ICF-based classification and measurement of functioning.

If we aim towards a comprehensive understanding of human functioning and the development of comprehensive programs to optimize functioning of individuals and populations we need to develop suitable measures. The approval of the International Classification, Disability and Health (ICF) in 2001 by the 54th World Health Assembly as the first universally shared model and classification of functioning, disability and health marks, therefore an important step in the development of measurement instruments and ultimately for our understanding of functioning, disability and health. The acceptance and use of the ICF as a reference framework and classification has been facilitated by its development in a worldwide, comprehensive consensus process and the increasing evidence regarding its validity. However, the broad acceptance and use of the ICF as a reference framework and classification will also depend on the resolution of conceptual and methodological challenges relevant for the classification and measurement of functioning. This paper therefore describes first how the ICF categories can serve as building blocks for the measurement of functioning and then the current state of the development of ICF based practical tools and international standards such as the ICF Core Sets. Finally it illustrates how to map the world of measures to the ICF and vice versa and the methodological principles relevant for the transformation of information obtained with a clinical test or a patient-oriented instrument to the ICF as well as the development of ICF-based clinical and self-reported measurement instruments.