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Outcome Measurement: The Importance of Time

Standardized measures are required to evaluate interventions and compare health care outcomes across patient groups and institutions in order to provide accountability. Rehabilitation outcomes are often chosen based on the International Classification of Function (ICF) framework that evaluates impairments, activity limitations and participation restrictions. Additionally, the ICF includes personal and environmental contextual factors that may influence activity limitations and participation restrictions. Little is known about the relationships of the concepts in this model and, specifically, it is not known if different concepts are more important at different times in the trajectory of recovery. We will seek patients’ perspectives in identifying important outcomes and will evaluate this model over the trajectory of recovery in patients undergoing total hip and knee replacement. If, as we expect, the relationships among the concepts in this model vary depending on the stage of recovery, this work will provide the basis for choosing specific, time appropriate outcome measures. Understanding the outcomes is the first step in identifying subgroups of patients and in developing innovative interventions that will improve outcomes and lessen the burden of disability.

This project is funded from October 2005 to September 2009 by Canadian Institutes of Health Research (CIHR).

ACREU Investigator: Dr. Aileen Davis