Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2002; 7: 107
In May 2001, the World Health Organization (WHO), passed a major revision of the former International Classification of Impairments, Disability and Health (ICIDH) to complement the widely used classification International Classification of Diseases (ICD), tenth Revision (ICD-10). Unlike the ICD-10, which provides an aetiological framework, the International Classification of Functioning, Disability and Health (ICF) aims at classifying functioning and disability associated with health conditions. The ICF comprises of two parts, each of which has two components.
Part one, Functioning and Disability, classifies changes in body functions (i.e. physiological correlates) and in body structures (i.e. anatomical correlates). The second component comprises Activities (‘Capacity’, i.e. executing tasks in a standard environment) and Participation (‘Performance’, i.e. executing tasks in the current environment). Part two focuses on Contextual Factors (components: ‘Environmental Factors’ and ‘Personal Factors’). The last component, however, is not yet classified in the current version of the ICF.
Each component can be expressed in both positive and negative terms, and consists of so called ‘domains’. Within each domain there are categories, which are the units of classification. Health and health-related states of an individual may be recorded by selecting the appropriate category code(s), and then adding ‘qualifiers’, which are numeric codes specifying the extent/magnitude of the functioning or disability in a given category, or the extent to which an environmental factor is a facilitator or barrier.
Since the underlying philosophy of many complementary and/or alternative medical interventions is essentially that of an individualised, patient-centred (rather than a pathology driven) approach, the ICF represents a highly suitable tool to define ‘pragmatic’ therapeutic targets, the (perceived) effectiveness of which can be quantified regardless of whether or not the underlying mode of action is known. The fact that it is increasingly accepted in the scientific community may facilitate the dialogue between mainstream medicine and complementary and alternative medicine, and may help to differentiate the clinically relevant from the irrelevant.
