Content Validity of the Comprehensive ICF Core Set for Chronic Obstructive Pulmonary Diseases: An International Delphi Survey

Andrea Jobst 1, 2, Inge Kirchberger*, 1, 2, Alarcos Cieza 1, 2, 3, 4, Gerold Stucki 2, 4, 5, Armin Stucki 6, 7
1 Institute for Health and Rehabilitation Sciences (IHRS), Ludwig Maximilians Universität, Munich, Germany
2 ICF Research Branch, WHO FIC CC Germany (DIMDI) at SPF, Nottwil, Switzerland and at IHRS, Ludwig Maximilians Universität, Munich, Germany
3 Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton, UK
4 Swiss Paraplegic Research, Nottwil, Switzerland
5 Department of Health Sciences and Health Policy, University of Lucerne and SPF, Nottwil, Switzerland
6 Clinic and Policlinic for Pulmology, Inselspital, University Hospital Berne, Switzerland
7 Berner Rehabilitation Center Heiligenschwendi, Switzerland

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© Jobst et al.; Licensee Bentham Open.

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* Address correspondence to this author at the Department of Medical Informatics, Biometry and Epidemiology, Chair for Public Health and Health Care Research, Unit for Biopsychosocial Health, Ludwig-Maximilians Universität, Munich, Germany; Tel: ++49-89-2180-78216; Fax: ++49-89-2180-78230; E-mail:



The “Comprehensive ICF Core Set for Chronic Obstructive Pulmonary Diseases (COPD)“ is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of problems in functioning of patients with COPD. The objective of this study was to validate this ICF Core Set from the perspective of physicians.

Materials and Methodology:

Physicians experienced in COPD treatment were asked about the patients’ problems treated by physicians in patients with COPD in a three-round electronic mail survey using the Delphi technique. Responses were linked to the ICF.


Seventy-six physicians in 44 countries gave a total of 1330 responses that were linked to 148 different ICF categories. Nine ICF categories were not represented in the Comprehensive ICF Core Set for COPD although at least 75% of the participants have rated them as important. Nineteen concepts were linked to the not yet developed ICF component personal factors and seventeen concepts were not covered by the ICF.


The high percentage of ICF categories represented in the ICF Core Set for COPD indicates satisfactory content validity from the perspective of the physicians. However, some issues were raised that were not covered and need to be investigated further.

Keywords: Chronic obstructive pulmonary disease, asthma, rehabilitation, international classification of functioning, disability and health, ICF core set..