Neurological Outcome Measures
Introduction
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. Many neurological conditions have specific outcome measures like acquired brain injuries, Cerebral Palsy, Multiple Sclerosis, Spinal Cord Injury[1]and Stroke[2].
Patient Reported Outcome Measures
A patient-reported outcome (PRO) is “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”[3]. Their use in clinical practice helps to ensure the patient ‘voice’ is present in all aspects of care, which is essential to ensure therapeutic management remains patient-centred[4].
Examples for PROs include: 36-item short form survey (SF-36), Visual Analogue Scale (VAS), Parkinson's Disease Questionnaire (PDQ-39) and Barthel Index [4].
Psychometric properties
The outcome measure should have been shown to test some psychometric properties such as 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, standardized, valid, reliable and responsive outcome measure is used to evaluate the change in the patient’s health status" (Core standards of physiotherapy practice, 2005).
Statistical Analysis
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
Guide to Selecting Outcome Measures
Resources
References
- ↑ Alexander MS, Anderson KD, Biering-Sorensen F, Blight AR, Brannon R, Bryce TN, et al. Outcome measures in spinal cord injury: recent assessments and recommendations for future directions. Spinal Cord [Internet]. 2009 Apr 21;47(8):582–91. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722687/
- ↑ Baker K, Cano SJ, Playford ED. Outcome Measurement in Stroke. Stroke. 2011 Jun;42(6):1787–94.
- ↑ Johnston BC, Patrick DL, Devji T, Maxwell LJ, Bingham III CO, Beaton D, Boers M, Briel M, Busse JW, Carrasco-Labra A, Christensen R, da Costa BR, El Dib R, Lyddiatt A, Ostelo RW, Shea B, Singh J, Terwee CB, Williamson PR, Gagnier JJ, Tugwell P, Guyatt GH. Chapter 18: Patient-reported outcomes [last updated October 2019]. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane, 2024. Available from www.training.cochrane.org/handbook.
- ↑ 4.0 4.1 Kyte DG, Calvert M, van der Wees PJ, ten Hove R, Tolan S, Hill JC. An introduction to patient-reported outcome measures (PROMs) in physiotherapy. Physiotherapy. 2015 Jun;101(2):119–25.