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Are they relevant? A critical evaluation of the international classification of functioning, disability, and health core sets for osteoarthritis from the perspective of patients with knee osteoarthritis in Singapore
  1. F Xie1,
  2. J Thumboo2,3,
  3. K-Y Fong2,3,
  4. N-N Lo4,
  5. S-J Yeo4,
  6. K-Y Yang4,
  7. S-C Li1
  1. 1Department of Pharmacy, National University of Singapore, Republic of Singapore
  2. 2Department of Medicine, National University of Singapore
  3. 3Department of Rheumatology and Immunology, Singapore General Hospital
  4. 4Department of Orthopaedic Surgery, Singapore General Hospital
  1. Correspondence to:
    Dr Shu-Chuen Li
    Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117543; phalisc{at}


Objectives: To determine the extent to which health items identified from the perspective of patients with knee osteoarthritis can be linked with the International Classification of Functioning, Disability and Health (ICF); and to evaluate critically the content validity of ICF comprehensive and brief core sets for osteoarthritis.

Methods: Items identified from a focus group study were linked independently by two researchers based on the 10 a priori linking rules. Both percentage agreement and κ statistics were calculated to measure interobserver agreement. Any disagreements were resolved by reaching a consensus among the researchers. The categories linked with all items were compared with the comprehensive core set, while the categories linked with those items reported as important by over 30% of subjects within each of three local ethnic groups (Chinese, Malay, and Indian) were compared with the brief core set. Both comparisons were made only at the second level of the ICF.

Results: In all, 74 items were linked with 44 different ICF categories through 105 linkages with generally good interobserver agreement. The 69 items were linked with the ICF at the third or fourth levels. Both commonalities and disparities were found through comparison between the categories linked with these items and both core sets.

Conclusions: All items could be successfully linked with the ICF. The comprehensive core set showed good content validity, while the brief core set needs to be supported by more empirical evidence in various sociocultural contexts. This study specifically complemented the development and refinement of both core sets from the perspective of patients with knee osteoarthritis.

  • ICF, International Classification of Functioning, Disability and Health
  • osteoarthritis
  • knee
  • ICF

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  • Published Online First 5 January 2006

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