The relationship between therapist-rated function and patient-reported outcome measures

Area of Science:

• Orthopedics and Rehabilitation
• Occupational Therapy
• Psychology

Background:

• Third-party payers often require hand therapists to assess patient functional disability.
• Assessment methods include patient self-rating via Patient-Reported Outcome Measures (PROMs), objective impairment measures, and functional task observation by hand therapists (Hand Therapist-Rated Function - HTRF).

Purpose of the Study:

• To evaluate the correlation between Hand Therapist-Rated Function (HTRF) and two PROMs: the Upper Limb Functional Index (ULFI) and the Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE).
• To investigate the association of psychological factors with HTRF and PROMs in patients with upper extremity conditions.

Main Methods:

• A prospective cohort study involving 100 new patients with upper extremity conditions was conducted.
• Data collected included demographic, condition-related, and psychological factors, alongside PROMs (ULFI, PROMIS UE) and HTRF.

Main Results:

• HTRF demonstrated moderate correlations with PROMIS UE (r = -0.49) and ULFI (r = -0.56).
• A strong correlation was observed between PROMIS UE and ULFI (r = 0.78).
• Psychological factors were found to be the primary drivers of variation in both HTRF and PROMs.

Conclusions:

• The correlation between hand therapist ratings and patient-reported outcomes is weaker than the correlation among different patient-reported outcome measures.
• Discrepancies between HTRF and PROMs highlight the potential impact of psychological factors like stress and distress on recovery.
• These findings suggest an opportunity for collaborative goal-setting between therapists and patients and indicate a need for research into effective strategies for addressing psychological barriers in hand therapy.