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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: Short-form McGill Pain Questionnaire (SF-MPQ)

  • Self-administered pain questionnaire 
  • For non-specific neck-and-shoulder pain, low back pain, post-surgical and obstetric pain
  • Has acceptable reliability and validity

1. What it measures

This instrument aims to evaluate the intensity of pain experienced by an individual, to monitor pain over time and to determine the effectiveness of any interventions. It was developed on post-surgical, obstetric, and low back and neck-and-shoulder pain patients, whose pathology was non-specific. It is a self-administered questionnaire, originally designed in English.

2. How it is scored and what the score means

There are three sections in this questionnaire. 

Section A contains 15 representative words from the sensory and affective categories of the full version of the McGill Pain Questionnaire. The first 11 descriptors represent the sensory component, and the final 4 descriptors (beginning with ‘tiring-exhausting’) represent the affective component. Scores for each component (sensory and affective) are obtained by summing the intensity ratings (0–3) for the words selected by the patient. A total score is obtained by summing the sensory and affective scores.

Two other separate sections provide additional information on pain. Section B = an AVAS scale to describe symptom intensity using a 10 cm line on which patients rate their pain intensity during the last week, and Section C = a single choice of words which describe the current pain nature/ presentation to which a score is ascribed. A total score can be computed as the sum of A, B and C, however it is usual to separate the scores for the three sections.

Score reduction over time is the most logical approach to interpretation, and comparisons could be made using raw scores over the episode of care, or percentage change compared with the initial (baseline) score.

Note: This questionnaire was developed by Ronald Melzack and reproduced with permission only for clinical use in the outcomes calculator. Those wishing to use this instrument for research or commercial purposes should contact the author for individual permission for use. Copyright R. Melzack, 1970, 1987.

Please refer to page 34 of the Musculoskeletal Outcomes Calculator user manual for a copy of the SF-MPQ.

References:

Burckhardt and Bjelle (1993): A Swedish version of the Short Form McGill Pain Questionnaire. Scandinavian Journal of Rheumatology, 23: 77-81. 

Melzack R (1987): The Short-Form McGill Pain Questionnaire. Pain, 30:191-7.

Dempster M & Donnelly M. Validity of the Perceived Health Competence Scale in a UK primary care setting. Psychol Healt Med 2008; 13(1): 123-127.

Areas of study and research

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