Measurement of patient outcomes- a critical step in clinical practice?

Measurement of patient outcomes is a critical step in clinical practice and researches. Health care providers and policy makers alike rely on patient outcome measures to identify appropriate treatment interventions and treatment effectiveness making it essential to identify quality outcome measures. The value of the information provided by outcome measures, depends, largely on the psychometric properties of those measures, including reliability, validity, responsiveness, interpretability, and the practical feasibility.

Clinometrics

The purpose of Clinometrics is to alert clinicians to the psychometric properties of instruments that have clinical utility in current health practice. The website of ‘COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) http://www.cosmin.nl/cosmin_1_0.html could be of interest. The purpose for the COSMIN is to improve the selection of health measurement instruments and developed a critical appraisal tool for evaluating the methodological quality of studies on the measurement properties of health measurement instruments. Furthermore, the publication of Maarten Boers et al. (2013), see http://omeract.org/pdf/JCE%20FILTER%202.0%20FINAL.pdf focus on the discussion about developing a core outcome measurement. Of importance is the term ‘Core Domain Set’ which is defined as the minimum set of Domains and Subdomains necessary to adequately cover all Core Areas, that is, fully measure all relevant concepts of a specific health condition within a specified setting.

 

Challenges of standardized testing?

Standardized tests are designed to enable us to compare the performance…. However, the publications of the PhD candidate Kariann Krone and coworkers (2013;2014) revealed that health professionals navigate between adherence to the test standard and meeting what they consider to be the individual patient’s needs in the test situation. Furthermore, her study illustrate the overlap between objective and subjective data in everyday practice. She stated that in clinical practice, by way of the clinicians’ gaze on how the patient functions, the subjective and objective components of test information are merged, allowing individual characteristics to be noticed and made relevant as test performance justifications and as rationales in the overall communication of patient needs. Just read the references yourself!

 

References

Boers M; Kirwan JR; Wells G; Beaton D; Gossec L; d’Agostino MA; Conaghan PG; Bingham CO 3rd; Brooks P; Landewé R; March L; Simon LS; Singh JA; Strand V; Tugwell P. Developing Core Outcome Measurement Sets for Clinical Trials: OMERACT Filter 2.0. J Clin Epidemiol 2014; 67: 745-53

Krohne,K Torres S; Slettebø Å, Bergland A. Individualizing Standardized Tests Physiotherapists’ and Occupational Therapists’ Test Practices in a Geriatric Setting. Qual Health Res September 2013; 23: 1168-1178.

Krohne,K; Torres S; Slettebø Å; Bergland A. Everyday uses of standardized test information in a geriatric setting: a qualitative study exploring occupational therapist and physiotherapist test administrators’ justifications. BMC Health Serv Res. 2014; 14: 72 doi:  10.1186/1472-6963-14-72

 

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