Using Evidence-Based Practice to Decide on an Outcome Measure

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Introduction

An outcome measure is a tool used to assess a patient's current status. It can provide a score, an interpretation of results and/or a risk categorisation of the patient. It can provide baseline data prior to an intervention and the initial results may help determine and direct the course of any treatment intervention. The outcome measure can also be used during the course of treatment to assess any "change in the construct of interest over time, during and after rehabilitation."

Outcome measures that are used in clinical practice include:

• Patient-reported outcome measures (PROM)
• Therapist-administered outcome measures
• Clinical tests
• Observed outcome measures

Psychometric Properties of Outcome Measures

Applying Evidence-Based Practice in Deciding on an Outcome Measure

Table 1. Applying Evidence-Based Practice in Deciding on an Outcome Measure

Evidence-based practice steps	Summary of specific evidence-based practice step
Determining the patient's needs to formulate a clinical question	deciding on an outcome measure: consider what you want to measure (function, perception, experience?) how do you want to measure it (self-reported or therapist-administered) Examples of a clinical question: "What are the best outcome measures to determine function and well-being in a patient with ...? OR Is outcome measure (x) or outcome measure (y) a better outcome measure to determine function and well-being in a patient with...?
Locating the knowledge sources	Use a modified PICOT pneumonic and focus on POT part P - patient/population O - outcome - specific outcome T - Type - Type of outcome measure (e.g. patient-reported outcome) Decide on a database to use
Appraising the quality of the outcome measure	Allied Health Professions (AHP) Outcome Measures UK Working Group: Key questions to ask when selecting outcome measures: a checklist for allied health professionals
Discussing the options with the patient	combine the discussion on which outcome measures to use with the discussion on best treatment options outcome measures used should align with the needs of the condition, patient context, goals, values and preferences and patient environment discuss cost implications, time taken to administer outcome measure and frequency
Included outcome measure into the treatment plan	outcome measure chosen should fit the goal of the intervention
Implement the treatment plan with the outcome measure	apply treatment plan and outcome measure
Evaluate the effectiveness of treatment plan, outcome measure and the evidence-based practice process	Does the outcome measure do what it needs to do? Is it as responsive as stated in the literature? Did you find a freely available outcome measure? Where can you make changes in the process?

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