ICF illustration library



Steve Sutch

Senior Consultant and Analytical and Statistical Services Manager, NHS Information Authority, King's Court, The Broadway, Winchester SO23 9BE, England (email:



The ICF illustration library is an illustrated website version of the WHO International Classification of Functioning, Disability and Health (ICF). It provides a simple and understandable way of navigating the structure and construction of ICF. The web site shows Japanese ( and English ( versions of the library. Access to both versions is free, and the web pages enable the user to view the classification via a hierarchical structure with accompanying codes, text and illustrations. The site's design permits other languages to be added simply to the library.

Upon opening the web site, the user is presented with a screen showing the top level structure of ICF: Body Functions; Body Structures; Activities and Participation; Environmental Factors. Clicking on any one of these headings leads to a display of the associated chapters. The key feature of the library is its use of illustrations at all levels to support the text. If a concept can be further classified by a more detailed ICF code, a "MORE" button is displayed; by clicking on it, the user is taken to the next deeper code layer. The route by which the user has arrived at a particular code is displayed on screen, allowing easy access to any part of the hierarchy, thus making the web pages very easy to navigate. Fig. 1 shows the image of a page of the ICF illustration library, with the righthand expanded set of images showing the page obtained when a user presses the "MORE" button shown below d410.

Development of the illustrative library was based on experience gained in devising a functional assessment tool for the elderly in Japan. The illustrations, which were drawn by a professional artist under supervision, are marked by their simplicity and provide a good graphical description of the classification concepts and codes. The illustrations are copyrighted by Dr Tai Takahashi (International University of Health and Welfare, Japan) but the creators are keen to allow the non-commercial use of their work. The textual information taken from ICF is comprehensive and includes the full descriptions of the codes as well as notes on inclusions and exclusions.

The pages on the site can be potentially used as a training aid to understanding the structure and composition of ICF, as well as an online aid to using and interpreting the ICF classification system. Use of the illustrations in addition to the text may also result in a more standardized interpretation of the classification and thus ensure consistency. Although the library has been specifically designed for dealing with elderly patients, its design would also lend itself to being adapted for other patients groups and used in other cultural settings.

World Health Organization Genebra - Genebra - Switzerland