Perspective of physicians within a multidisciplinary team: content validation of the comprehensive ICF core set for head and neck cancer.

BACKGROUND The Comprehensive International Classification of Functioning, Disability and Health Core Set for Head and Neck Cancer (ICF-HNC) is an application of the ICF and guides multidisciplinary cancer follow-up and rehabilitation in patients with head and neck cancer. The objective of this study was to understand the role of physicians within the multidisciplinary team and to explore the content validity of the ICF-HNC from the perspective of physicians. METHODS In a 3-round Delphi survey, physicians experienced in the treatment of head and neck cancer were asked what patients' problems, resources, and aspects of environment they treat. The responses of the first round were linked to the ICF. In the second round the participants received a list of identified ICF categories and were asked if these ICF categories represent patients' problems, resources, and aspects of the environment they treat. Round 3 required a reconsideration of the given answers in accord with the group response. The agreement of the linking process between 2 health care professionals was calculated using kappa statistics. RESULTS In all, 55 physicians from 25 countries gave 781 statements; 83 ICF categories were linked to the statements after the first round; 55 ICF categories reached consensus of ≥ 75% after the third round. Of these, 46 categories (84%) are already included in the ICF-HNC. Within the entire ICF-HNC, physicians treat most categories from body structures (88%) and functions (76%) and some categories from activities and participation (15%) and environmental factors (21%). The kappa coefficient for linking ICF categories was 0.988 (95% bootstrapped confidence interval: 0.95-0.99). CONCLUSIONS The content validity of the ICF-HNC was supported by the perspective of physicians. This study supports the need for a multidisciplinary team. The aspects of functioning which are not treated by physicians should be addressed by timely involvement of other health professions.