Recommending core outcome measures for adults with musculoskeletal knee conditions : a consensus development conference

Musculoskeletal knee conditions present a growing burden for community based rehabilitation. Outcome measures profile current health status, detect change and evaluate response to interventions. There is, however, an abundance of outcome measures but no recommendation on which to use or what data to collect, leading to widespread variation in practice. The purpose of this study was to identify those outcome measures with robust scientific evidence for adults undergoing conservative treatment of musculoskeletal knee conditions and establish, through consensus with clinicians, researchers and patients, which are acceptable and feasible for use in community based settings. An investigation of current clinical practice in NHS Scotland profiled data collection and outcome measure use in community rehabilitation. Evidenced based, validated patient vignettes were developed to establish the scope of the study. The literature reporting and testing the clinimetric properties of outcome measures was systematically reviewed and the OMERACT filters of 'truth' and 'discrimination' applied to the data for each outcome measure by an expert panel. Those measures meeting predefined quality thresholds were presented to a national Consensus Development Conference where delegates voted on their acceptability and feasibility, followed by wider public consultation. None of the 37 outcome measures identified had been fully tested or were fully supported with sufficient quality and breadth of evidence for all components of the OMERACT filter, only ten met the preset criteria for 'truth' and 'discrimination' . Five were presented to Conference and two (Lysholm and WOMAC) were subsequently recommended for use in clinical practice. Barriers to implementation included time, administration and cost. This thesis reports on a study to recommend a core set of outcome measures that could facilitate standardisation of data collection and demonstrate effectiveness of interventions for adults with musculoskeletal conditions of the knee. It captures thoughts and concerns of clinicians on the introduction of a minimum core set of outcome measures.EThOS - Electronic Theses Online ServiceGBUnited Kingdo