The Applicability of the International Classification of Functioning, Disability, and Health to Study Lifestyle and Quality of Life of Colorectal Cancer Survivors

Abstract

Background: Well-designed studies on lifestyle and health-related quality of life (HRQoL) in colorectal cancer survivors based on a biopsychosocial instead of a traditional biomedical approach are warranted. We report on the applicability of the International Classification of Functioning, Disability, and Health (ICF) as useful biopsychosocial framework to improve research on how lifestyle influences colorectal cancer survivors' HRQoL, using the Energy for life after ColoRectal cancer (EnCoRe) study as an example.Methods: The ICF was used to develop a conceptual model for studying lifestyle and colorectal cancer survivors' HRQoL, by identifying relevant factors from literature and mapping them within the ICF. Subsequently, this model was used for selection of measurement instruments and biomarkers. By linking meaningful concepts within selected measures to the ICF, we could assess the ICF coverage of our developed conceptual model.Results: Within selected measures, 450 meaningful concepts were identified, of which 88% were linked to the ICF. The linking process resulted in 132 distinctive ICF categories assigned (38% within "Body Functions," 2% within "Body Structures," 46% within "Activities and Participation," and 14% within "Environmental Factors").Conclusions: The selected EnCoRe study measures broadly cover ICF domains relevant to colorectal cancer survivors, stressing the relevance of using a biopsychosocial approach for studying this population's HRQoL.Impact: The developed conceptual model will guide data analyses and interpretation, and facilitate early transfer of results for development, evaluation, and implementation of personalized multidisciplinary lifestyle interventions. We recommend the ICF as an invaluable framework for improving the quality and scope of HRQoL studies. Cancer Epidemiol Biomarkers Prev; 23(7); 1394-405. Ó2014 AACR.

Associations of adipose and muscle tissue parameters at colorectal cancer diagnosis with long-term health-related quality of life

“…Methods of the EnCoRe study have been described in detail elsewhere [41]. The cross-sectional part of the EnCoRe study was conducted in CRC survivors recruited 2–10 years post-diagnosis.…”

“…The main aim of the EnCoRe study is to investigate the associations of lifestyle factors with HRQoL in CRC survivors. Patients with stage IV CRC were therefore not included, since we hypothesized that their poor prognosis, and not lifestyle behavior, likely determines their HRQoL to the largest extent [41]. Participants were recruited between May 2012 and December 2013.…”

“…When designing the EnCoRe study, a conceptual model was developed for studying HRQoL in CRC survivors [41], based on the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization [42]. The ICF adopts a broad biopsychosocial definition of human functioning, including physical health components (body perspective) and the ability to perform daily activities and societal roles (individual and societal perspectives) [43].…”

“…Additionally, it enables the identification of environmental and personal factors and the presence of health conditions that can influence functioning. The developed conceptual model [41] was adapted for the current research questions to identify relevant variables to be included in data analyses (Online Resource 1, Supplementary Fig. 1).…”

Plasma metabolites associated with colorectal cancer stage: Findings from an international consortium

“…Data from four cohort studies within the MetaboCCC Consortium, a large consortium of European colorectal cancer cohorts established to investigate metabolic profiles across the continuum of colorectal cancer carcinogenesis, were included. The participating cohorts included: (i) the COLON study 15 from the Netherlands (ClinicalTrials.gov Identifier: NCT03191110), (ii) the EnCoRe study 16 from the Netherlands (Netherlands Trial Register: 7099), (iii) the Heidelberg, Germany, site of the international ColoCare Study 17 (ClinicalTrials.gov Identifier: NCT02328677) and (iv) the Colorectal Cancer Study of Austria (CORSA). All cohorts were approved by local medical ethics committees and all participants provided written informed consent.…”