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Table 2 Study specific ICF-CY linking rules

From: Methods for conceptualising ‘visual ability’ as a measurable construct in children with cerebral palsy

Identification of linking units
i. Determine the type of information to be linked: patient-oriented measure (self-report, caregiver report, or health professional reported) or clinical assessment.
ii. Identify linking unit(s). The linking unit of a measure answers the question: What is the item about?
The names of measures, the instructions, and subscale titles provide useful information to define the linking units.
e.g., Item 17 from the CVI Questionnaire asks whether the child “Sits right in front of the television”. This item needs to be considered in the context of being an item in a measure screening for cerebral visual impairment. The item falls in the section of ‘Visual attitude’ and the subscale of ‘visual attention’. This item is not about ‘sitting’.
For Patient-oriented measures:
• Refer to the item as it appears in the questionnaire
• Identify response options of items that contain linking unit(s)
For Clinical assessments:
• Refer to the aim of the clinical assessment
• Consider that the linking unit may change depending on the context in which the clinical assessment is used.
iii. Identify any relationship between concepts: when there are more than two linking units the relationship between the units is also provided.
e.g., Item 21 in the Functional Visual Questionnaire asks whether the child “Looks at a toy or object while reaching/moving hand towards it”. This item is about looking ‘whilst’ reaching. The relationship should be recorded.
Linking of linking units to the ICF-CY
a. Select the appropriate code(s) to describe the linking unit:
Is the linking unit an element of Body Functions, Body Structures, Activities and Participation, or Environmental factors?
Which chapter within the selected domain is the most appropriate?
Which category within the selected chapter is the most precise?
b. If the content of an item is not explicitly named in the corresponding ICF-CY category, then the “other specified” is linked. This code allows for coding of functioning that is not included within any of the other specific categories. When an “other specified” code is used, the specification has to be annotated.
c. If the content of an item is insufficient to permit assignment of a more specific category, the “unspecified” is linked. The code has the same meaning as the second- or third-level term immediately above (b), without any additional information.
i.e., Use d199 Learning and applying knowledge, unspecified rather than d1 Learning and applying knowledge
d. If the linking unit is an element of ‘Health condition’ the code HC is used.
e. If the linking unit is an element of ‘Personal factors’ it would be considered to have a positive or negative influence on disability and functioning. To determine if a linking unit is a Personal factor ask: Can the linking unit be impaired, restricted or limited? If no, it is a personal factor.
f. If the content of an item is unclear or too general to permit assignment of any category or component, the “nondefinable” (nd) is used. The perspective is documented as General Health (nd-gh), Quality of life (nd-qol), Physical health (nd-ph), Mental health (nd-mh), or Life satisfaction (nd-s).
g. If the linking unit is not a Health condition, Body function/body structure, Activity, Participation, Environmental factor or Personal factor, it is “Not covered” (nc).