J.E. Sullivan, PT, DHS, Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Chicago, IL 60611 (USA).
Phys Ther. 2013 Oct;93(10):1383-96. doi: 10.2522/ptj.20120492. Epub 2013 May 23.
The use of standardized outcome measures (OMs) can support clinicians' development of appropriate care plans, guide educators in curricular decisions, and enhance the methodological quality and generalizability of clinical trials. The purposes of this case report are: (1) to describe a framework and process for assessing psychometrics and clinical utility of OMs used poststroke; (2) to describe a consensus process used to develop recommendations for stroke-related OMs in clinical practice, research, and professional (entry-level) physical therapist education; (3) to present examples demonstrating how the recommendations have been utilized to date; and (4) to make suggestions for future efforts.
A task force of 7 physical therapists with diverse clinical and research expertise in stroke rehabilitation used a 3-stage, modified Delphi consensus process to develop recommendations on OM use. An evidence-based systematic review template and a 4-point rating scheme were used to make recommendations on OM use by care setting and patient acuity, for research, and for inclusion in professional education.
An initial list of 77 OMs was developed based on input from numerous professional sources. Screening measures and duplicate measures were eliminated. Fifty-six OMs received full review. Measures spanned the constructs of body structure/function (21), activity (28), and participation (14). Fourteen measures received a rating of "highly recommend."
Use of highly recommended OMs may provide a common set of tools enabling comparisons across patients, interventions, settings, and studies. The use of a clearly defined, comprehensive assessment template may facilitate the pooling of data on OMs and contribute to best practice guidelines. Educational recommendations may inform curricular decisions.
使用标准化结局测量（OM）可以支持临床医生制定适当的护理计划，指导教育者制定课程决策，并提高临床试验的方法学质量和普遍性。本病例报告的目的是：（1）描述一种评估中风后使用的 OM 的心理测量学和临床实用性的框架和流程；（2）描述一种共识过程，用于为中风相关 OM 制定临床实践、研究和专业（入门级）物理治疗师教育的建议；（3）展示迄今为止如何利用这些建议的示例；（4）为未来的努力提出建议。
一个由 7 名物理治疗师组成的工作组，他们在中风康复方面具有不同的临床和研究专业知识，使用了一个 3 阶段的改良 Delphi 共识过程来制定 OM 使用建议。使用循证系统评价模板和 4 分制评分方案，根据护理环境和患者严重程度、研究和纳入专业教育的情况，对 OM 的使用提出建议。
根据来自众多专业来源的输入，最初制定了 77 个 OM 的清单。筛选措施和重复措施被排除。56 个 OM 接受了全面审查。这些措施涵盖了身体结构/功能（21）、活动（28）和参与（14）的构念。14 项措施被评为“强烈推荐”。
使用强烈推荐的 OM 可能提供一套通用的工具，使患者、干预措施、环境和研究之间的比较成为可能。使用明确界定的、全面的评估模板可能有助于 OM 数据的汇总，并有助于最佳实践指南的制定。教育建议可能会影响课程决策。
