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Revision as of 11:56, 10 March 2015
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<div class="noeditbox">Welcome to [[WCPT Network for Amputee Rehabilitation Project]]. This page is being developed by participants of a project to populate the Amputees section of Physiopedia.
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*Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!
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'''Original Editor '''- [[User:Judy Scopes|Judy Scopes
]] as part of the [[WCPT Network for Amputee Rehabilitation Project
]]
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*If you would like to get involved in this project and earn accreditation for your contributions, [mailto:rachael@physio-pedia.com please get in touch]!
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'''Original Editor '''- [[User:Judy Scopes|Judy Scopes]]
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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== General introduction ==
== General introduction ==
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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 <ref name="condie">Condie ME, McFadyen AK, Treweek S, Whitehead L. The trans-femoral fitting predictor: a functional measure to predict prosthetic fitting in transfemoral amputees--validity and reliability. Arch Phys Med Rehabil 2011 08;92(8):1293-1297.</ref> <ref name="raya">Raya M, A., Gailey R, S., Gaunaurd I, A., Ganyard H, Knapp-Wood J, McDonough K, et al. Amputee Mobility Predictor-Bilateral: A performance-based measure of mobility for people with bilateral lower-limb loss. J Rehabil Res Dev 2013 11;50(7):961-968.</ref>.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 <ref name="hafner">Hafner BJ, Willingham LL, Buell NC, Allyn KJ, Smith DG. Evaluation of function, performance, and preference as transfemoral amputees transition from mechanical to microprocessor control of the prosthetic knee. Archives of Physical Medicine &amp;amp;amp; Rehabilitation 2007 02;88(2):207-217.</ref>. 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<ref name="rau">Rau B, Bonvin F, de Bie R. Short-term effect of physiotherapy rehabilitation on functional performance of lower limb amputees. Prosthet Orthot Int 2007;31(3):258-270.</ref> 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 <ref name="mokkink">Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 2010;63(7):737-745.</ref>. 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 <ref name="kirshner">Kirshner B, Guyatt G. A methodologicalframework for assessing health indices. J Chronic Dis 1985;38(1):27-36.</ref>. 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 <ref name="streiner">Streiner DL. Clinimetrics vs. psychometrics: an unnecessary distinction. J Clin Epidemiol 2003 12;56(12):1142-1145.</ref> <ref name="galea">Galea M. Introducing Clinimetrics. Australian Journal of Physiotherapy 2005;51(3):139-140.</ref>.<br><br>
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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 <ref name="condie">Condie ME, McFadyen AK, Treweek S, Whitehead L. The trans-femoral fitting predictor: a functional measure to predict prosthetic fitting in transfemoral amputees--validity and reliability. Arch Phys Med Rehabil 2011 08;92(8):1293-1297.</ref> <ref name="raya">Raya M, A., Gailey R, S., Gaunaurd I, A., Ganyard H, Knapp-Wood J, McDonough K, et al. Amputee Mobility Predictor-Bilateral: A performance-based measure of mobility for people with bilateral lower-limb loss. J Rehabil Res Dev 2013 11;50(7):961-968.</ref>.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 <ref name="hafner">Hafner BJ, Willingham LL, Buell NC, Allyn KJ, Smith DG. Evaluation of function, performance, and preference as transfemoral amputees transition from mechanical to microprocessor control of the prosthetic knee. Archives of Physical Medicine &
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amp;amp;amp;amp;amp; Rehabilitation 2007 02;88(2):207-217.</ref>. 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<ref name="rau">Rau B, Bonvin F, de Bie R. Short-term effect of physiotherapy rehabilitation on functional performance of lower limb amputees. Prosthet Orthot Int 2007;31(3):258-270.</ref> 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 <ref name="mokkink">Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 2010;63(7):737-745.</ref>. 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 <ref name="kirshner">Kirshner B, Guyatt G. A methodologicalframework for assessing health indices. J Chronic Dis 1985;38(1):27-36.</ref>. 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 <ref name="streiner">Streiner DL. Clinimetrics vs. psychometrics: an unnecessary distinction. J Clin Epidemiol 2003 12;56(12):1142-1145.</ref> <ref name="galea">Galea M. Introducing Clinimetrics. Australian Journal of Physiotherapy 2005;51(3):139-140.</ref>.<br><br>
== Considerations before choosing an outcome measure ==
== Considerations before choosing an outcome measure ==
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'''Measurement error:'''This is the degree to which scores or ratings are identical irrespective of who performs or scores the test and can be reported using the standard error of measurement (SEM)or minimal detectable change (MDC), which is the same as smallest detectable change (SDC) <ref name="stratford">Stratford P, W., Riddle D, L. When Minimal Detectable Change Exceeds a Diagnostic Test-Based Threshold Change Value for an Outcome Measure: Resolving the Conflict. Phys Ther 2012 10;92(10):1338-1347.</ref> .<br>
'''Measurement error:'''This is the degree to which scores or ratings are identical irrespective of who performs or scores the test and can be reported using the standard error of measurement (SEM)or minimal detectable change (MDC), which is the same as smallest detectable change (SDC) <ref name="stratford">Stratford P, W., Riddle D, L. When Minimal Detectable Change Exceeds a Diagnostic Test-Based Threshold Change Value for an Outcome Measure: Resolving the Conflict. Phys Ther 2012 10;92(10):1338-1347.</ref> .<br>
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*Deathe& Miller (2005) reported the SEM in absolute values, which was 3sec for the L-Test <ref name="deathe">Deathe AB, Miller WC. The L test of functional mobility: measurement properties of a modified version of the timed "up &amp;amp;amp;amp;amp;amp; go" test designed for people with lower-limb amputations. Phys Ther 2005 07;85(7):626-635</ref> .
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*Deathe& Miller (2005) reported the SEM in absolute values, which was 3sec for the L-Test <ref name="deathe">Deathe AB, Miller WC. The L test of functional mobility: measurement properties of a modified version of the timed "up &
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amp;amp;amp;amp;amp;amp;amp;amp; go" test designed for people with lower-limb amputations. Phys Ther 2005 07;85(7):626-635</ref> .
*Resnik& Borgia (2011) also reported MDCin absolute values for all the measures they studied: 2MWT (34.3m), 6MWT (45m), TUG (3.6s) and AMP (3.4pts) <ref name="resnik">Resnik L, Borgia M. Reliability of outcome measures for people with lower-limb amputations: distinguishing true change from statistical error. Phys Ther 2011 04;91(4):555-565.</ref>
*Resnik& Borgia (2011) also reported MDCin absolute values for all the measures they studied: 2MWT (34.3m), 6MWT (45m), TUG (3.6s) and AMP (3.4pts) <ref name="resnik">Resnik L, Borgia M. Reliability of outcome measures for people with lower-limb amputations: distinguishing true change from statistical error. Phys Ther 2011 04;91(4):555-565.</ref>
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There is little published evidence on the specific use of outcome measures with non limb-wearing lower limb amputees. ..................<br><br>
There is little published evidence on the specific use of outcome measures with non limb-wearing lower limb amputees. ..................<br><br>
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==Resources==
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== Resources ==
*[http://www.csp.org.uk/sites/files/csp/secure/toolbox_version_2.pdf CSP Outcome Measures Toolbox]
*[http://www.csp.org.uk/sites/files/csp/secure/toolbox_version_2.pdf CSP Outcome Measures Toolbox]