1) Outcome Measures Flashcards
What is an outcome measure in physiotherapy
something used to accurately measure an aspect of a patient’s problem which may be improved by the therapist’s treatment.
An outcome measure should be standardised, reliable, valid, acceptable to the patient and responsive to the clinical change that may occur.
Why do physios use outcome measures
1) It is used to determine whether or not treatment is being effective.
2) It is used as part of both the initial and ongoing assessment of a patient. Data from outcome measures may be used in research to test a hypothesis, whereas outcome measures are used clinically to monitor the response of the patient to the intervention.
Examples of outcome measures
Patient-reported questionnaires e.g. McGill Pain Questionnaire
Clinician- reported observation scales e.g. Elderly Mobility Scale
Measures of overall health e.g. SF-36
Measures of overall functional ability e.g. Functional Independence Measure
Disease or symptom specific measures e.g. St George’s Respiratory
Questionnaire
Activity/task specific measures e.g. Timed Up and Go Test
Specialised measuring equipment/devices e.g. Goniometer
Physiological tests carried out by other health professionals e.g.
Electromyography
Reliability
Reliability refers to how consistent the test is and how it can be repeated when used on more than one occasion or by more than one therapist.
Reliability is not a fixed property. It is important that the type of problem or patient and the situation in which it is used are taken into account when considering reliability.
Intra-rater reliability
Evaluates whether repeated measurements give the same result when administered by the same therapist.
Consistency of one practitioner.
Inter-rater reliability
evaluates whether the measurements give the same result for the same patient when administered by different therapists.
Validity
Validity- measure what it sets out to, does the test measure what its asked to.
It’s not a fixed property but dependent on the context and population in which the test is used, i.e. the location and types of patients.
A measure should be used according to any guidelines relating to its specific purpose and intended environment.
Standardisation
An outcome measure should be standardised, with explicit instructions for:
◾️measuring
▪️scoring the item of interest.
Standardisation of the measurement procedure improves validity and reliability of the outcome measure.
Interpretability
Determining what the results mean by comparing results with the scores of a ‘normal’ population if that information is available.
Some questionnaires have tables of normal values associated with them (e.g. Peak Expiratory Flow Rate).
Responsiveness
Responsiveness or sensitivity is the degree to which the measure detects a change in scores over time.
If a measurement scale has large differences between
each point on the scale it wont be sensitive to small changes in the patient’s condition.
There is a ceiling and floor effect.
Ceiling effect
Can occur when an outcome measure is too easy for a patient, therefore they score maximally, leaving no room to demonstrate progression.
Floor effect
Can occur when an outcome measure is too difficult for a patient to demonstrate progression towards the lowest score.
Acceptability
It is essential that an outcome measure is reasonable and tolerable for patients.
This might involve issues such as the time required to complete the measure or the layout of a questionnaire being difficult for patients to complete.
Feasibility
In clinical practice, there may be financial or organisational barriers to performing “gold-standard” outcome measures with patients, therefore a simpler, quicker, cheaper test may be practicable.
What are the 2 groups of data
- Numeric
2. Categorical
