the patient's injury, condition, or pathology is improving
validates our intervention
improves our performance as physical therapists
justifies our treatments to the insurance companies
what is pay-for-performance?
it is an evaluation of outcome measures of the physical therapist or physical therapy clinic. It outcome measure scores are high the physical therapist or clinical will have a higher reimbursement rate. If outcome measures are low than the physical therapist or clinic will have a lower reimbursement rate
what are the three principles when considering patient treatment and intervention
Are any of these principles more important than the other?
evidence
client factors/patient values
clinical art and expertise
No
what is evidence-based practice?
the integration of current best evidence
The physical therapist clinical expertise
Patient values
what is a PICO question
the formulation of answerable clinical question
what does PICO stand for?
patient
intervention
comparison
outcomes
what are patient values
they are unique preferences, concerns and expectation each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient
what are the five things that a physical therapist should do when treating a patient ( from beginning to end)?
examine
evaluate
diagnose
prognosis
intervention
What is traditional research
cover standard evaluation of range of motion, strength, radiographs, etc.
what is outcome research and is this important?
outcome research covers what the patient thinks of the results of care given
it is meant to enhance evaluation, not replace the usual methods
it also identifies what the patient wants from physical therapy
Yes this is very important because we care about the patient thinks
what are the barriers that outcomes research
attitudes, paradigms, lack of understanding
time pressures – the biggest barrier
unseen value by some
who came up with the "end result" idea
Ernest Armory Codman, M.D.
what is the "end result" idea
it is the idea that every hospital should follow every patient treats, long enough to determine whether or not the treatment has been successful, and then to inquire if not, why not?... With a view to preventing similar failures in the future
Ernest Codman is also known for his?
pendulum exercises– often used in physical therapy
Codman paradox
Coman's triangle
true or false – as physical therapy develops as a career there has been a greater focus on patient outcome measures over the last 20 years
true
true or false – almost all outcome measure tools can be administered to any patient of any age for any condition
false – as physical therapist we need to know the conditions for each outcomes measurement tool we use
why do we use outcome measures
impairment measures alone are not enough
Enhance patient care
May improve clinical decision-making
Communication – we can show patients, physicians, surgeons, referral sources, research groups, insurances, and employers how the intervention has improved the patient's condition from start to finish in a numerical fashion
what are the three major components that make a quality outcomes measures instrument
content
Psychometric
Clinical utility
what are three major things to consider when looking at psychometric properties
validity, responsiveness, reliability
what is validity
extent to which the instrument measures what it is supposed to measure
what is responsiveness
ability of instrument to change as the status of the patient changes – referred to as sensitivity to valid change
what is reliability
ability of the instrument to measure something the same way twice
Doesn't matter who administers the outcome measurements instrument
what is construct validity
refers to items like pain or disability – can be divergent or convergent
convergent – high correlation between two different tools measuring similar attributes
Divergent to similar tools do not correlate highly if they measure different attributes – emotional versus physical
when talking about validity what is important about the criterion of outcome measurement
the criteria correlates with the gold standard
what is internal consistency when talking about reliability
how consistent the questions are in measuring the same outcome
what is reproducibility when talking about reliability
reproducibility is how well this outcome measurement tool can be administered by two different people in the score comes out the same both times
what is the minimal detectable change
error estimate of change for oven instrument
what is the minimal clinical importance difference
the minimal change in a score, indicative of change in function, that is truly important to the patient
in order to show true change in outcome measure the second score must exceed the minimal detectable change value
floor and ceiling effects
True or false – useful measurements must provide room for client to demonstrate improvement or deterioration
true
what is the ceiling effect
top out – on scale, achieving normal function when some disability remains
what is floor effect
bottom out – on scale, unable to detect a decline in status
what is an example of a floor and ceiling effect
an outcome measurement tool administered to young athletes that is designed for older athletes
what is clinical utility
the clinical usefulness of an outcome measurement tool
what are some important things to consider about clinical utility
patient friendly
time to administer
clear, concise, easy to understand
patient comfort and answering questions
Clinically friendly
staff versus self administration
staff effort/cost of administering, recording, and analyzing
what is a visual analog scale
a scale that can measure pain
what does PSFS stand for
what does it measure
patient specific functional scale
the functional ability of the patient
true or false – the patient specific functional scale it's great for follow-up appointments with doctors.
true –
what is the NDI
neck disability Index
what is the Oswestry disability index
questionnaire that assesses pain related disability in patients/clients with low back pain
what does SANE stand for
single assessment numeric evaluation
how is the single assessment numeric evaluation administered
asked the patient – on a scale of 0 to 100, how would you rate your shoulder function with 100% be in normal?
is the single assessment numeric evaluation a valid test in comparison to other tests, such as ASES and ROWE
yes
is a simple shoulder test condition specific?
yes
true or false – the DASH is only used for the elbow when assessing function
false – it evaluates the function of the shoulder elbow wrist and hand. Or other words the entire upper extremity
Higher the score = higher the disability
most commonly used in the world
what is a Harris hip score
client-based outcome designed to assess the level of pain and functional impairment of a total hip replacement
what is a lower extremity functional scale
a test that measures the level of disability for lower extremity
the lower extremity functional scale is similar to what test for the upper extremity
The DASH
What does KOS stand for
knee outcomes survey
what does FAAM stand for
foot and ankle ability measure
Author
BPT
ID
59539
Card Set
quiz #1 – a primer on musculoskeletal outcome measures and instruments
Description
a primer on musculoskeletal outcome measures and instruments
