Patient report outcome measures: balancing the dilemma of professional requirements and clinical practicality

This paper presents three new short-form Functional Index patient report outcomes (PROs) that provide a simplified approach to balance professional requirements with clinical practicality. The use of PROs is an increasing demand for physiotherapists in order to meet the requirements of government, insurer and professional groups. Physiotherapists find PRO tools an integral part of patient management, apart from the practical dilemma of choice and time demands on both therapists and patients. The balance to this dilemma can be achieved through the use of a minimal number of tools that possess the critical methodological and practical characteristics, and are consistent in format across the critical regions of the spine and the upper and lower limbs. Three short-form PROs have been developed from the existing 25 item Spine, Upper and Lower Limb Functional Index series and are consistent in format and structure. These 10–item tools have an essential quantitative section and optional sections on qualitative patient specific items, duties and an 11–point VAS of overall status. Each tool has demonstrated methodological reliability (ICC 2:1 more than 0.94), responsiveness (ES more than 1.22), change scores (MDC less than 8%), internal consistency (alpha range 0.83–0.91) and all forms of validity including criterion (r more than 0.85 with all preferred published regional tools). The practical characteristics show brevity (one page), simplicity (three point single line items), efficiency (completion and scoring less than 2 minutes) and application across conditions and disease severity ranges. These tools offer a realistic method of recording and managing outcome measures in physiotherapy