Frequently Asked Questions Outcome Measures

What are Outcome Measures?
Is there a need to use Outcome Measures?
How to access Outcome Measures?
Will the use of outcome measures increase administrative time?
How to obtain a greater understanding of VWA’s approach to Outcome Measures?
References
Links

What are Outcome Measures?*
Outcome measures are diagnostic tools and/or systems to measure performance, ability, or function of patients. Not all measures are appropriate for all patients or instances. The measurement tool employed must be reliable, valid, and sensitive to change for the purpose for which it is being used.

An outcome measure is a "test or scale administered and interpreted by physical therapists that has been shown to measure accurately a particular attribute of interest to patients and therapists and is expected to be influenced by intervention" (Mayo, 1994).

It is a measure of change, the difference from one point in time (usually before an intervention) to another point in time (usually following an intervention) (Kendall, 1997).

An outcome measure should be standardised, with explicit instructions for administration and scoring (McDowell, 1996).

It is expected that all health professionals providing services to injured workers for longer than 4-6 weeks will routinely use outcome measures to clinically justify their treatment.

A wide selection of standardised outcome measures has been published. These range from:

simple, short questionnaires included in full within a published article (e.g. Knee Injury and Osteoarthritis Outcome Score (KOOS), Roos, 1998)
customised functional measures that are designed with a standardised measurement scale (e.g. Patient Specific Functional Scale, Stratford, 1995)
measures that require a manual and/or scoring system to be obtained or purchased (e.g.Oswestry Disability Questionnaire, Fairbank, 2000)

The results obtained from these measures can be used to evaluate the impact of an intervention, provide information to the patient, or provide information to VWA or its Authorised Agents.

*adapted from The Chartered Society of Physiotherapists (CSP) website www.csp.org.uk

Is there a need to use Outcome Measures?
Yes. The VWA expects that all acupuncture, chiropractic, osteopathy, physiotherapy and remedial massage providers who provide services to injured workers for longer than 4-6 weeks will use functional outcome measures to assist in the clinical justification of their treatment.

How to access Outcome Measures?
Some outcome measurement tools can be downloaded from the VWA's website under the Service Providers section or the Transport Accident Commission website under the Physical Therapy Resources section. There are extensive bibliographies on the topic of outcome measures available online (see 'links' for details).

Will the use of outcome measures increase administrative time?
Outcome measures reduce administrative time for busy health professionals by providing the following benefits:

the questionnaires can be completed by the worker independent of the treating health professional;
instead of the treater having to ask a number of questions as part of their subjective assessment, they can scan the questionnaires to pick out the most important issues; and
assessment of the outcome of treatment is determined more rapidlyand with greater objectivity using standardised measures.

Outcome measures are also beneficial in report writing. For example:
outcome measures abbreviate information that is required by external parties including referring health professionals and VWA Authorised Agents; and
subsequent reports are also abbreviated by simply referring to the scores over time and how it has varied.

How to obtain a greater understanding of VWA's approach to Outcome Measures?
The VWA's approach to outcome measures is based upon:

Clinical Framework for the Delivery of Health Services to Injured Workers (VWA);
Book by Yeomans, S.G. (2000) The clinical application of outcomes assessment. Stamford, CT, Appleton & Lange;
Australian Physiotherapy Association's Position Statement on Clinical Justification and Outcome Measures (2003); and
Transport Accident Commission Clinical Justification flow chart (2003, endorsed by the VWA).

References

Fairbank, Jeremy and Roland, Martin (2000) The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire, Spine 25 (24), 3115 - 3124.
Kendall N (1997) Developing outcome assessments: a step by step approach, New Zealand Journal of Physiotherapy Dec, 11 - 17.
Mayo N, Cole B, Dowler J, Gowland C, Finch E (1994) Use of outcome measures in physiotherapy: survey of current practice, Canadian Journal of Rehabilitation, 81 - 82.
McDowell I, Newell C (1996) Measuring Health - a Guide to Rating Scales and Questionnaires, Oxford University Press ISBN 0-19-510371-8.
Roos EM, Roos HP, Lohmander LS et al (1998) Knee injury and osteoarthritis outcome score (KOOS) - development of a self-administered outcome measure, Journal of Sports Physical Therapy 78, 2, 88 - 96.
Stratford, P, Gill, C, Westaway, M, & Binkley, J (1995) Assessing disability and change on individual patients: a report of a patient specific measure, Physiotherapy Canada, 47, 258-263.

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