Outcome Assessments

Outcome Assessments

Outcome assessments are instruments to help determine the progress of a patient. They are usually specific questionnaires (though they can include some examination findings) relevant to the patient’s chief complaint. They are given to the patient before treatment and again at various re-examination intervals. Good ones have been heavily researched for both validity, they give the information wanted, and reliability, they are consistent. Because of this research, they are considered to be very good indicators as to whether a patient is improving, staying the same, or getting worse. Insurance companies like them as they support whether or not the patient is getting better. There are hundreds of different outcome assessments and some insurance companies will make them readily available to practitioners.

Using these are the best way to document progress with patients. Without them, it is much easier for insurance companies to deny claims. Using them makes it much more difficult for them to deny payment and allows us to successfully appeal such decisions. They may require some differences in how patient flow occurs in the office, however. But not much. In order to use outcome assessments, a patient must fill one out when they first come into the office. The chief complaint needs to be determined and an appropriate assessment chosen.

General Instruments

Areas of the Body

Specific Diseases

Activities of Daily Living (ADL) Instruments

Katz Index of Independence in Activities of Daily Living

Barthel ADL Index

Kenny Self-Care Evaluation (Schoening,1965)

For a comparison of these first three assessments of ADLs please see this paper.

Klein-Bell ADL Scale (Klein, 1982)

Time Care Profile (Halstead, 1975)

Scale for Instrumental Activities of Daily Living (Lawton, 1969)

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Comprehensive Functional Assessment

Edinburgh Rehabilitation Status Scale (ERSS) (Affleck, 1988)

Functional Independence Measure (FIM) (Granger 1993)

Functional Life Scale (FLS) (LORS, LORS-II, LORS-IIB, LADS, LORS-III) (Sarno, 1973)

Patient Evaluation Conference System (PECS) (Harvey, 1981)

PULSES Profile (Moskowitz , 1985)

Rankin Scale

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Quality of Life

Quality of Life Scale (QLS)

Lehman Quality of Life Interview

Lancashire Quality of Life Profile (Nieuwenhuizen, 2001)

SmithKline Beecham Quality of Life Scale (SBQOL) (Stoker, 1992)

Oregon Quality of Life Self-Report Questionnaire and Semi-Structured Interview Rating Version [ ]

Quality of Life Index for Mental Health (QLI-MH) (Becker, 1993)

Index of Health Related Quality of Life (Ford. 2001)

Piloting of the Health of the Nation Outcome Scales

Team for the Assessment of Psychiatric Services (TAPS) Measures

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Back

Aberdeen Back Pain Scale

Maine-Seattle back questionnaire (Atlas, 2003)

Oswestry Disability Index (Fairbank, 1980) – Scale content: The Chiropractic Resource Organization

Roland Questionnaire (Roland, 1983)

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Elbow

American Shoulder and Elbow Surgeons´ Elbow Index (ASES-e) (King, 1999)

Assessment of Elbow function scale (King, 1999)

Patient Rated Elbow Evaluation (PREE) (MacDermid, 2001)

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Forearm

Patient Rated Forearm Evaluation Questionnaire (PRFEQ) (Overend, 1999)

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Foot and Ankle

AAOS foot and ankle core score

Ankle function score (KAFS) (Karlson, 1991)

Ankle joint functional assessment tool (Rozzi, 1999)

Ankle osteoarthritis score (Domsic, 1998)

Ankle-rating scale (Kaikkonen, 1994)

Ankle score (Liu)

Ankle score (St. Pierre, 1982)

Calcaneal fracture assessment score (Crosby, 1996)

Calcaneal fracture rational scoring system (Kerr, 1996)

Clinical rating system for the ankle-hindfoot (Kitaoka, 1994)

Foot and ankle grading system (Good, 1975)

Foot and ankle outcome score (Roos, 2001)

Foot function index (Budiman-Mak, 1991)

Foot health status questionnaire (Bennett, 1998)

Freiburg Ankle score (Lahm, 1998)

Functional outcome assessment (Thordarson, 1996)

Iowa ankle score (Merchant, 1989)

Karlstrom Olerud ankle score (Karlstrom, 1977)

Mazur ankle score (Manzur, 1979)

Oral analogue scale for calcaneal fractures (Morin, 1998)

Painful foot rating score (Sanders, 1993)

Scoring scale for symptom evaluation after ankle fracture (Olerud, 1984)

Scoring system for calcaneal fracture (Paley, 1993)

Sports ankle rating system (Williams, 2005)

Visual analog scale for calcaneal fracture (Hildebrand, 1996)

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Gastrointestinal system

Generic gastroenterologic instruments

Gastrointestinal Quality of Life Index (GIQLI) (Eypasch, 1995)

Gastrointestinal Symptom Rating Scale-interviewer administered (GSRS-interv)

Gastrointestinal Symptom Rating Scale-self administered (GSRS-self) (Pare, 2003)

Constipation

Constipation Assessment Scale (CAS) (McMillan , 1989)

Hemorrhoids

Rand Surgical Conditions Battery: Haemorroids – Rubenstein RS, Beck S, Lohr KN. Conceptualization and Measurement of Health forAdults.Vol.15. Surgical Conditions. Santa Monica, CA: RandCorporation, 1983

Inflammatory Bowel Disease

Inflammatory Bowel Disease Quality of Life questionnaire (IBDQOL) (Casellas, 2004)

Rating Form of IBD Patient Concerns (RFIPC)

Short Inflammatory Bowel Disease Questionnaire (SIBDQ) (Vlachonikolis, 2003)

Inflammatory Bowel Disease Questionnaire (IBIQ) (Guyatt, 1989)
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Hand/wrist

Alderson McGall Hand Function Questionnaire (AMHFQ) (Alderson, 1999)

Australian Canadian Osteoarthritis Hand Index (AUSCAN) (Bellamy, 2002)

Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) [Levine, 1993]

Brigham (Levine, 1993)

Hand Function Sort (HFS) (Matheson, 2001)

Michigan Hand Outcomes Questionnaire (MHQ) (Chung, 1998)

Patient Rated Wrist Evaluation (MacDermid, 1996)

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Hip

AAOS hip and knee score (Johanson, 2004)

Charnley hip score (Charley, 1972)

Functional rating scale (Keene, 1982)

Functional recovery score (Zuckerman, 2000)

Harris Hip Questionnaire (Harris, 1969)

Hip disability and Osteoarthritis Outcome Score (HOOS) (Nilsdotter, 2003)

Lequesne scale for osteoarthritis of the hip and knee (Lequesne, 1987)

Lower extremity measure (Jaglal, 2000)

Mayo hip score (Kavanagh, 1985)

Merle D’Aubigne-Postel hip score (D’Aubigne, 1954)

Mobility score after hip fracture (Parker, 1993)

Non-arthritic hip score (Christensen, 2003)

Patient Specific Index hip rating scale (PASI) (Wright, 1994)

Perception about hip replacement questionnaire (Dawson, 1996)

Rating scale for hip disabilities (Larson, 1963)

Salvati Hip Score, also known as HSS hip score (Salvati, 1973)

Thompson and Epstein score (Thompson, 1951)

Total hip arthroplasty outcome evaluation (Liang, 1991)

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Knee

AAOS hip and knee score

AAOS sports knee scale

ACL evaluation format (Lukianov, 1987)

Activity rating scale for disorders of the knee (Marx, 2001)

American Knee Society score (AKS) (Insall, 1989)

Anterior Knee Pain Scale (Kujala, 1993)

Bristol scale (Mackinnon, 1988)

Cincinnati knee rating system (Noyes, 1983)

Hospital for Special Surgery knee scale (HSS) (Ranawat, 1976)

Hungerford scoring system (Hungerford, 1982)

Index of severity for osteoarthritis of the hip and knee (Lequesne, 1987)

International Knee Documentation Committee scoring system (IKDC) (Irrgang, 2001)

Iowa knee evaluation (Merchant, 1989)

Knee functional assessment chart (no author, 1978)

Knee Injury and Osteoarthritis Outcome Score (KOOS) (Koos, 1998)

Knee scoring scale (Kettelkamp, 1975)

Lower extremity functional scale (LEFS) (Binkley, 1999)

Lysholm´s Knee Scale (Lysholm, 1982)

Neer knee score (Neer, 1967)

Patellofemoral joint evaluation score (Fulkerson, 1990)

Patient-reported measure of function of the knee (Irrgang, 1998)

Questionnaire on the perceptions of patients about total knee replacement (Dawson, 1998)

Rheumatoid and Arthritis Outcome Score (RAOS) (Bremander, 2003) Scale content: http://www.koos.nu/

Single Assessment Numeric Evaluation (SANE) (Williams, 2000)

Tegner Activity Level Scale (Tegner, 1985)

Western Ontario and McMaster OA index (WOMAC) (Bellamy, 1988)

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Neck

Copenhagen Neck Functional Disability Scale (Jordan, 1998)

Neck Disability Index (Vernon, 1991)

Neck Pain and Disability Scale (Wheeler, 1999)

Northwick Park Neck Pain Questionnaire (Leak, 1994)

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Pelvis

Iowa pelvic score (Templeman, 1996)

Majeed pelvic score (Majeed, 1989)

Orlando pelvic outcome score (Cole, 1996)

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Shoulder

American Shoulder and Elbow Surgeons Shoulder Index (King, 1999)

Athletic shoulder outcome scoring system (Tibone, 1993)

Criteria for rating results of rotator cuff surgical repair (Wolfgang, 1974)

Disabilities of the Arm, Shoulder and Hand (DASH) (Hudak, 1996)

Flexilevel scale of shoulder function (FLEX-SF) (Cook, 2003)

Functional assessment of the shoulder questionnaire (Constant, 1987)

Herscovici shoulder scale (Herscovici, 1992)

Hospital for Special Surgery shoulder assessment (HSS) (Warren, 1982)

Imatani shoulder score (Imatani, 1975)

Neer shoulder score (Neer, 1970)

Oxford Shoulder Scale (Dawson, 1996)

Rotator cuff quality of life measure (RC-QOL) (Hollinshead, 2000)

Rowe scale (Rowe, 1978)

Shoulder disability questionnaire (van der Heidjden, 2000)

Shoulder instability questionnaire (Dawson, 1999)

Shoulder Pain and Disability Index (SPADI) (Roach, 1991)

Shoulder pain score (Winters, 1996)

Shoulder Rating Questionnaire (L´Insalata, 1997)

Shoulder-related disability questionnaire (Croft, 1994)

Simple shoulder test (SST) (Lippitt, 1993)

Simple Shoulder Test (Matsen, 1993)

Single Assessment Numeric Evaluation (SANE) (Williams, 1999)

Subjective Shoulder Rating System (SSRS) (Kohn, 1997)

Swanson shoulder score (Swanson, 1989)

UCLA pain and function score (Ellman, 1986)

UCLA shoulder rating score (Amstutz, 1981)

University of California – Los Angeles Shoulder Scale (UCLA) (Elman, 1986)

Upper extremity functional limitation scale (Simonsick, 2001)

Upper extremity function scale (Pransky, 1997)

Western Ontario Osteoarthritis of the Shoulder Index (WOOS) (Lo, 2001)

Western Ontario Rotator Cuff (WORC) (Kirkley, 2003)

Western Ontario Shoulder Instability Index (WOSI) (Kirkley, 1998)

Wheelchair User´s Shoulder Pain Index (WUSPI) (Curtis, 1995)

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Upper extremity as a whole

Capabilities of Upper Extremities Instrument (CUE) (Marino, 1998)

Disabilities of the Arm, Shoulder and Hand (DASH) (Hudak, 2003 ) Scale content: http://www.dash.iwh.on.ca/

Modified American Shoulder and Elbow Surgeons´ Shoulder Index (m-ASES) (Beaton, 1998)

Prosthetic Upper Extremity Functional Index (PUFI) (Wright, 2001)

Student Health-Related Role Functioning Questionnaire (SHRQ) (Katz, 2002)

Upper Extremity Functional Scale (UEFS) (Pransky, 1997)

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Arthritis/Joints

Arthritis Helplessness Scale (AHI)

Arthritis Impact Measurement Scales (AIMS) (Meenan, 1980 ), later revised to AIMS2 (Meenan, 1990 )

EURIDISS (European Research on Incapacitating Diseases and Social Support (Suurmeijer, 1995)

Functional Status Index (FSI) (Deniston,1980)

Health Outcomes Institute TyPE (HOI-TyPE) – Joint Conditions

Hornquist´s Quality of Life Status and Change Scale

MACTAR (McMaster-Toronto Arthritis) Patient Function Preference Questionnaire (Tugwell, 1987)

Office of Population Censuses and Surveys (OPCS) Disability Scale (Martin, 1988 ) – Psychometric properties: (Hornquist, 1993)

Osteoporosis Assessment Questionnaire (OPAQ) (Randell, 1998)

Patient-Rated Wrist Evaluation (PRWE) (MacDermid, 1998)

Patient-specific index (Wright, 1997)

Pediatric Quality of Life inventory (PedsQL) (Varni, 1999)

Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) (Lips, 1996) -

Rand Joint Problems Battery

Rheumatoid Arthritis Impact on the Homemaker Questionnaire

Scale content: International Osteoporosis Foundation Quality of Life – Rheumatoid Arthritis scale (QOL-RA) (Danao, 2001)

Schedule for the Evaluation of Individual Quality of Life (SEIQoL)

Short osteoporosis quality of life questionnaire (Badia, 2000)

Stanford Arthritis Center Health Assessment Questionnaire (HAQ) (Fries, 1980) – Psychometric properties: (Bruce, 2003 ) full-text

Western Ontario and McMaster Universities Arthritis Index (WOMAC)

Western Ontario Osteoarthritis of the Shoulder index (WOOS) (Lo, 2001)

Western Ontario Rotator Cuff index (WORC) (Kirkley, 2003)

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Fibromyalgia

Fibromyalgia Impact Questionnaire (FIQ) (Burckhardt, 1991)

Neurological Conditions


Mental Health

Abbreviated Mental Test Score (AMTS) (Burleigh, 2002)

Mini-Mental State Examination (MMSE)

Mental Status Questionnaire (MSQ) (KAHN, 1960)

Older Americans´ Resources and Services Schedule (ARS) mental health measures

Brief Cognitive Functioning Scale (SIP subscale)

Geriatric Mental State (GMS) (Copeland, 2002)

Comprehensive Asssessment and Referral Evaluation (CARE)
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Epilepsies
Seizure Severity Scale (Carpay, 1997)

Washington Psychosocial Inventory (Dodrill, 1980)

Epilepsy Surgery Inventory (Selai, 2000)

Katz Adjustment Scales (revised for use with Epilepsy)
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Functional ability
Barthel Index (Mahoney, 1965 )

Nottingham Extended Activities of Daily Living Questionnaire (Nouri, 1987 )

Frenchay Activities Index (Holbrook, 1983 )

Rivermead Mobility Index (Collen, 1991 )
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Headache/Migraine

Migraine-Specific Quality of Life Questionnaire (MSQ) (Santanello, 1995)

Migraine Disability Assessment (MIDAS) (Iigaya, 2003)

Headache Needs Assessment questionnaire (HANA) (Cramer, 2001)
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Neuropsychological Functioning

Trail Making Test (Reitan, 2004)

Wechsler Memory Scale (WMS) (Baker, 2003)

Wechsler Adult Intelligence Scale (WAIS) (Greve, 2003)
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Stroke scales
Health Outcomes Institute TyPE Scales (HOI-TyPE) – Acute Stroke

Rankin Handicap Scale (Rankin, 1957 )

National Institute of Health Stroke Scale (Brott, 1989 )

Canadian Neurological Scale (Cote, 1986) – Psychometric properties: (Folstein, 1975)

Hemispheric Stroke Scale (Adams, 1987 )
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