Applicability of the ICF checklist to traumatically brain-injured patients in post-acute rehabilitation settings.

OBJECTIVE To evaluate the applicability of the International Classification of Functioning, Disability and Health (ICF) checklist in post-acute traumatically brain-injured patients in rehabilitation settings. DESIGN A cross-sectional study based on the written documents of an interdisciplinary rehabilitation team. SUBJECTS A sample of 55 patients with traumatic brain injury. METHODS Two raters extracted information from the patients' medical documents using the ICF checklist. The most common ICF categories were identified and the agreement between the raters was evaluated. RESULTS Of the 123 checklist categories, 30 reached a prevalence of 30% or more in the ratings of both raters, and 18 further categories reached a prevalence of 30% or more in the ratings of either one rater. Seventy-five categories (61%) did not reach the cut-off point and were thus considered irrelevant. Fourteen ICF categories not included in the checklist were also considered important. Extracting the data from pre-existing documents seems to be reliable: in 86% of the most relevant categories the difference between the raters in the qualifier values was at most 1. CONCLUSION A checklist is a practical tool in clinical work. However, the current ICF checklist seems not to be adequate in characterizing patients with post-acute traumatic brain injury. Developing an ICF core set for these patients might prove useful.