Technical Report - The Inclusion of Assistive Technology Outcomes in Current Health and Rehabilitation Outcome Measures
Instruments Technical Report (PDF, 769KB)
Executive Summary
This report presents the results of the field scan effort to clarify how assistive technology (AT) is treated in current and developing health and rehabilitation outcomes assessment instruments. Health and rehabilitation outcome measures vary widely on the basis of their purpose and scope. The number and variety of disciplines that consider the issue of function in their outcome measurement is many. Outcome can be measured in clinical, functional, psychosocial, and cost terms. Regardless of their intent, all outcome measurements contain a complex integration of information designed to capture change. Assistive technology (AT) is one of many potential interventions in the rehabilitation process.
While a primary focus of this review is to look at popular outcome measures in current use, several instruments important from an historical perspective (and widely used in early functional outcome studies) are included. Additionally, several authors of developing instruments consulted with us for feedback regarding assistive technology inclusion in the instruments they have in progress. Review of 100 prominent instruments reveals three primary categories of how AT is treated in the scaling and methodology of current assessments. First, instruments do not mention AT in their scoring procedures. Second, the functional outcome score is lowered when the subject uses AT. Third, the instrument allows the use of assistive technology to obtain a full functional score. This cataloguing of outcome measures reveals the extent to which assistive technology is either ignored or considered as a covariate of function. Overall, the findings suggest that many current assessments totally disregard AT and others fail to appreciate the significance of AT as a positive contribution to health and rehabilitation.
A second purpose of this project was to examine existing instrumentation for potential methodological strategies that might benefit AT outcomes measurement. If there is a system that works, there is no purpose to reinventing the wheel. The three instruments that provide a method for isolating the impact of AT are identified and their methodologies explained. Additionally, trends revealed in the literature reviewed are discussed. The instruments reviewed were published between the years 1957 and 2001. One unfortunate and one positive trend are identified. Finally, the report concludes with recommendations for stakeholders in the process of AT delivery and use.