Chronic COPD (COPD) and asthma are the most common Conditions associated with chronic airflow limitations and COPD is projected to become the 5th leading cause of years lived with disability. The recognition of the importance of systematically assessing symptoms and functional limitations to optimize the management of COPD and asthma has led to the development and use of a number of condition-specific health-status measures. A number of professional organizations in the area of cardiovascular and pulmonary medicine have reviewed the use and properties of currently available health-status measures for COPD. However, none of these organizations have made recommendations regarding the use of specific health-status measures nor provided a systematic framework that covers the spectrum of symptoms and limitations in functioning of persons with COPD.

To tackle this issue, the ICF Research Branch and the World Health Organisation (WHO) with the scientific support of University Hospital of Berne and AarReha Schinznach (both Switzerland), Istituto Scientifico di Montescano (Italy), Rehab Center Rössingh Enschede (The Netherlands) and Ludwig-Maximilian University (Germany), initiated a project to develop internationally-accepted and evidence-based ICF Core Sets for COPD. This project was part of a larger project examining 12 chronic conditions with a high burden of disease.

The preparatory phase included a systematic literature review, a Delphi exercise and an empirical data collection using the ICF checklist:

• The systematic literature review was performed to identify and compare the concepts contained in outcome measures of randomized, controlled clinical trials published from 1993-2003 involving patients with COPD.
• The international expert survey (via email) using the Delphi technique was conducted with 21 health professionals, experts on the treatment of persons with COPD, to identify the set of domains that best describe the prototypical spectrum of problems in functioning and health in persons with COPD from the of health professional perspective.
• The multicentre cross-sectional study using the ICF checklist with a convenient sample of 89 patients undergoing inpatient or outpatient rehabilitation was performed to identify the common problems experienced by persons with COPD.

An international ICF consensus conference took place from 30 May - 2 June 2003 at a quiet monastery situated in a pleasant landscape far from any city and distractions. The aim of the conference was to establish the Comprehensive and Brief ICF Core Sets for patients with COPD. Seventeen experts (physicians in various sub-specialities, physiotherapists, psychologist, nurse) from 8 different countries decided which ICF categories are to be included in the ICF Core Sets for COPD following a formal, decision-making and consensus process which integrated the results from the 3 preparatory studies.

67 ICF categories were selected for inclusion in the Comprehensive ICF Core for COPD. These categories can be taken into account when conducting a comprehensive, multidisciplinary assessment. Out of the 67 Comprehensive ICF Core Set categories, 17 ICF categories were selected for the Brief ICF Core for COPD. The Brief ICF Core Set can be used in assessing patients participating in a clinical study on COPD.

Validation studies have been conducted.

For more information, feel free to contact the ICF Research Branch (melissa.selb@paranet.ch).

• Comprehensive & Brief ICF Core Sets for COPD (download PDF)