disease, diabetes mellitus, and breast cancer. METHODS: An international expert survey using the Delphi technique was conducted. Data were collected in 3 rounds. Answers were linked to the ICF and analysed for the degree of consensus. RESULTS: Between 21 (osteoporosis, chronic ischaemic heart disease, and obstructive pulmonary disease) and 43 (stroke) experts responded in each of the conditions. In all conditions, with the exception of depression, there were categories in all ICF components that were considered typical and/or relevant by at least 80% of the responders. While all conditions had a distinct typical spectrum of relevant ICF categories, there were also some common relevant categories throughout the majority of conditions. CONCLUSION: Lists of ICF categories that are considered relevant and typical for specific conditions by international experts could be created. This is an important step towards identifying ICF Core Sets for chronic conditions.

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ICF Core Sets for low back pain.

OBJECTIVE: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of a Comprehensive ICF Core Set and a Brief ICF Core Set for low back pain. METHODS: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review and an empirical data collection. After training in the ICF and based on these preliminary studies, relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. RESULTS: The preliminary studies identified a set of 503 ICF categories at the second, third and fourth ICF levels with 211 categories on body functions, 47 on body structures, 190 on activities and participation and 55 on environmental factors. Eighteen experts from 15 different countries attended the consensus conference on low back pain. Altogether 78 second-level categories were included in the Comprehensive ICF Core Set with 19 categories from the component body functions, 5 from body structures, 29 from activities and participation and 25 from environmental factors. The Brief ICF Core Set included a total of 35 second-level categories with 10 on body functions, 3 on body structures, 12 on activities and participation and 10 on environmental factors. CONCLUSION: A formal consensus process integrating evidence and expert opinion based on the ICF framework and classification led to the definition of ICF Core Sets for low back pain. Both the Comprehensive ICF Core Set and the Brief ICF Core Set were defined.

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ICF Core Sets for chronic widespread pain.

OBJECTIVE: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of a Comprehensive ICF Core Set and a Brief ICF Core Set for chronic widespread pain. METHODS: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review and an empirical data collection. After training in the ICF and based on these preliminary studies relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. RESULTS: The preliminary studies identified a set of 365 ICF categories at the second, third and fourth ICF levels with 143 categories on body functions, 45 on body structures, 125 on activities and participation and 125 on environmental factors. Thirty experts attended the consensus conference on chronic widespread pain (16 physicians with at least a specialization in physical and rehabilitation medicine, 4 rheumatologists, 2 psychiatrists, 5 physical therapists, one psychologist, one occupational therapist and 1 social worker). Altogether 65 second-level and 2 third-level categories were included in the Comprehensive ICF Core Set with 23 categories from the component body functions, one from body structures, 27 from activities and participation and 16 from environmental factors. The Brief ICF Core Set included a total of 24 second-level categories and 2 third-level categories with 10 on body functions, 10 on activities and participation and 6 on environmental factors. No body structures were included in the Brief ICF Core Set. CONCLUSION: A formal consensus process integrating evidence and expert opinion based on the ICF framework and classification led to the definition of ICF Core Sets for chronic widespread pain. Both the Comprehensive ICF Core Set and the Brief ICF Core Set were defined.

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ICF Core Sets for obstructive pulmonary diseases.

OBJECTIVE: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of the Comprehensive ICF Core Set and a Brief ICF Core Set for obstructive pulmonary diseases. METHODS: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review and an empirical data collection. After training in the ICF and based on these preliminary studies relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. RESULTS: The preliminary studies identified a set of 287 ICF categories at the second, third and fourth ICF levels with 97 categories on body functions, 33 on body structures, 104 on activities and participation, and 53 on environmental factors. Seventeen experts from 8 different countries attended the consensus conference on obstructive pulmonary diseases. Altogether 67 second-level and 4 third-level categories were included in the Comprehensive ICF Core Set with 19 categories from the component "body functions", 5 from "body structures", 24 from "activities and participation" and 23 from "environmental factors". The Brief ICF Core Set included a total of 17 second-level categories with 5 on "body functions", 3 on "body structures", 5 on "activities and participation" and 4 on "environmental factors". CONCLUSION: A formal consensus process integrating evidence and expert opinion based on the ICF framework and classification led to the definition of ICF Core Sets for obstructive pulmonary diseases. Both the Comprehensive ICF Core Set and the Brief ICF Core Set were defined.

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