Outcome Measures for Patients with Lower Limb Amputations

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Aim:

1. To enable the reader to select appropriate outcome measures to demonstrate effective intervention. (See CSP Outcome Measures Toolbox)

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• Evidence based
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General introduction

Outcome measures can be used for many different purposes. A predictive measure should be able to classify individuals according to a set of pre-defined categories either concurrently or prospectively e.g. whether an amputee will use a prosthesis successfully(1)(2). Detecting differences between people or groups demonstrates the discriminative value of an outcome measure e.g. being able to determine the different abilities of a trans-tibial or trans-femoral amputee or differences between prosthetic components from scores or times recorded(3). Whereas an evaluative measure should be able to detect changes, usually over a period of time in an individual or group. An evaluative outcome measure may also detect changes occurring following some kind of intervention, e.g a therapy programme(4) or provision of a prosthetic component. Some outcome measures are designed to do only one of the above, while others may do a combination, though some of the requirements of these different types of outcome measures are competing(5). Whichever purpose it is designed for, the psychometric properties of the outcome measure need to be reported to satisfy the user that it is fit for purpose with the population they wish to use it(6). The psychometric properties of an outcome measure are the characteristics that express it’s adequacy in terms of reliability, validity and responsiveness. Another term often used is clinimetric properties. While being developed from similar origins as psychometrics, clinimetricshas been described as the practice of assessing or describing symptoms, signs, and laboratory findings by means of scales, indices, and other quantitative instruments, all of which should have adequate psychometric properties(7)(8).

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References

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