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iCAHE Outcome Calculators

 


What are Outcome Measures?

An outcome measure is a diagnostic tool to measure performance, ability, or function of an individual.  They are valuable tools for healthcare professionals to engage in the recovery, rehabilitation and return to work of injured individuals. The outcome measures contained within the CAHE Outcomes Calculator Version 5 have been selected on their psychometric properties (validity, reliability, sensitivity to detect change over time and clinical utility for patient populations with peripheral joint disorders).  The outcome measures represent a range of aspects of functioning and/ or disability, which are measured at the level of body functions / structure, the individual and society, as defined by the International Classification of Functioning. The international Centre for Allied Health Evidence website houses five outcome calculators as follows:

Basic Outcomes Calculator

Musculoskeletal Outcomes Calculator

Neurological Disorders Outcomes Calculator

Incontinence Outcomes Calculator  

Chronic Disease Management Outcomes Calculator

Details of all the Outcomes Instruments used in each of the iCAHE Outcomes Calculators can be viewed in the following document: iCAHE OC Benchmarking

Outcome Measures

 

The iCAHE Outcomes Calculator has been under development since 1999 by researchers in the International Centre for Allied Health Evidence, and the School of Computing Science (University of South Australia), in a series of staged research strategies. Preliminary investigations comprised:

 

 

  • Wide-spread data collection from over 2000 clinicians regarding current use of measures of health outcome in clinical practice
  • Investigation of requirements of funding bodies regarding health outcomes derived from treatment by clinicians
  • Literature review to assess evidence of validity, reliability, sensitivity to change and clinical utility of common measures of health outcome used by clinicians, as well as other measures of health outcome that may be useful for clinicians
  • Discussions with health Australian clinicians regarding the barriers and facilitators to regular use of health outcomes in clinical practice and
  • Evaluation of the content of common measures of outcome and their usage by researchers and clinicians.

About outcome measures

The term outcome incorporates the health gain and costs associated with treatment. For the management of many conditions, this involves an episode of care (a number of linked occasions of service). Currently the most common type of outcome information is on cost, or number of contacts with the patient.

Our investigations highlighted that most clinicians collect no standard information from patients on health outcome, despite this being the most important information required by health funders. What information is collected is non-standardised, collected at variable time frames throughout the episode, and is usually handwritten in patient notes, which makes it inefficient and less than useful for clinical benchmarking. The need for a simple, efficient mechanism for collecting standard information routinely on patient progress was identified from our preliminary investigations. The Outcomes Calculator software was developed to address this need.

Advantages of using the iCAHE Outcomes Calculators

The iCAHE Outcomes Calculators aim to facilitate the use of standardised outcome measures in clinical practice to monitor changes in patient status over time. Patients complete selected outcome measures prior to, or following treatment (without reference to the clinician) and the data can be entered into the iCAHE Outcomes Calculators by administrative staff. This avoids the potential bias by the clinician and ensures that the patient's view of their condition is recognised. The iCAHE Outcomes Calculators automatically compute the score for each outcome measure and use norms for comparison, as appropriate. Summarising outcomes in this way assists in the communication of patient progress between clinicians, patients and funders.

For example, the outcome measures contained within the iCAHE Musculoskeletal Outcomes Calculator have been selected based on their validity, reliability, sensitivity to detect change over time and clinical utility for patient populations frequently treated by physiotherapists. They represent a range of aspects of functioning/disability, which are measured at the level of body functions/structure, the individual and society, as defined by the International Classification of Functioning.

Details on the outcome instruments in each of the five iCAHE Outcomes Calculators can be found under 'Contents' on page 2 of each of the Outcomes Calculator User Manuals.

The iCAHE Outcomes calculator is accompanied by a iCAHE OC User Manual and Software Guide. We encourage users to provide feedback for evaluation, and to enable iCAHE to provide additional information about new versions of the calculator.

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About Outcomes Calculators

Outcome Calculator screen shot

What are they?

There are now five iCAHE Outcomes Calculators:

iCAHE Basic Outcomes Calculator

iCAHE Musculoskeletal Outcomes Calculator

iCAHE Incontinence Outcomes Calculator

iCAHE Neurological Disorders Outcomes Calculator

iCAHE Chronic Disease Management Outcomes Calculator

All 5 iCAHE Outcome Calculators are available for purchase on the one CD, click here for more information.

We are very proud of the iCAHE Outcomes Calculators which have been developed from the combined efforts of many iCAHE staff since 1999. We are also grateful for the input of researchers at Stellenbosch University, Capetown, South Africa. The iCAHE Outcomes Calculator Introduction PowerPoint file (below) provides an outline of the iCAHE OCs and how they can be used.

iCAHE Outcomes Calculators Introduction (PDF 3.7MB)

What do they do?

The iCAHE Outcomes Calculators aim to facilitate the use of standardised outcome measures in clinical practice to monitor changes in patient status over time. Patients complete selected outcome measures prior to, or following treatment (without reference to the clinician) and the data can be entered into the iCAHE Outcomes Calculator by administrative staff. This avoids the potential bias by the clinician and ensures that the patient's view of their condition is recognised. The iCAHE Outcome Calculator automatically computes the score for each outcome measure and uses norms for comparison, as appropriate. Summarising outcomes in this way would assist in communicating patient progress, between clinicians, patients and funders.

How much do they cost?

All five calculators are available on the one CD-ROM, complete with CAHE Outcomes Calculator User Manuals and Software Guides for AU$100 including postage and handling (plus GST).  This is a once off fee, allowing institutions to install the calculators on multiple systems and includes development, maintenance and any future upgrades to the calculators. To register for a copy of the CD-ROM containing all four iCAHE Outcomes Calculator's simply open the iCAHE OC Order Form for more information and ordering details.  Fill out your details, and fax, email or post them in as per instructions on page 2.  (International enquiries: Please contact Olivia Thorpe regarding postage costs).

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User Manuals:

There are now five iCAHE Outcomes Calculators  and each Outcomes Calculators have a dedicated iCAHE OC User Manual and  Software Guide. The iCAHE OC User Manuals and Software Guides are designed to make the iCAHE Outcomes Calculators accessible and simple to use.

iCAHE Basic Outcomes Calculator

iCAHE Musculoskeletal Outcomes Calculator

iCAHE Incontinence Outcomes Calculator

iCAHE Neurological Disorders Outcomes Calculator

iCAHE Chronic Disease Management Outcomes Calculator

 

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Feature Outcome Measures, User Videos

Bergs Balance Scale

The Berg Balance Scale (BBS) is an objective performance-based measure of balance abilities.  It has been used to identify and evaluate balance impairment in the elderly.  It consists of 14 tasks in everyday life.  The items test the client’s ability to maintain positions or movements of increasing difficulty by diminishing the base of support from sitting, standing to single leg stance. The ability to change position is also assessed. The test is simple, easy to administer and safe for the evaluation of elderly patients. It only requires a watch and a ruler as equipment and takes approximately 15 min to perform.

9 Hole Peg test

The Nine-Hole Peg (NHP) Test is a simple, timed test of fine motor coordination, involving placing dowels (9 mm in diameter and 32 mm long) in 9 holes. It measures finger dexterity among patients with physical disabilities. The test administration is brief involving only the time it takes to place and remove all 9 pegs in a 5-inch square board.

 

 

6 minute walk test

The Six-Minute Walk Test (6MWT) is used as a measure of exercise tolerance and endurance for community dwelling older adults. It has been used to describe and monitor an individual's endurance level, as a one-time measure of functional status as well as a predictor of morbidity and mortality. The self-paced Six-Minute Walk Test is dependent on an individual's ability to ambulate.

 

Functional Reach test

Functional Reach Test is a measure of balance and is the difference, in inches, between arm’s length and maximal forward reach, using a fixed base of support. This can be used to detect balance impairment, change in balance performance over time and in the design of modified environments for impaired older persons.  

 

 

Clinical Test of Sensory Interaction and Balance

The Clinical Test of Sensory Interaction and Balance (CTSIB) is a timed test that was developed for systematically testing the influence of visual, vestibular and somatosensory input on standing balance.  It has been used clinically to assist in the evaluation and monitoring of persons with vestibular dysfunction. CTSIB has also been used to determine fall risk in older adults and with persons post-stroke, for persons with peripheral neuropathy, for persons with lower extremity amputation and with children.

The test consists of 6 conditions: Conditions 1, 2 & 3 involve standing on the floor with eyes open, eyes closed, and wearing a visual-conflict dome. Use of the conflict dome results in a discrepancy between vestibular input stimulated by postural sway and visual flow. Conditions 2 and 3 should examine different aspects of sensory organization of visual information that may require different postural adjustments.  Conditions 4, 5 and 6 involve standing on foam and repeating the visual conditions described for conditions 1-3. For each condition, the length of time the subject can maintain standing and the amount of body sway that occurs are assessed.

Timed up and Go test

The original purpose of the TUG was to test basic mobility skills of frail elderly persons. This test measures mobility in people who are able to walk on their own. If they use an assistive device they are permitted to do so during the test as well. It tests dynamic balance and functional independence by measurement of the time in seconds taken for a person to rise from sitting from a standard arm chair, walk 3 meters, turn, walk back to the chair, and sit down. 

Tardieu Scale

The Tardieu Scale is a passive measure that evaluates spasticity. The scale accounts for the velocity-dependent nature of spasticity by passively stretching the muscles either at the speed of a limb falling under gravity or as fast as possible (greater than the speed of a limb falling under gravity) as these velocities elicit the stretch reflex.

 

 

Sit to Stand test 

This test is used to get a measure of functional lower limb muscle strength. It may also be useful in quantifying functional change of transitional movements. There are many variations of this test. The one described here is the five times sit to stand test where the patient stands up and sits down in a chair with arms crossed five times as fast as possible.

 

Motor Assessment Scale

The Motor Assessment Scale was designed to assess the ability of stroke patients to perform functional tasks rather than isolated patterns of movement or synergies. This was based on the principles of Motor Relearning Programme.  

 

 

 

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Ordering information

iCAHE Outcomes Calculators order form

Cost

All five calculators are available on the one CD-ROM, complete with iCAHE Outcomes Calculator User Manuals and Software Guides for AU$100 including postage and handling (plus GST). This is a one off fee, allowing institutions to install the calculators on multiple systems and includes development, maintenance and any future upgrades to the calculators. To register for a copy of the CD-ROM containing all four iCAHE Outcomes Calculator's simply open the iCAHE OC Order Form for more information and ordering details. Fill out your details, and fax, email or post them in as per instructions on page 2. (International enquiries: Please contact Olivia Thorpe regarding postage costs).

System Requirements

All 5 iCAHE outcomes calculator are made available on the one CD, as opposed to a download. This allows better flexibility across different operating systems. Included in the OC CD-ROM is an additional software program that ensures the iCAHE Outcomes Calculator software is compatible with the majority of computer operating systems (both PC and MAC).

To assist you with the installation and use of the iCAHE Outcomes Calculators the
iCAHE Outcomes Calculator user manuals are available online.

  • Please note that the iCAHE Outcomes Calculators can only be loaded onto individual PC hard-drives and not shared over an office network system.  The iCAHE OC CD, containing the iCAHE Outcomes Calculator software, also includes a software patch which should be activated if the calculators do not immediately install. iCAHE Outcomes Calculators are not suitable for loading on MAC computers.
Hardware The minimum recommended is a Pentium II 450 MHz or
faster processor with 64MB RAM. A mouse is required
to operate the software.

 

Disk space Approximately 30MB of disk space is required for the
initial installation of the Outcome Calculator. Additional
space will be required as the amount of data stored in
your copy of the calculator grows.

 

Operating System The Outcome Calculator will run on Microsoft Windows 98
(1st and 2nd editions), Windows ME, Windows NT 4.0
(with Service Pack 6a), Windows XP Home, Windows XP
Professional (with Service Pack 1), Windows 2000 Professional
(with Service Pack 3), and Windows Server 2003 (Web,
Standard, Enterprise, and Datacenter Editions in 32-bit).

Good luck and we look forward to hearing your feedback from you as you utilise this innovative tool.

 

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Feature Outcome Measure

Scale: Disabilities of the Arm, Shoulder and Hand (DASH)

  • Self-reported questionnaire
  • For evaluating physical function and symptoms in upper limb disorders
  • Reliable, valid and responsive to detect change

 

1. What it measures

The Disabilities of the Arm, Shoulder and Hand (DASH) was designed to assess physical function and symptoms in patients with any or several musculoskeletal disorders of the upper limb. A self-report questionnaire consisting of 30 questions, five of which are related to symptoms and 25 related to functional tasks. The questionnaire was designed to help describe the disability experienced by people with upper-limb disorders and also to monitor changes in symptoms and function over time. 
The DASH Outcome Measure contains two optional, four-item modules intended to measure symptoms and function in athletes, performing artists and other workers whose jobs require a high degree of physical performance. The goal of the optional modules is to identify the specific difficulties that professional athletes/performing artists or other groups of workers might experience but which may not affect their activities of daily living and consequently may go “undetected” in the 30-item portion of the DASH.


2. How it is scored and what the score means

The DASH is scored in two components: the disability/symptom questions (30 items, scored 1-5) and the optional high performance sport/music or work section (4 items, scored 1-5).

Disability/Symptom Score

At least 27 of the 30 items must be completed for a score to be calculated. The assigned values for all completed responses are simply summed and averaged, producing a score out of five. This value is then transformed to a score out of 100 by subtracting one and multiplying by 25. This transformation is done to make the score easier to compare to other measures scaled on a 0-100 scale.

DASH disability/symptom score = [(sum of n responses) - 1] x 25, where n is equal to the number of completed responses.

Optional Modules (Sport/Music or Work)

The same procedure described above is followed to calculate the optional four-item module score. All four questions must be answered in order to calculate the score. Simply add up the assigned values for each response and divide by four (number of items); subtract one and multiply by 25 to get a score out of 100.

For Missing Items: 

If more than 10 percent of the items (that is, more than three items) are left blank by the respondent, a DASH disability/symptom score may not be calculated. By this same rule (that is, no more than 10 percent of the items can be left blank), no missing values can be tolerated in the high-performance sports/ performing arts or work module because the module consists of only four items.


Please refer to page 124 of the Musculoskeletal Outcomes Calculator user manual for a copy of the SF-MPQ

References:

Atroshi I, Gummesson C, Andersson B, et al. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire. Reliability and validity of the Swedish version evaluated in 176 patients. Acta Orthop Scand 2000;71:613—8. 

Beaton DE, Davis AM, Hudak P, McConnell S. The DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure: What Do We Know About It Now? British Journal of Hand Therapy 2001; 6(4):109-118 

Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C. Measuring the Whole or the Parts? Validity, Reliability & Responsiveness of the Disabilities of the Arm, Shoulder, and Hand Outcome Measure in Different Regions of the Upper Extremity. Journal of Hand Therapy 2001; 14(2):128-146. 

Beaton DE, Wright JG, Katz JN (2005): Upper extremity Collaborative group. Development of the QuickDASH: comparison of 3 item-reduction approaches. The Journal of Bone and Joint Surgery (Am) 87:1038e46. 

Dowrick SA, Gabbe BJ, Williamson OD, Cameron PA. Outcome Instruments for the assessment of upper extremity following trauma: a review. Injury, Int. J. Care Injured (2005) 36, 468—476

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Areas of study and research

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