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PROClass: The Development and Validation of a Novel Prosthetic Component Sophistication Classification System
Daniel C Norvell1,2,3, Wayne T Biggs1, Jeffrey Bott4
1VA Puget Sound Health Care System, Seattle, WA.
Archives of Rehabilitation Research and Clinical Translation
|September 25, 2023
Summary
A new classification system, PROClass, reliably categorizes lower limb prosthesis (LLP) sophistication. This tool accurately assesses prosthetic components, aiding research on patient outcomes.
Area of Science:
- Prosthetics and Orthotics
- Rehabilitation Engineering
- Health Services Research
Background:
- Developing a standardized system to classify lower limb prosthesis (LLP) sophistication is crucial for research.
- Existing methods may not adequately categorize prosthetic components for large-scale data analysis.
- The Veterans Affairs (VA) system provides a rich dataset for such development.
Purpose of the Study:
- To develop and validate a classification system (PROClass) for lower limb prosthesis (LLP) sophistication.
- To categorize prosthetic component prescriptions into basic, intermediate, and advanced levels.
- To assess the content validity, reliability, and accuracy of the developed system.
Main Methods:
- A classification system (PROClass) was developed by an expert panel.
- The system was refined using data from 30 transfemoral and transtibial amputees.
- Inter- and intra-rater reliability and accuracy were assessed using Gwet's AC1 statistic.
Main Results:
- PROClass demonstrated almost perfect interrater and intrarater reliability (Gwet's AC1: .82–.96).
- Classification accuracy by research assistants was excellent (Gwet's AC1: .75–.92).
- The system showed strong face validity.
Conclusions:
- PROClass is a pragmatic, reliable, and accurate system for classifying prosthetic components.
- This system facilitates large dataset research on LLP sophistication and patient outcomes.
- PROClass enables evaluation of clinical questions related to prosthetic technology.
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