An outcome measure is the result of a test that is used to objectively determine the baseline function of a patient at the beginning of treatment. Once treatment has commenced, the same instrument can be used to determine progress and treatment efficacy. With the move towards Evidence Based Practice (EBP) in the health sciences, objective measures of outcome are important to provide credible and reliable justification for treatment. The instrument should also be convenient to apply for the therapist and comfortable for the patient.
Reliability, validity and responsiveness
The outcome measure should have been shown to test the particular aspect of function that it is reported to test (validity) and the results should be the same (or similar) regardless of who administers the test or when it is administered (reliability). Finally, the test or scale should actually be able to test change over time in whatever is being tested (responsiveness). The Chartered Society of Physiotherapists in the United Kingdom makes it clear that standardised outcome measures should be used routinely in normal practice:
"Taking account of the patient’s problems, a published, standardised, valid, reliable and responsive outcome measure is used to evaluate the change in the patient’s health status" (Core standards of physiotherapy practice, 2005).
Some outcome measures have been statistically tested to determine actual validity and reliability and it must be noted that some are more valid and reliable than others. Analysis should also be performed to determine if the change in score on the test is a result of the intervention (treatment), or not.
Guide to Selecting Outcome Measures
Orthopaedic Scores: a free outcome measure calculation service for certain orthopaedic OMs.
Regis University site for outcomes information: This is an excellent site that includes analysis of practice forms, outcome measures and the evidence for a variety of clinical topics. At the very bottom you will find the “health assessment outcomes indicators”, an 80+ page document that gives an overview of MANY outcomes tools.
Rehabilitation measures database: developed to help clinicians and researchers identify reliable and valid instruments used to assess patient outcomes during all phases of rehabilitation.
Patient-Reported Health Instruments: includes over 8,600 records with keyword search capability.
Clinical measurement instruments: from Centre for Evidence Based Physiotherapy.
PROQOLID Quality of life instruments database: lists 1,000 Patient Reported Outcomes questionnaires and provides detailed information on over 300 either generic or specific measures.
StrokeEngine Assess: provides information on outcome measures related to Stroke.
CEBP: Centre for Evidence Based Physiotherapy: provides an extensive database of physiotherapy outcome measures
The Neurology Section: recommendations for outcome measures used in neurological clinical practise, research and education
Article: Hefford et al. Outcome measurement in clinical practice: practical and theoretical issues for health related quality of life (HRQOL) questionnaires. Provides a detailed description of HRQOL measures, how to choose outcome measures, and what psychometric properties to look out for.
Related books from Elsevier
|Rehabilitation Outcome Measures is a comprehensive review and comparison of measurement instruments in rehabilitation. It includes a high-level section on professional practice in physiotherapy and an introduction to the World Health Organisation’s (WHO) International Classification of Health. For those who wish to learn more about the relevance of reported measurement properties, the text focuses on how this knowledge can assist clinical decision-making. Additionally, the book reviews a range of measurements in neurological rehabilitation as well as mobility, fatigue, physical activity and patient satisfaction.|