Outcome Measures Flashcards
Outcome measures are sued to quantify: (2)
1) Changes in impairments in body functions/structures, activity limtations, and participation restrictions
2) Changes in health, wellness, fitness
Self-report measures can be: (2)
Global or (body region) Specific
Global Rating of Change (GRC)
- Related to function and/or pain
- No specifics on here (pain, walking up stairs, etc)
- “How much better do you think you are since day 1?”
- VERY subjective
Disabilites of the arm, shoulder, and hand (DASH and Quick=DASH)
- Related to function of the upper extremities
- Only for people with UE disabilities
- Region specific
- Gets converted to a %
- Should be done initially AND during re-evals
Numeric Pain Rating Scale
Related to pain
Clinimetric Properties
Measurement characteristics used to assess outcome measures
Questions addressed by Clinimetric Properties (8)
- Was there adequate description in the survey development process?
- Is the self-report measure easy to administer?
- Is the self-report measure reliable?
- Is the self-report measure responsive?
- Can the scores of the measure be interpreted in a meaningful way?
- Is there more than 1 method for administering the self-report measure?
- Is the self-report measure available in other languages?
Adequate Description of the Survey Development Process (3)
1) Choose the phenomenon of interest to be captured by the self-report measure
2) Outline the measure’s scope (generic or region-specific)
3) Conduct focus groups to generate survey questions
Outcome Measures should be Easy to Administer (2)
- Should include MINIMAL number of questions to capture domain of interest
- Easy to understand and not time intensive
Reliability is established by testing for: (3)
1) Internal Consistency
2) Reproducibility
3) Agreement
Internal Consistency (2)
- Degree to which subsections of a survey measure the same concept or construct
- Want the questions in each subsection to measure the same type of thing
Internal Consistency determined by:
- Using Chronbach’s alpha
- Want correlation coefficient between .70-.95
Reproducibility
Stability of repeated scores from respondents that are supposed to be unchanged over a specific time period
Agreement
How close repeated measures are to one another
3 types of Validity
1) Content Validity
2) Construct Validity
3) Criterion Validity
Validity
Is the test testing what it’s supposed to?
Responsiveness
Ability of an outcome measure to determine change which is perceived to be meaningful
2 measures of Responsiveness
1) Statistical Change
2) Clinically meaningful change
- Provide info regarding meaningful change on outcome measures
3 Measures of Statistical Change
1) effect size
2) Standardized effect size
3) Standardized response mean
Effect Size
- Aka Magnitude of Change
- Mean(test1) - Mean(test2)
- Ex: Pre Quick Dash meas- Post Quick Dash meas = Effect size
Standardized Effect Size
-(Mean(test 1) - Mean(test2)/SD(test1))
Large Effect Size
.80
Moderate Effect Size
0.50
Minimal Effect Size
.20
Standardized Response Mean
(mean(test1)-Mean(test2)/SD(difference))
3 Things that Make Up Clincially Meaningful Change
1) Minimum Clinically Important Change (MCID)
2) Sufficiently Important Difference (SID)
3) Smallest Worthwhile Effect (SWE)
MCID
Smallest difference in score in the domain of interest, which patients perceive as beneficial and which mandate (in absence of side effects and excessive cost) a change in the patient’s management
SID
Has been established for the common cold
SWE
Has been established for LBP
