LECT 2.1: variables and outcomes Flashcards
define a variable
A characteristic or attribute that can be measured and that varies across people, places, and time.
AFTER STUDYING, REFER TO TABLE IN SLIDE 7 TO NAME AND CLASSIFY THE VARIABLES
what are the 2 broad classification of variables
independent and depend
what is an independent variable
used to explain or predict a response, outcome or result:
– Exposure – Explanatory – Exposure/ cause – Risk factor – Intervention / drug / stimulus
=independent variable is usually what the researcher is manipulating/is the intervention
what is a dependent variable
Outcome of the study (e.g., ROM, pain, function, HRQOL)
– Depend on the changes in the independent variables
=usually are the variables that are BEING MEASURED/observed that are INFLUENCED by the independent variable
what is an outcome
attribute of an individual that is expected to change owing to intervention or exposure
=outcome= dependent variable
(outcome is the variable that is expected to change/be affected by the independent variable/intervention
in a study, the dependent variable would also be known as the
outcome
in a study, the independent variable would also be known as the
intervention
outcomes can be divided into primary and secondary outcomes… what is the primary one
one that drives the study, design, methods
what is a construct
broad concept that is not directly observable
represent abstract concepts that are difficult to directly measure
may have multiple domains
give construct examples
HRQOL
life satisfaction
function
participation
what does it mean for a dependent variable needs to be operationally defined
it means that the researcher must decide how to measure this outcome/dependent variable
what is the conceptual definition of HRQOL
HRQOL is subjective and multidimensional, encompassing physical and occupational function, psychological state, social interaction and somatic sensation”
in order to measure HRQOL you need an operational definition, what does that mean
you need to put the construct (HRQOL) into a measurable context… you would need some sort of tool
what is the operational definition of HRQOL
ex: – The score resulting from completing the EuroQOL-5D (EQ-5D) questionnaire evaluates a patient’s health across 5 dimensions
EQ5-D is a measure of what construct
HRQOL
explain what the EQ5D is
The EQ-5D is a standardized instrument for measuring health-related quality of life (HRQoL) The EQ-5D is a self-administered questionnaire
true or false: the EQ5D is a self-administered questionnaire
true
true or false: a domain is defined by constructs
false, a construct is defined by domains
define a domain
Refers to a specific area(s) or aspects of a construct that is being studied or measured.
e.g.: HRQOL construct is formed by multiple domains.
A CONSTRUCT IS DEFINED BY DOMAINS
A CONSTRUCT IS DEFINED BY…
DOMAINS
true or false: you can have different domains for the same construct and give example
true (eq5d vs SF-36 both measure the construct of HRQOL using different domains)
what are the domains in the eq5d questionnaire that are used to measure HRQOL
mobility
self care
usual activities
pain/discomfrot
anxiety/depression
true or faslse: Domains are assessed by a sub-scale or portion of a questionnaire or measuring instrumen
true
what type of outcome measure is the EQ5d (clinro, performance-ro, patient ro
patient ro
what type of outcome measure is the SF-36 (clinro, performance-ro, patient ro
patient ro
what is the sf-36
The SF-36 (Short Form 36) is a widely used questionnaire designed to measure health-related quality of life (HRQoL). It consists of 36 questions covering eight health domains,
lower scores in the SF-36 indicate more or less disbilites
more disability
what are the domains of the Sf-36
vitality
physical functioning
bodily pain
general health perceptions
physical role functioning
emotional role function
social role functioning
mental health
are outcome measures and outcomes the same
no
what is an outcome measure
it is the tool or instrument used to measure an outcome
→ allows us to measure the current status of the patient and obviously the impact of an intervention and to see if there is a change occurring.
what are the 4 “categories” of outcome measures (NOT CLINRO STUFF)
1) self-report measures
2) physical performance measures
3) functional performance measures
4) physiological measures
true or false: physical performance outcome measures can only be CLINRO
false they can be CLINRO (ex: goniometer) but also performance reported (6MWT)
give examples of self report outcome measures
questionaries (DASH, lefs,SF-36
give examples of physical performance outcome measures
goniomoeter
dynammometer
gait speed test
6 min walk test
cardiovascular endurance test (Vo2 max)
give examples of functional performance outcome measures
berg balance
timed up and go
give examples of physiological outcome measures
HR monitor
sphygomanonmeter
weight scale
measuring
are outcomes and outcome measures the same thing
no outcome = dependent (the impact of the independent variable)
outcome measure= what you are using to measure
what is the ICF
a framework developed by the World Health Organization (WHO) to describing health, disability and function
divided into 2 components (functioning and contextual factors)
explain the components in the functioning section of the ICF
Body Functions and Structures:
This component of the ICF model refers to the physiological functions of the body (such as sensory, mental, and cardiovascular functions) and anatomical structures (such as organs and limbs).
Activities
Activities refer to the execution of tasks or actions by an individual, such as walking, writing, or communicating.
Participation
Participation refers to involvement in life situations, such as work, education, and social activities.
explain the components in the contextual section of the ICF
nvironmental Factors:
Environmental factors include the physical, social, and attitudinal aspects of the environment that can either facilitate or hinder an individual’s functioning. This component encompasses factors such as social support, accessibility of buildings and transportation, attitudes of others, and the presence of assistive devices or accommodations.
Personal Factors:
Personal factors refer to individual characteristics that are not part of a health condition but can influence an individual’s functioning and disability. These may include factors such as age, gender, coping styles, beliefs, and attitudes.
lets say someone has COPD (explain their disability using the ICF framework)
bodily structures: shortness of breath, loss of muscle mass etc
activities: may not be able to walk or do adl performance
participation: can no longer work
Environmental: can not longer walk up stairs and his work doesn’t support his condition
personal: will not stop smoking to making his COPD better
give some examples of outcomes that would go under the impairments section of the ICF
pain
dexterity
aphasia
range of motion
strength
balance
endurance
give some examples of outcomes that would go under the activtiy section of the ICF
ADL performance
mobility capacity (walking, stairs)
give some examples of outcomes that would go under the participation restriction section of the ICF
grocery shopping
work
what are the 3 reasons we measure in health (general)
discriminate
evaluate
predict
what are the 3 reasons we measure in health and explain
- Discriminate: between healthy and unhealthy persons so that we know who to treat (for ex: screening test)
- Evaluate: change over time so we may understand the benefits of treatment ( eq-5D, walk test)
3.Predict: so we may know who might benefit the most from treatment and help people to plan for different eventualities.
if you are given an example of a test, you must be able to know if it is discriminative, evaluative or predictive
is the box and block test considered discriminative, evaluative or predictive
discriminative
explain the box and block BBT test
Measure of unilateral gross manual dexterity individual’s ability to pick up, transport, and release small objects using one hand in 60 seconds
- The BBT discriminates between individuals with varying levels of manual dexterity
- A lower BBT score suggests greater difficulty in performing these activities, indicating potential motor impairment post-stroke
what are some of the pros of the BBT test
simple
cost effective
allows us to discriminate between individuals with varied dexterity
is the berg balance scale considered discriminative, evaluative or predictive
evaluative
explain the berg balance scale (CHAT GPT)
The Berg Balance Scale is a tool used to measure a person’s balance and stability. It’s often used by healthcare professionals, like physical therapists, to assess how well someone can maintain their balance during different activities.
The scale consists of 14 different tasks that the person is asked to perform. These tasks include things like standing up from a chair, turning around, and standing on one leg. Each task is scored based on how well the person can complete it without losing their balance or needing help.
The scores from each task are added together to give an overall score. A higher score indicates better balance and stability, while a lower score may indicate a higher risk of falling or balance problems.
explain why the berg balance is considered evaluative
allows us to evaluate the effectiveness of or of the rehabilitation intervention and how the patient has progressed over these six weeks.
(example take BBS at beginning before treatment, then give them exercises to improve balance and mobility and then redo he BBS 6 weeks later)
- allows us that to measure that change because it has been developed as an evaluative scale
is the BODE index considered discriminative, evaluative or predictive
predictive
a score of 0-20 on berg means what
wheelchair bound
a score of 21-40 on berg means what
walking with assistance
a score of 41-56 on berg means what
independent
what is the highest score of the berg
56
what are the 12 balance items of the berg (IDK IF WE EVEN HAVE TO KNOW THIS)
sitting unsupported
Sitting to standing:
Standing to sitting:
Transfers:
Standing unsupported
standing with eyes closed:
Standing with feet together:
tandem standing
standing on one leg
turning trunk (feet fixed).
Retrieving object from the floor:
Turning 360 degrees:
stool stepping
reaching forward while standing
what is the function of the BODE index
what is the function of the BODE indexallows us to predict future outcomes/events (used allot in people with COPD)
what are the variables of the BODE index
FEV1 test
distance walking in 6 minutes
MMRC dyspnea scale
BMI
a higher score on the BODe index indicates higher mortality or lower
higher
what are the 3 types of outcome measures
patient reported outcome
clinician reported outcome
performance based outcome
what is a patient reported outcome and give examples
information reported directly from the patient with regards to symptoms, feelings
ex: SF36, EQ5D, LEFS
what is a clinician reported outcome and give examples
assessments conducted by the clinicians
ex: BBS, barthel index
what is a performance based outcome and give examples
the OBJECTIVE measurement of functional, physical ,psychological abilities
ex: 6MWT, BBT, strength assessemt
give some examples of outcomes MEASUREs that would go under the impairments section of the ICF
goniometer
berg balance
6MWT
box and block text
give some examples of outcomes MEASUREs that would go under the activtity section of the ICF
lower extremity functional scale (LEGS)
barthel infex
sf-36
TUG
give some examples of outcomes MEASUREs that would go under the participant restriction section of the ICF
assessment of life habits (LIFE h)
what are the 2 times of quantitative data
continuous
categorical
explain a continuous variable and give examples
can take on ANY value (the presicison of which depends on the measure being used)
Distribution is expected to be normal (bell-shaped)
Age, gait speed, distance walked, ROM
explain the interval subtype of continuous data and give examples
=interval does not have a true” zero
ex: temperature, ph level, longitude)
explain the diff between interval and ratio
ratio data has a true zero point, allowing meaningful ratios to be calculated, whereas interval data does not have a true zero point, making ratios meaningless.
explain the ratio subtype of continuous data and give examples
=ratio has a true zero (represents the absence of the quality being measured)
ex: height, weight, time, distance
explain a categorical variable and give examples
Categorical data is a type of data that represents qualitative attributes or characteristics. categorical data describes categories or groups into which items fall
ex: yes/no, order of things, ratings (good, better)
what are the 3 subtypes of categorical data
binary (dichotomous)
nominal
ordinal
explain a binary (dichotomous)
categorical data and give examples
can take on only 2 distinc categories or levels
ex: yes/no, dead/alive
explain a nominal
categorical data and give examples
represents categories with named values and no inherent order
ex: eye colour (blue, brown, green)
marital status (single, divorced, widowed)
explain a ordinal
categorical data and give examples
represents categories with named values and inherent order
ex: education level
health rating (poor, fair, good, very good)
what are some of the ways we represent continuous data
through means, median, mode, standard dev
what are some of the ways we represent categorical data
proportions, counts
look at table on slide 34 and rank the variables as continuous, categorical etc
what are the metric properties you need to consider when selecting an outcome measure (general)
reliability
validity
responsiveness
floor and ceiling effects
what does reliabilityy mean (for selecting an outcome measure)
The extent to which a test or measure provides the same results on repeated trials or from different raters (≈ consistency, repeatability).
what does validity mean (for selecting an outcome measure)
Refers to the capacity of the instrument to measure the underlying construct it is assumed and anticipated to measure
what does responsiveness mean (for selecting an outcome measure)
The accurate detection of change when it has occurred and the ability to detect a minimally important difference (MID) in patient status.
give brief difference between reliability, validity and responsiveness (chat got)
reliability assesses the consistency of measurement (REPRODUCIBILITY) , validity assesses the accuracy of measurement (CAN IT ACTUALLY MEASURE THE CONSTRUCT), and responsiveness assesses the ability of a measurement instrument to detect meaningful changes in the construct being measured
explain floor and ceiling effects
Clustering of a sample at one or other end of the score. Significant if >20%
=if many patients results are at the upper or lower limit of the scale it means that the test is limited in ability to accurately measure the abilities of the patients
what are the theoretical considerations for selecting an outcome measure (dont know the details just understand)
Interpretability: refers to issues such as meaning for the results obtained, classifications for results and availability of comparative norms
Feasibility: deals with effort, burden and expenses related to the administration of the outcome measure
Acceptability: Whether scale completion is laborious to patient and whether scales can be completed by a proxy.
Translation: Whether translated items mean the same or words have to be changed e.g. “I’m feeling down and blue”.
Cultural Sensitivity: Whether items in the scale are culturally relevant or not e.g. Action Research Arm Test, Montreal Cognitive Assessment (MoCA)
what are the practical considerations for selecting an outcome measure (dont know the details just understand)
- Cost / Feasibility – equipment, staff time
- Available in English, French
- Respondent burden (questions, time)
- Standardized instructions
- Time/expertise for data management and analysis
- Pilot test in specific clinical or research setting prior to implementation
