Methodological considerations in cross-sectional studies validating the International Classification of Functioning,...

Area of Science:

• Health Services Research
• Rehabilitation Medicine
• Disability Studies

Background:

• The International Classification of Functioning, Disability and Health Core Sets (ICF-CS) are crucial for standardizing health status assessment.
• Cross-sectional studies are commonly employed for ICF-CS validation.
• Evaluating the methodological quality of these validation studies is essential for reliable data.

Purpose of the Study:

• To systematically review and analyze the methodological characteristics and quality of cross-sectional studies that have validated ICF-CS.
• To identify strengths and weaknesses in the existing ICF-CS validation research.

Main Methods:

• A systematic review of empirical studies published in English validating any ICF-CS using a cross-sectional design.
• Searched multiple databases (Web of Science, Scopus, CINAHL, PubMed, Embase, PsycINFO) with updates in Nov 2022 and Oct 2023.
• Two independent reviewers assessed methodological quality and risk of bias using the AXIS tool.

Main Results:

• Analyzed 87 articles validating 24 ICF-CSs.
• Most studies demonstrated consistency between objectives and outcome measures.
• A significant majority (up to 94.2%) failed to report sample size calculation, and few studies were conducted in the WHO African and Eastern Mediterranean regions.

Conclusions:

• The methodological quality of cross-sectional ICF-CS validation studies is generally satisfactory.
• Improvements are needed in reporting sample size calculations and conducting studies across diverse WHO regions.
• Future research should focus on multicenter studies, replication in different regions, and synthesis of existing evidence to strengthen validity.