ICF and Outcome Measures

Question 1

what could be under body functions and structures

Answer 1

injury severity
neurologic level
cognition
fitness level

Question 2

what goes under activities?

Answer 2

ADLs
mobility in the home/community
physical activity and exercise

Question 3

what goes under participation

Answer 3

quality of life
IADLs
community participation
social engagement
self-care and self esteem
work/employment

Question 4

what is the importance of outcome measures

Answer 4

get a comprehensive assessment of the problem
observe any change

Question 5

what is a good outcome measure

Answer 5

easy to administer

not inconvenient the patient

relevant/applicable to clinical setting

assists in classifying the patient’s

impairment/ setting goals / prognosis and assessing response to intervention

has good psychometric / measurement properties

Question 6

what are the 3 main reasons why we use objective measures

Answer 6

discriminate between impairment level of each patient

determine prognosis

evaluate change in status over time

Question 7

what are latent traits? examples

Answer 7

pain, disability, balance

typically cannot quantify objectively how much of each of these are present but it can be seen or discussed

ie = balance can be improved but cannot be quantified across every patient

Question 8

what is performance based testing

Answer 8

clinician administered outcome measure where a patient performs specific tasks included in the measure for clinician to assess and score

Question 9

pros of clinician administered / performance based testing

Answer 9

removes bias from patient’s old perception of impairment
can clearly see and measure the impairment

Question 10

cons of clinician administered / performance based testing outcome measures

Answer 10

interrater variability
– things are different between specific clinicians testing

Question 11

what are patient administered / patient-reported outcome measures

Answer 11

outcome measures that rate the impact of injury on broad range functions and ability to participate in life roles

typically have an associated frame of reference

Question 12

which outcome measures (clinician or patient administered) has more latent constructs

Answer 12

patient administered

Question 13

steps to using outcome measures in practice

Answer 13

need to know and follow the precise instructions for
adminstering, scoring, dealing with missing items, interpreting score on measure

Question 14

what are the key measurement properties

Answer 14

reliability
validity
responsiveness

Question 15

what is reliability

Answer 15

ability of a measure to provide consistent results across different time points when underlying clinical status does not change

Question 16

what types of relaibilty are there

Answer 16

relative and absolute

Question 17

what is relative reliability also called?

Answer 17

systematic error

Question 18

what are the categories of relative error

Answer 18

intrarater
interrater
test-retest

Question 19

what is intrarater error

Answer 19

same rater doing an assessment at different time points

Question 20

what is interrater error

Answer 20

different raters doing assessments at different time points

Question 21

what are the categories of absolute error

Answer 21

standard error of measurement
minimal detectable change

Question 22

what is standard error

Answer 22

error associated with inherent variability of the device

Question 23

how is intra/interrelater reliability decreased

Answer 23

measurement device is calibrated

rater or two different raters use consistent techniques

there is a change in clinical status where condition improves

Question 24

what is test-retest

Answer 24

patient complete a self-reported measure at one point in time, then retested after a short time interval

Question 25

what does test-retest do? how is reliability assessed?

Answer 25

assess the extent to which the scores obtained for both the test and retest agree less difference between test and retest = more reliable

Question 26

what is test-retest reliability crucial for

Answer 26

patient reported outcomes involved self-assessment of impairment on a scale ie pain rating

Question 27

what is used to determine relative reliability

Answer 27

intraclass correlation coefficient (ICC)

Question 28

describe the ICC

Answer 28

between 0 and 1 0 - worst / 1 - perfect reliability >0.75 = very good >0.90 = excellent

Question 29

what is the kappa coefficient

Answer 29

Metha's Definition: Less common and used for measures where the score of the measure is dichotomous Mine: interrater reliability

Question 30

decribe the kappa coeffecient

Answer 30

0- worst / 1 - perfect score K > 0.7 = acceptable

Question 31

how is standard error measurement recorded in units

Answer 31

same unit as original measure

Question 32

what is validity

Answer 32

assesses the trait or health domain that it is supposed to assess in a comprehensive way

Question 33

what is content validity

Answer 33

measure is comprehensive and has all possible questions/items to measure the trait of interest

Question 34

what is criterion / construct validity

Answer 34

addresses the necessary aspect of the construct it intends to measure

Question 35

what is reliable but not valid

Answer 35

a bunch of darts thrown in the same spot but not in the center

Question 36

what is valid but not reliable

Answer 36

darts all over the board in no particular pattern

Question 37

what is neither reliable nor valid

Answer 37

darts on all the top half of the board but in no particular order

Question 38

what is both reliable and valid

Answer 38

all darts in the center of the board

Question 39

what is responsiveness

Answer 39

ability of a measure to detect change when the patient's underlying condition is improved or deteriorated

Question 40

how is responsiveness measured

Answer 40

using effect sizes - measures standardized rate of change

Question 41

what are common values of effect size

Answer 41

>0.8 = very good >1 = excellent

Question 42

what does responsiveness not tell you

Answer 42

how to interpret change in score of a measure whether the change in score is big enough to conclude that there is a true improvement

Question 43

what is used to interpret change in status

Answer 43

minimal detectable change minimal clinically important difference

Question 44

what is minimal detectable change

Answer 44

minimum change in score required to be confident that a "true" or statistically important change has occurred

Question 45

what does MDC___ mean

Answer 45

underline = a # MDC95 = 95% sure that a true change has occurred

Question 46

what is the minimal clinically important difference

Answer 46

minimum change in score required for patient to report the recovery is meaningful to them

Question 47

what are synonyms for MCID

Answer 47

MCIC - minimal clinically important change CID - clinically important difference CIC - clinically important change

Question 48

what are patient acceptable symptom states

Answer 48

lelve of a symptom state that patient considers themselves "well"

Question 49

what is the PASS for pain?

Answer 49

<3/10

Question 50

what determines short based goals vs long term

Answer 50

short - MCID long - PASS