Law M, King G, Russell D, MacKinnon E, Hurley P, Murphy C
Neurodevelopmental Clinical Research Unit, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Arch Phys Med Rehabil. 1999 Jun;80(6):629-36. doi: 10.1016/s0003-9993(99)90164-8.
To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation.
A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures.
A children's rehabilitation center in a city of 50,000.
All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology.
Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months.
Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up).
Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change.
The "All About Outcomes" software is clinically useful. Further research should evaluate whether using the software affects the use of outcome measures in clinical practice.
开发并测试一个计算机化的自主软件程序的可行性和临床实用性，该程序旨在使儿童康复服务提供者能够就客户和项目评估中使用的最合适的结果测量方法做出决策。
采用前后设计来测试决策结果软件在提高临床结果测量知识和使用方面的可行性和初步影响。
一个拥有5万人口城市的儿童康复中心。
儿童康复中心的所有服务提供者。所代表的学科包括幼儿教育、职业治疗、物理治疗、言语和语言病理学、听力学、社会工作和心理学。
基于国际损伤、残疾和障碍分类（ICIDH）的概念框架，制定了结果测量决策协议。该决策协议在一个教育软件程序中实现了计算机化，并附有经过严格评估的测量数据库。参与者通过该程序了解结果测量方法，并选择符合其规格的结果测量方法。该计算机软件在儿童康复中心进行了6个月的可行性测试。
在可行性测试前后，通过对中心目前所有服务提供者的调查以及对30份随机选择的康复记录（在预测试、后测试和随访时）的审核，确定临床结果测量方法的知识和使用情况。
服务提供者表示结果软件易于遵循，并认为使用ICIDH框架有助于他们在选择结果测量方法时做出决策。调查结果表明，服务提供者在选择测量方法的舒适度和了解可用测量方法方面有显著变化。通过审核确定的结果测量方法的使用情况没有改变。
“关于结果的一切”软件具有临床实用性。进一步的研究应评估使用该软件是否会影响临床实践中结果测量方法的使用。
