Beyond the Basics of Clinical Outcomes Assessment: Selecting Appropriate Patient-Rated Outcomes Instruments for Patient Care

The fifth edition of the Athletic Training Education Competencies emphasizes the concepts of clinical outcomes assessment. In athletic training, clinical outcomes assessment, especially as it relates to patient-rated outcomes (PRO) instruments, is new, which produces uncertainty with regard to how to integrate PROs into athletic training education. Our goal was to review the concepts associated with selecting PRO instruments and to provide a teaching strategy for implementing these concepts into education programs. When selecting a PRO instrument, clinicians should follow a systematic process that evaluates a variety of criteria related to the development and performance of the instrument as well as the clinical utility of the instrument. Considering the importance of the selection process, athletic training educators may be unsure of strategies to guide their students through the process. The process of selecting PRO instruments is not unlike that used to select other clinical tools, such as tools with which to measure range of motion or strength. Selecting PRO instruments requires consideration of both essential elements (ie, instrument development, reliability, validity, responsiveness and interpretability, and precision) and clinical utility components (ie, acceptability, feasibility, and appropriateness). This manuscript provides key considerations for the selection criteria as well as a case scenario assignment that is used to demonstrate how the criteria can be applied to a clinical case. Creating assignment strategies to apply the concepts of clinical outcomes assessment into clinical practice may result in clinicians who appreciate the value of patient outcomes as integral components of patient care. The evaluation of the essential elements and clinical utility of an instrument provides a framework by which to select an appropriate PRO instrument. By using a case scenario assignment, athletic training educators can guide their students through the selection process and highlight important considerations when comparing PRO instruments.