Table 2.

Gaps that Limit Full Integration of Functional Assessment in Clinical Research

Gap	Desirable characteristics of tools or research to fill the gap	What filling the gap would enable
Set of feasible measures for use in clinical settings	• Brief • Administration requires minimal training or equipment • Can be integrated into electronic health record and/or Medicare Minimum Data Set • Reliable and reproducible • Accurately assesses health domains relevant to function, even in people with multiple impairments (eg, cognitive assessment in people with hearing or visual impairment)	Incorporation of functional measures in clinical care in a manner that is standardized and benchmarked across clinical settings
Data sets that characterize clinically relevant aspects of function	• Account for changes in function over time (dynamic or repeated measures) • Allow comparison of measured and reported function (from patient, caregivers, providers) • Assess individual preferences and values related to function • Assess acute stressors or precipitants of change in function	Research to validate and more fully explore the role of function in health and clinical decision making
Population norms of function and its determinants, including for populations who are underrepresented in clinical research	• Can be used to explore racial, ethnic, and sex trends • Characterize expected functional trajectories associated with various chronic conditions, comorbidities, and procedures • Describe how changes in health domains over time relate to functional changes	Early detection of decline in function and targeting for intervention