Towards Optimal Practice
What can we gain from assessment of patient progress with standardized outcome measures?
The goal of every PT clinician and researcher is competency in applying the most effective treatment available to achieve the best outcomes for our patients. In her 2005 McMillan Lecture1, Dr. Rebecca Craik endorsed a three-pronged approach to competency that is comprised of: 1) classifying patients in meaningful ways, 2) standardizing our interventions, and 3) agreeing on the best outcome measures.
To advance the process of agreeing on the best outcome measures, the Section on Research formed the EDGE Taskforce (for Evaluation Database to Guide Effectiveness) in 2006. The primary goal of the taskforce is to assist in the identification of a core set of tests/measures for each practice area. It is understood that this process is dynamic and that the core sets may change over time. It is also understood that clinicians/researchers may choose to include additional evaluation/outcome measures beyond those in the recommended core set.
Why is agreement on outcome measures important? Before one can apply the most effective treatment available, it must be clear what is the most effective treatment. One necessary step in the process of accumulating evidence of the effectiveness of a treatment approach is to gather sufficient data to support that approach. In order to gather sufficient evidence, it is often necessary to pool results/data from multiple sources – but data can only be pooled if the same valid tests/outcome measures are used.
The bottom line is that evidence of intervention effectiveness depends on, among other things, common use of valid and reliable tests/measures, which reflect clinically important outcomes and are responsive to change. One of the first steps on the road to optimal practice by all physical therapists, for all the patients we treat, is the identification and selection of the most appropriate outcome measures. The EDGE Taskforce is engaged to move forward with this process.
Edelle Field-Fote, PT, PhD
Chair, EDGE Taskforce.
1Craik RL. Thirty-Sixth Mary McMillan Lecture: Never satisfied. Phys Ther. 85:1224-37, 2005.