Skip to main content
  • Other Publications
  • Subscribe
  • Contact Us
Advertisement
JCORE Reference
this is the JCORE Reference site slogan
  • Home
  • Most Read
  • About Us
    • About Us
    • Editorial Board
  • More
    • Advertising
    • Alerts
    • Feedback
    • Folders
    • Help
  • Patients
  • Reference Site Links
    • View Regions
  • Archive

Invited Commentary

Catherine R. Sykes
DOI: 10.2522/ptj.20140009.ic3 Published 1 March 2014
Catherine R. Sykes
C.R. Sykes, MSc, MCSP, GradDipPhys, CertEd, World Confederation for Physical Therapy, London, United Kingdom, and Health Systems and Global Populations Group, Faculty of Health Sciences, University of Sydney, Sydney, Australia.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

I congratulate Dijkers and colleagues for their summary of work in progress toward a rehabilitation taxonomy.1 As Thomas Mann said, “Order and classification are the beginning of mastery, whereas the truly dreadful enemy is the unknown.”2 So it follows that ordering and classifying various elements of health and health systems is a way to understand and manage the complexity. The World Health Organization (WHO) under its constitution is required to “establish and revise as necessary international nomenclatures of diseases, of causes of death and of public health practices.”3 In undertaking the remit, WHO has developed a family of international classifications (World Health Organization Family of International Classifications [WHO-FIC]).4 The WHO-FIC is a suite of classification products that, when used together, cover various aspects of health information systems. The International Classification of Diseases (ICD)5 and the International Classification of Functioning, Disability and Health (ICF)6 are established classifications. Missing has been the third reference classification recognized in the family, the International Classification of Health Interventions (ICHI). Since 2007, there have been concerted efforts to develop the ICHI. This commentary will explore the possible links between the internationally endorsed classifications and the proposed rehabilitation treatment taxonomy (RTT).7

Interventions Classification

To date, international and national classifications of health interventions, such as the International Classification of Procedures in Medicine8 and the International Classification of Diseases, Clinical Modification (ICD-9-CM)9 have tended to focus on high-profile, high-cost medical, surgical, and diagnostic interventions accessed by limited sections of the population. Interventions delivered in public health, rehabilitation, and community settings are less well defined and rarely measured and reported to the same extent. The policy implications are that those interventions measured and reported are valued and funded, whereas lower-cost interventions with the potential to benefit broad areas of the population receive less attention. The ICHI will provide a basis for collecting, analyzing, and reporting on the full range of health interventions. Thus, the ICHI has the potential to support evidence building for rehabilitation relevant interventions.

Purposes

The purpose of the RTT is to describe and evaluate the clinical practice of rehabilitation using a discrete and detailed set of treatments. Treatments, as a subset of health interventions, lie within the scope of the broader ICHI. The elements of rehabilitation practice that are purposely excluded from the RTT, such as diagnostic interventions, may also be found in chapters of the ICHI.10

The purposes of the ICHI are to provide a classification of appropriate scope and detail for use by countries without a national classification of health interventions, to provide a base that can be extended to develop more finely grained national or specialty classifications, to establish a framework for comparisons of the use of health interventions in different countries, to provide a building block for international case-mix development, and to avoid duplication of effort at a national level.

Similarities and Differences

Both the proposed RTT and the ICHI are intended for collecting information on health interventions consistently and reliably. Both have a tripartite structure with each intervention described in terms of an entity on which the intervention has an effect, an action, and an operational entity. The axes and their definitions are shown in the Table. Both the RTT and the ICHI use the ICF to inform the classification and are profession and setting neutral. As such, it would be desirable if the ICHI could provide the “backbone” for the more finely grained RTT. Although fine-grained information is appropriate for clinical and clinical research purposes, aggregation to broader categories is required for statistical and administrative purposes. Collecting data once and using it for multiple purposes is desirable and would be feasible if the RTT were to relate to the ICHI.

View this table:
  • View inline
  • View popup
  • Download powerpoint
Table.

Tripartite Structures of the International Classification of Health Interventions (ICHI) and the Rehabilitation Treatment Taxonomy (RTT)

The groupings of treatment categories described in the RTT reflect the influence of the ICF. The treatments that alter the structure of tissues relate to the body structure component of the ICF; likewise, the treatments that alter or replace functions relate to the body functions component. Skilled performances relate to the life areas classified in the activities and participation component. In the ICHI, the actions that apply to the life areas are different for skilled performances and for the acquisition and interpretation of knowledge. Analysis of the ICHI interventions according to the RTT groupings could be done. The knowledge arising out of such an exercise has the potential to benefit both projects.

Intervention classifications enable the definition and subsequent monitoring of the range of interventions provided across the continuum of health services, and thus the ability to evaluate the respective contributions toward the health of individuals and populations of preventive, primary, acute, rehabilitation, and palliative and support services. The interventions generally, but not exclusively, used by rehabilitation providers will be able to be defined and reported such that the role and efficacy of individual professions within multiprofessional and interprofessional teams can be identified.

Conclusions

In view of the common aims and similarities between the 2 classification products and the significant resources required to develop and maintain a national classification for a single sphere of practice, I would encourage the developers of the RTT to join the international collaborative team in the development of an ICHI that meets the needs of rehabilitation providers.

Footnotes

  • The author thanks Richard Madden from the National Centre for Classification in Health, University of Sydney, who has led ICHI development, and all members of the ICHI development team; it is their combined thoughts and efforts that underpin this commentary.

  • © 2014 American Physical Therapy Association

References

  1. ↵
    1. Dijkers MP,
    2. Ferraro MK,
    3. Hart T,
    4. et al
    . Toward a rehabilitation treatment taxonomy: summary of work in progress. Phys Ther. 2014;94:319–321.
    OpenUrlFREE Full Text
  2. ↵
    1. Mann T
    . The Magic Mountain. Everyman's Library Contemporary Classics. New York, NY: Alfred A. Knopf; 2005.
  3. ↵
    World Health Organization. 1946. Constitution of the World Health Organization. Available at: http://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf. Accessed: November 11, 2013.
  4. ↵
    1. Madden RC,
    2. Sykes CR,
    3. Ustun TB
    . World Health Organization Family of International Classifications: definition, scope and purpose. 2007. Available at: http://www.who.int/classifications/en/FamilyDocument2007.pdf. Accessed: November 11, 2013.
  5. ↵
    International Classification of Diseases. Geneva, Switzerland: World Health Organization; 1990.
  6. ↵
    International Classification of Functioning, Disability and Health: ICF. Geneva, Switzerland: World Health Organization; 2001.
  7. ↵
    1. Dijkers MP,
    2. Hart T,
    3. Tsaousides T,
    4. et al
    . An intervention taxonomy for medical rehabilitation: past, present, and prospects. Arch Phys Med Rehabil. 2014;95(1 suppl):S6–S16.
    OpenUrlCrossRefPubMed
  8. ↵
    International Classification of Procedures in Medicine. Geneva, Switzerland: World Health Organization; 1978.
  9. ↵
    National Center for Health Statistics and Centers for Disease Control and Prevention. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), Volume 3. 2011. Available at: http://www.cdc.gov/nchs/icd/icd9cm.htm. Accessed: November 28, 2013.
  10. ↵
    1. Sykes CR
    . Rehabilitation treatment taxonomy and the International Classification of Health Interventions. Arch Phys Med Rehabil. 2014;95(1 suppl):S91–S93.
    OpenUrlCrossRefPubMed
  11. ICHI Development Project. ICHI Alpha2 (September 2013), Introduction. Available at: http://sydney.edu.au/health-sciences/ncch/resources.shtml. Accessed: November 11, 2013.
View Abstract
PreviousNext
Back to top
Vol 94 Issue 3 Table of Contents
Physical Therapy: 94 (3)

Issue highlights

  • Toward a Rehabilitation Treatment Taxonomy
  • Applying Evidence to a Patient With HIV Disease
  • Clinical Utility of the BESTest
  • Determinants of Guideline Use in Primary Care Physical Therapy
  • Cognitive Declines, Hazardous Mobility, and Falls
  • Direct Access to Physical Therapy for Low Back Pain in the Netherlands
  • Interrater Reliability of the Berg Balance Scale for People With Lower Limb Amputations
  • AM-PAC “6-Clicks” Inpatient Daily Activity and Basic Mobility Short Forms
  • Functional Gait Assessment in Patients With Parkinson Disease
  • Outcome Measures for Community Mobility and Social Interaction After Transfemoral Amputation
  • Dosing Parameters for Children With Cerebral Palsy
  • Future Directions in Painful Knee Osteoarthritis
Email

Thank you for your interest in spreading the word on JCORE Reference.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Invited Commentary
(Your Name) has sent you a message from JCORE Reference
(Your Name) thought you would like to see the JCORE Reference web site.
Print
Invited Commentary
Catherine R. Sykes
Physical Therapy Mar 2014, 94 (3) 325-326; DOI: 10.2522/ptj.20140009.ic3

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Save to my folders

Share
Invited Commentary
Catherine R. Sykes
Physical Therapy Mar 2014, 94 (3) 325-326; DOI: 10.2522/ptj.20140009.ic3
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Article
    • Interventions Classification
    • Purposes
    • Similarities and Differences
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Rothstein Roundtable Podcast—“Putting All of Our Eggs in One Basket: Human Movement System”
  • Rothstein Roundtable Podcast—“Interprofessionalism: Is It Campfire Kumbaya, or the Means to the Triple Aim (Better Health, Better Care, Lower Cost)?”
  • Toward a Rehabilitation Treatment Taxonomy: Summary of Work in Progress
Show more Health Policy in Perspective

Subjects

  • Health Services Research
  • Health Policy in Perspective

Footer Menu 1

  • menu 1 item 1
  • menu 1 item 2
  • menu 1 item 3
  • menu 1 item 4

Footer Menu 2

  • menu 2 item 1
  • menu 2 item 2
  • menu 2 item 3
  • menu 2 item 4

Footer Menu 3

  • menu 3 item 1
  • menu 3 item 2
  • menu 3 item 3
  • menu 3 item 4

Footer Menu 4

  • menu 4 item 1
  • menu 4 item 2
  • menu 4 item 3
  • menu 4 item 4
footer second
footer first
Copyright © 2013 The HighWire JCore Reference Site | Print ISSN: 0123-4567 | Online ISSN: 1123-4567
advertisement bottom
Advertisement Top