Outcome measures

Use this section of the site to find out more about outcome measures including an updated, online database: see the menu on the left hand side for links to other pages. Introductory information on this page covers:

What is an outcome measure?

  • Outcomes are 'the results of health care processes'   (Baumberg, 1995)
  • A physical therapy 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'   Cole (1994) based on 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, p494)
Back to top

A measure should be reliable, valid, and responsive to the clinical change that occurs over time. This is an attempt to closely define subjective information in a robust manner:

  • Reliability is how uniformly the test can be repeated when administered on more than one occasion or by more than one rater.
  • Validity is the extent to which the measure measures what it intends to measure, (Cole et al, 1994), that is, is it asking the right questions?
  • Responsiveness is the ability of the measure to detect true change in patients' status over time (Binkley, 1999), that is, is it sensitive to the subtle changes patients make?

Measures should be convenient for use by clinicians and especially acceptable for the patient. In this respect they need to be comfortable and painless. A wide selection of standardised measures have 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), to
  • measures that require a manual and / or scoring system to be obtained or purchased (e.g. Bristol Female Lower Urinary Tract Symptoms questionnaire, Jackson, 1996), to
  • more sophisticated systems with software, that require a financial and training investment through a commercial company, providing more in-depth information on outcomes (e.g. TELER, Le Roux, 1993; LIFEware, Granger, 1995).

Back to top

What to do with the results

The results obtained with a measure should be analysed to see if the change in health status recorded is attributable to the intervention, or not. To make rational decisions about whether an intervention is of value, careful analysis of the cause of the outcome should be made.

The results obtained can be used to evaluate the impact of an intervention, or treatment; provide information to the patient; or provide information for commissioners of physiotherapy.

Back to top

Core standards of physiotherapy practice and outcome measures

Standard 6 from the 'Core Standards of Physiotherapy Practice' (2005) makes an explicit requirement for members to use published, standardised outcome measures in their routine clinical practice:
Taking account of the patient’s problems, a published, standardised, valid, reliable and responsive outcome measure is used to evaluate the change in the patient’s health status.

Although not a new standard - the Society published 'Standards for administering tests and taking measurements for chartered physiotherapists' in 1994 - embodying the requirement within the core standards does raise the profile and reflect the increasing pressure for members to have information on the results of their work.

Back to top