Asogwa Angel Ezinne

2020624016

MRH 461

Outcome Measures
Introduction
An outcome measure is a tool used to assess a patient's current status. |1] Outcome measures
may provide a score, an interpretation of results and at times a risk categorization of the
patient.
Prior to providing any intervention, an outcome measure provides baseline data. The initial
results may help determine the course of treatment intervention. Once treatment has
commenced, the same tool may be used in serial assessments to determine whether the
patient has demonstrated change.
With the move towards Evidence Based Practice
(EBP) in health care, outcome measures provide credible and reliable justification for
treatment on an individual patient level. The results from outcome measures may also be
grouped for aggregated analysis focused on determining quality of care. When outcome
measures are used in an aggregated data situation to compare
Classification
Patient Reported Outcome
Measure
Outcome measures that we use in clinical practice are divided into four categories:
1. Self-report measures
2. Performance-based measures
3. Observer-reported measures
4. Clinician-reported measures
Self-report measures
Self-report measures are typically captured in the form of a questionnaire. The questionnaires
are scored by applying a predetermined point system to the patient's responses. Although self-
report measures seem subjective in nature, self-report measures objectify a patient's
perception.
that use paper and pencil for completion are considered a fixed-form questionnaire.
Computer based or electronic self-report measures are available. Electronic measures may be
fixed -form or adaptive. Computerized adaptive testing is a method of testing that determines
the questions for a response based on the patient's previous responses. (4] The questionnaires
where the patient reports on health or physical function are known as patient-reported
outcomes (PRO). (5] PROs can be categorized as disease specific or generic. PROs have been
defined as "any report of the status of a patient's health condition that comes directly from
the patient, without interpretation of the patient's response by a clinician or anyone else." [6]
Performance-based measures
Performance-based measures require the patient to perform a set of movements or tasks.
Scores for performance- based measures can be based on either an objective measurement
(e.g., time to complete a task) or a qualitative assessment that is assigned a score (e.g.,
normal or abnormal mechanics for a given task).
Performance-based measures and patient reported measures both capture a current status.
These measures do not typically equate with each other. Performance-based measures tend to
bring to light physiologic factors. Patient
Treasures arra patert reported measures both capture a current status. These measures do
not typically equate with each other. Performance-based measures tend to bring to light
physiologic factors. Patient reported outcome measures may capture a patient's perception,
beliefs, social factors and/or health factors. 171
Observer-reported measures
Observer-reported measures are measurements completed by a parent, caregiver or someone
who regularly observes the patient on a daily basis.
Clinician-reported measures
Clinician-reported measures are measurements that are completed by a health care
professional.
The professional uses clinical judgement and reports on patient behaviors or signs that are
observed by the professional.
Statistical Aspects
Important features of an outcome measure that need to be taken into account when using an
outcome measure are its psychometric properties.
Psychometric properties are the intrinsicproperties of an outcome measure. Ideally, the
psychometric properties of an outcome measure used in practice should have been developed
and tested through a series of research studies.
These properties include validity, inter-rater reliability, intra-rater reliability, responsiveness,
ceiling effects, floor effects and minimal clinically important difference. Validity refers to the
how accurately the test actually measures what it is supposed to measure. High validity
means the measure is consistently stable in its ability to measure its intended focus. Inter-
rater reliability takes into consideration the consistency of the results of the measure when
two different people are evaluating the results of a common subject. With performance-based
measures, if two physiotherapists scored the performance, high inter-rater reliability would
mean that both determined similar scores on the performance evaluated. For patient reported
outcome measures, a high intra-rater reliability indicates that the patient consistently

Respond to attain the same results

The following checklist is intended to provide a framework that guides clinicians in appraising
and selecting appropriate outcome measures for their patients. 1121
Why Am I Using the Outcome Measure?
o Identifying the impact of a disorder on an individual?
o Establishing a baseline measure from which to monitor changes over time?
o Evaluating the impact of an intervention?
o Evaluating the needs of those attending a service?
What Am I Aiming to
Measure?
o Impairments of body structure and function?
o Activity limitations?
o Participation restrictions?
o Quality of life?
Have the Psychometric
Financial Considerations
o What is the cost of this test?
o Is a licence required?
o Is equipment required?
Therapist Implementation
o Is the measure easy for a clinician to conduct?
o Is special training required available?
o Are there clear standardised instructions on how to carry out and score the measure?
o How long does it take to carry out the measure?
o How long does it take to record results?
Client
o How much time does it take for the person to complete?
 o Is the task difficult?
o Is privacy required?
Patient-Reported Outcome
Measures (PROM)
o Is face-to-face contact required or can this measure be completed in the waiting room?
o Does the questionnaire cover sensitive personal issues?
o Is there a specific reading level required?
o Is the measure available in other languages?