Chapter 4 Flashcards
What are conceptual models of health?
Provide a framework for selecting outcome measures.
Contemporary health models are moving away from a biomedical view to acknowledge the contribution of physical, social, and psychological well-being and emphasizing the importance of the interaction between the individual and the environment.
What is the International Classification of Functioning Model?
Emphasis is placed on the influence of personal and environmental factors on the three dimensions of body functions and structures, activities, and participation.
Outcome scales can serve what clinical purposes?
Evaluate change over time
Discriminate between different groups
Predict future status
What are psychometric methods?
Creating instruments where a specific domain of content is sampled and items are developed to represent this domain
What is the decision theory?
Understanding how people value their life or health state (e.g., utility measures)
What are types of outcome measures?
Generic instruments
Disease or symptom-specific measures that focus on the key aspects of a disease or symptom
Regional or body part-specific measures that focus on a body area
Patient-specific measures where items are selected to be meaningful to patient
What are the structural characteristics of outcome measures?
Individual items and response options
Instructions provided to respondents about how to attribute their symptom or function
One-dimensional or have subscales that reflect different aspects of the health domain
Scoring of individual questions and subscales
Instructions on how missing items are handled and other procedural elements
How can you identify outcome measures for use in clinical practice?
Texts, websites, and journal articles provide access to information about outcome measures
Contacting developers may be needed to get forms and permissions
How do you evaluate outcome measures?
Responsiveness is important for using instruments to evaluate change over time.
Discriminative validity is important for using an instrument to determine which group a patient belongs (to determine a diagnosis; or status such as “able to return to work”).
Reliability/stability: Or consistency of a measure when no change occurs
Is important to insure a stable baseline AND
Because any measurement error is background noise that makes it difficult to determine when REAL change has occurred
What are facilitators to using outcome measures?
National initiatives by the professional associations; traditional workshops; published editorials, scientific articles, and textbooks; professional association endorsement; and development of outcomes databases.
What are barriers to using outcome measures?
Lack of time, administrative support, or specific knowledge on how to find and apply measures.
