Chronic ischemic heart disease is the leading cause of death worldwide and is predicted to become the leading cause of global disability-adjusted life years and the major contributor to the burden of disease worldwide by 2020. Current recommendations for the treatment of chronic ischemic heart disease focus on increasing the "quantity" of life (i.e. prevent myocardial infarction and death) and improving the quality of life (by reducing symptoms related to angina/ischemia). The importance of systematically assessing symptoms and functional limitations to optimize the management of chronic ischemic heart disease has led to the development and use of a number of condition-specific health status measures. Recently the American College of Cardiology and the American Heart Association reviewed the use and the properties of currently available health-status measures for patients with chronic ischemic heart disease.

However, none of these organizations has made recommendations regarding the use of specific health-status measures or provided a systematic framework to cover the spectrum of symptoms and limitations in functioning of patients with chronic ischemic heart disease. To tackle this issue, the ICF Research Branch and the World Health Organisation (WHO) with the scientific support of University Hospital of Berne (Switzerland), University Hospital Elias (Romania), Kaiser-Franz-Josef-Spital (Austria), Ludwig-Maximilian University (Germany) and University of Texas Health Science Center at San Antonio (USA), initiated a project to develop internationally-accepted and evidence-based ICF Core Sets for chronic ischemic heart disease. This project was part of a larger project examining 12 chronic conditions with a high burden of disease.

The preparatory phase included a systematic literature review, a Delphi exercise and an empirical data collection using the ICF checklist:

• The systematic literature review was performed to identify and compare the concepts contained in outcome measures of randomized, controlled clinical trials published from 1993-2003 involving patients with chronic ischemic heart disease.
• The international expert survey (via email) using the Delphi technique was conducted with 21 health professionals, experts on the treatment of persons with chronic ischemic heart disease, to identify the set of domains that best describe the prototypical spectrum of problems in functioning and health in persons with chronic ischemic heart disease from the of health professional perspective.
• The multicentre cross-sectional study using the ICF checklist with a convenient sample of 72 patients undergoing inpatient or outpatient rehabilitation was performed to identify the common problems experienced by persons with chronic ischemic heart disease.

An international ICF consensus conference took place from 30 May - 2 June 2003 at a quiet monastery situated in a pleasant landscape far from any city and distractions. The aim of the conference was to establish the Comprehensive and Brief ICF Core Sets for patients with chronic ischemic heart disease. Sixteen experts (physicians in various sub-specialities, physiotherapists, epidemiologists) from 7 different countries decided which ICF categories are to be included in the ICF Core Sets for chronic ischemic heart disease following a formal, decision-making and consensus process which integrated the results from the 3 preparatory studies.

61 ICF categories were selected for inclusion in the Comprehensive ICF Core for chronic ischemic heart disease. These categories can be taken into account when conducting a comprehensive, multidisciplinary assessment. Out of the 61 Comprehensive ICF Core Set categories, 36 ICF categories were selected as categories for the Brief ICF Core for chronic ischemic heart disease. The Brief ICF Core Set can be used in assessing patients participating in a clinical study on chronic ischemic heart disease.

For more information, feel free to contact the ICF Research Branch (melissa.selb@paranet.ch).

• Comprehensive & Brief ICF Core Sets for chronic ischemic heart disease (download PDF)