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INTRODUCTION

QUESTIONS TO CONSIDER

  1. State three or more psychometric properties that are commonly reported in studies of outcome measures.

  2. State two important characteristics to consider when appraising the applicability of a study of an outcome measure.

  3. State two types of outcome-measure reliability that are studied.

  4. Describe two important design features you consider when appraising the quality of a reliability study.

  5. State important design features to consider when appraising the quality of a criterion-related study of outcome-measure validity.

CHAPTER-AT-A-GLANCE

This chapter will help you understand the following:

  • The different psychometric properties of clinical outcome measures that are studied

  • The types of studies used to assess outcome-measure psychometric properties

  • Appraisal of studies that assess outcome-measure reliability, quality, and clinical meaningfulness

  • Interpretation of the results of studies of outcome-measure reliability, validity, and clinical meaningfulness

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This chapter introduces you to the appraisal of research studying outcome measures. We begin this chapter by defining common features of outcome measures and describing the different categories of outcome measures that you are likely to encounter in clinical practice, that is, questionnaires and performance-based measures. This chapter does not focus on the appropriate use of outcome measures in a particular research study; rather, we focus on how you can use the appraisal process to determine whether a study of an outcome measure is applicable, valid, and clinically useful.

Appraisal is the third step in the five-step evidence based practice (EBP) process. We describe the process of appraising the literature for each study discussed in this chapter, including completing all four parts of appraisal:

  • Part A: Determining the applicability of the study

  • Part B: Determining the quality of the study

  • Part C: Interpreting the results of the study

  • Part D: Summarizing the clinical bottom line

We review the appraisal of studies of reliability, validity, and clinical meaningfulness of outcome measures and provide corresponding checklists for appraisal with key questions. A full appraisal of each type of study of clinical meaningfulness is beyond the scope of this text. References are included for further in-depth study.1–3

TYPES AND UTILITY OF OUTCOME MEASURES

An outcome measure is any characteristic or quality measured to assess a patient’s status. Outcome measures are commonly collected at the beginning, middle, and end of a course of physical therapy care. Outcome measures that you are likely to encounter in clinical practice can be divided into two categories: (1) questionnaires and (2) performance-based measures.

Two Types of Outcome Measures

Questionnaire-based measures require that either a therapist interviews a patient or the patient independently completes the questionnaire. Questionnaires are typically scored by applying a preset point system to the patient’s answers. Performance-based measures require the patient to perform a set of movements or tasks. Scores for performance-based measures can be based on either an objective measurement (e.g., time to complete a task) ...

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