Review articleHealth assessment instruments for people with intellectual disabilities—A systematic review
Section snippets
What this paper adds
People with ID experience health disparities. The prevalences of certain diseases (e.g. epilepsy, osteoporosis, visual impairment) in the population of people with ID differ from those in the general population. Health assessment instruments can guide health care professionals to reveal the health needs of people with ID. In this study, the quality of the health assessment instruments was assessed on four domains; development, clinimetric properties, content and effectiveness. We found 20
Methods
We performed a systematic review to detect the available health assessment instruments for people with ID in primary care and collect information about their development, clinimetric properties (i.e. validity, reliability, feasibility, acceptability), content, and effectiveness. We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews (Liberati et al., 2009).
General characteristics
We identified 5970 articles (see Fig. 1). After applying exclusion criteria and removing double citations, 2983 articles remained. These articles were screened on title and abstract. For this first level of screening the calculated kappa was 0.81, indicating good agreement between the two reviewers (Steiner & Norman, 2008). Of the retrieved 65 articles, two reviewers (EB, PL) independently assessed the full text of each article. For this second level of screening, kappa was 0.77. With reference
Main findings
We detected 20 different health assessment instruments for people with ID. The instruments vary in size, content, the way they are administered, and in their design. This implies that not all quality criteria used apply to all instruments. The process of development of the instruments has been described for four of the instruments, but only for two it was described clearly. We found limited information about the clinimetric properties of the instruments. The reliability and validity were tested
Conclusions
Health assessment instruments can help primary care professionals to provide better medical care to people with ID, and are a way to bridge the health disparity gap. In general, such instruments are well appreciated. However, the results of this review show that there is room for improvement in the application of more rigorous methods for the development and evaluation of high-quality health assessment instruments for people with ID. Such instruments should be appropriate, evidence-based and
Conflict of interest
The authors have no conflict of interest to declare.
Source of funding
This study was supported by consortium ‘Stronger on your own feet’, in which the Radboud university medical center collaborates with the following care organisations for people with ID: Pluryn, Siza, Dichterbij, Oro, de Driestroom, ‘s Heerenloo, Philadelphia and Koraalgroep. The consortium “Stronger on your own feet” had no involvement in the study design; in the collection, analysis and interpretation of the data; in writing the report, and the decision to submit the article.
Acknowledgements
We would like to thank Alice Tillema, information specialist at the Medical Library of the Radboud University for her contribution and assistance with the literature searches.
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