Post on 10-Jan-2016
description
INTERIM PROSTHESIS PILOT TRIAL AN UPDATE FEB 2008
AIMS OF TRIALPilot trial to integrate acute prosthetic service delivery using private and public prosthetic services.Compare the cost and outcomes of private and public prosthetic services of fabricating mechanical interim prosthesis.Determine relevant and practical outcome measures for amputee rehabilitation services.
BACKGROUND OF TRIALTwo SitesJHH/RPCEmploy additional onsite public prosthetist to make mechanical interims.WESTMEADContract services from private company (APC) to make mechanical interims.
Reflects current / possible service provision
BACKGROUND OF TRIALTrial began in February 2006 at Westmead hospital and May 2006 at John Hunter/Rankin Park. Public prosthetist used existing onsite facilities located next to the rehabilitation gym at Rankin Park.Private Prosthetic on call service at Westmead hospital. Prosthetist attend rehabilitation gym to see patients.
OUTCOME MEASURESBasic demographic dataAgeGenderCo-morbiditiesInsurance statusMilestone dates Functional Scales and measures (see over)Variance
FUNCTIONAL OUTCOME MEASURES
COMPARISON OF DATANumbersDemographicsMilestone DatesFunctional Outcome Measures
PATIENT NUMBERS
DEMOGRAPHICSSimilar in age, sex and side of amputation.Differences in level of amputation. Higher rate (38.6%) TFA at JHH compared with Westmead (20.8%)Higher percentage of cause being PVD or DM at Westmead (83%) compared to JHH (62%)
DEMOGRAPHICS
Chart3
3139
2211
43
4241
1512
2523
3230
2426
1218
65
51
112
3431
2322
John Hunter
Westmead
Demographic
COMPARISON OF DEMOGRAPHICS
Sheet1
Unilateral BK's2006/2007
NO.PatientAmp DateCause ofSideRehab AdmissionRehab AdmissionRehab D/CDischargeHospital LOSRehab LOSInterim legAMP to InterimStartDefinativeInterim toDischarge fromAgeAMP No ProK- ClassAmpProK ClassTGUAG10m walk2min WalkLCISATPRO
AmputationFIMFIMhomeafter AmputationPhysiolegDefinitivephysio
1Tleige, Khatib1/9/06DM/PVDLeft2/8/0630TFA otherside
2Dove, Peter2/3/06PVDLeft3/3/06283/1/06267/11/0613262Moved back to rural area data incomplete
3Whiteley, Ray3/11/06DMRight4/5/06253/31/062048RIP
4Cahill, Jeanine3/3/06DMLeft4/13/06414/5/06337/13/0699372523738.637.9311239.0018.0057.00
5Bernardinis, John2/8/06DMLeft3/20/06404/12/06634/3/0612/8/0624010/27/06513630.00
6Fayle, Bill2/8/06PVDLeft3/2/063/30/06505/24/061054/11/0711/29/061892/12/077530240315.2813.256345.0025.0050.00
7Shawkey, Mohamed6/16/06DMLeft6/26/061021168/15/0660507/31/064511/30/06122702223529.308.208650.0022.0053.00
8Davies, RogerTraumaLeft08/18/0637383
9Flahey, Paul8/16/06PVDRight8/25/061141209/12/0627189/27/064210/4/063/1/071557/18/077014.2312.656542.0033.0042.00
10Porter, Eric10/22/07PVDRight11/21/073011/17/072611/23/0662Moved back to rural area definitive limb made elsewear
11Hales, Margaret10/1/06PVDRight10/24/061001181/28/071199611/23/06531/31/075/11/071697127236321.0020.854045.0026.0049.00
12Clarke, Ruth10/20/06DMRight11/30/0674811/27/07995812/5/06465/17/071637813124125.3018.0030
13Hanna, Sam8/29/06PVDRight9/6/06812/15/0644Ulcer on leg nil definitive yet
14Iskander, SamDMLeft2/7/0661191
15McGrath, Daniel12/12/06DMRight1/10/07292/12/07621/29/076/21/0712941222
16Palangas, Steve1/5/07PVDLeft1/19/07911133/30/0784702/15/07416/7/071128620241313.5312.227052.0025.0050.00
17Hanna, Mark2/2/07PVDRight2/20/071201212/28/072683/14/07403/5/078/16/071553337356.0026.0049.00
18Smith, Eric2/15/07PVDLeft3/6/07803/21/0734153/14/07276/20/0798653634337.577.2511052.0022.0053.00
19Baldwin, Bill12/1/06DMRight12/15/06143/27/0711612/18/065/23/07574818130240.8031.706020.0023.0052.00
20Haszcnyzyk, Michael2/27/07PVDLeft3/13/073/22/072394/4/07364/4/07503634038.347.1011252.0019.0056.00
21John Downey3/15/07DMRight4/3/071121186/1/0778594/23/07396/4/079/20/071507419135213.8010.808749.0016.0059.00
22Michael Mantoufeh5/23/07DM/PVDLeft5/23/07701097/20/0758586/15/07237/24/0710/11/071187219131220.2015.605633.0033.0042.00
23Mark Moulds4/17/07DMLeft7/21/07956/14/07588/27/0712/13/071824922225128.0016.404532.0017.0058.00
24Michael Lanyon5/16/07DMRight5/29/071071227/13/0758456/18/07337/18/07402224338.977.5712553.0022.0053.00
25Ilma Saunders5/25/07PVDRight6/19/0783957/19/0755306/27/07337/27/0773141
26Thomas Palmer6/12/07DMRight6/28/0779917/20/0738227/9/07277/25/0710/31/07114711814039.408.7013051.0015.0060.00
27Pat Smith1/30/07PVDLeft4/19/0760765/16/07106277/26/071775/23/0766101
28Anthony Hutchinson10/4/06PVDLeft10/24/06798711/29/0656367/9/0712/6/0658343
29William Millar3/2/07PVDRight5/11/07704/2/07315/15/077/3/0710/18/077020238311.809.809531.0022.0053.00
30Boot, Maria7/10/07PVDRight9/12/07648/30/075111/15/071/15/087213118170.1076.1013.00=
31Tia Tia, Peter5/23/07DMRight7/13/0765658/31/07100498/30/07991/14/081376021232219.1012.9062.0030.0016.00
32Farquarson8/23/07DMLeft10/26/076412/3/0769732223739.888.34117
33Smith, Jeff9/26/07TraumaLeft10/29/073310/28/0732423734348.435.38160.00
34Spiteri9/25/07PVDRight10/15/079612312/13/07795910/30/07357033216.808.65100.0054.0015.0060.00
35Darnely, Kathleen8/31/07PVDRight10/18/077511311/15/07762810/26/075656
36Bowen, Lesley10/11/07DMLeft10/13/07211/20/074074
37McCormack, FionaTraumaLeft
38Whittiker, RichardPVDRight
39Balangue, MichealTraumaLeft
89104524150.44140Mean61.2023.291.8834.672.3918.7715.7082.2643.8822.0052.6087.67
40Standard Deviation14.018.510.807.090.8515.0415.9038.2011.075.705.67
Median65.0021.502.0035.502.5013.8010.8086.0049.5022.0053.00
Range37-8610-371-335-432-37.57-70.17.25-76.113-13020-5615-33
homeInterim legDefinativedaysto definative
AV = (59)AV=(85.43)Av=(151)Av=(160)Av=(79.68)
Median = (33.5)Median=(57)Median=(132)Median=(147)Median=(57.5)
Amp DateDischargeInterim legStartDefinativeDischarge from
homePhysiolegphysio
1George Congerton10/6/06PVDLeft11/1/069311212/22/067711/17/06421/9/077718125173681862451.00
2Wayne Fensom7/10/06TraumaLeft7/14/0649/9/06618/19/064239342310.728.683532154.00
3Jozo Jedinak3/20/06PVDLeft4/11/06901045/4/06454/28/06395/11/067518122112132451.00
4Aleksy Paszyn6/2/06PVDLeft7/27/068911310/22/0614210/4/0612411/6/067827230238.231.432292253.00
5Max Richards4/10/06PVDLeft4/19/06921195/24/06447/10/06916/14/067/10/067125239312.611.564422253.00
6Alex Sarkany2/12/07PVDLeft1/23/0771982/10/072/15/072/13/077230231253.56515222253.00
7Bernie Walsh8/24/06PVDRight9/22/069410010/17/06549/29/063610/23/07393834439.36.1112561857.00
8Noel Wasson5/4/07PVDLeft5/16/0780956/20/07476/4/07316/26/0774222
9Robert Boulter3/27/07TumorLeft4/11/071071144/27/07314/25/07295/1/077528242.130.630293441.00
10Graham WhitehallotherRight
11Saula ArkarvellaPVDLeft
12Kubelka, EddieLeft5657Mean67.0027.222.0033.292.1434.2031.6045.7531.2523.3851.6386.04
Standard Deviation15.207.630.718.520.9024.4825.9036.6518.004.69
Median74.0027.002.0031.002.0038.2030.6031.0029.0022.00
Range39-7818-391-322-441-39.3-53.56.1-6.512-1126-5618-24
Male41
Female10
TFA11John HunterWestmead
TTA39TTA3139
Bilateral TTA3TFA2211
OTHER43
MALE4241
FEMALE1512
653230
PVD2426
DM1218
TRAUMA65
22 rightTUMOR51
30 leftOTHER112
LEFT3431
RIGHT2322
Sheet1
LCI
Sheet2
John Hunter
Westmead
Demographic
COMPARISON OF DEMOGRAPHICS
Sheet3
299
132
390.00
99
240
164
189
109
122
132
264
215
155
173
124
194
180
49
163
36
129
128
112
155
98
162.04
8Mar20062Apr2007Jan200631
Feb200628
Mar200631
Apr200630
May200631
Jun200630
Jul200631
Aug200631
Sep200630
Oct200631
Nov200631
Dec200631
Jan200731
Feb200728
Mar200731
Apr200730
May200731
Jun200730
Jul200731
Aug200731
Sep200731
Oct200731
Nov200730
Dec200731
RRD PROGRAMMEBoth sites have found that the application of RD or RRD postoperatively does impact on stump volume and interim fittingAt Westmead it was found that those who were not fitted with a RD immediately postoperatively started at a higher stump volume and took longer to stabilise in size than those who were.
RRD PROGRAMME
Chart1
39.638663105436.478260869633.317858633743.172887521540.071428571436.9699696213
37.414698118434.665217391331.915736664242.449853154338.666666666734.8834801791
36.380714275833.523809523830.666904771842.871692944137.944444444433.0171959447
35.437347836333.157894736830.878441637440.507895849435.666666666730.8254374839
33.460226445731.291666666729.123106887737.780516041433.857142857129.9337696729
33.67698556631.230769230828.784552895539.190415759834.529.8095842402
32.616025546230.4528.283974453838.895386282933.7528.6046137171
33.623234146530.545454545527.467674944437.340751572532.7528.1592484275
RD Mean + SD
RD Mean
RD Mean - SD
Soft Dressing Mean + SD
Soft Dressing Mean
Soft Dressing Mean - SD
Weeks Post Operatively
Stump Measurements End of Tibia (cm)
Comparison of Stump Measurements Post Operatively 2006/2007Rigid Dressing vs Soft Dressing
Sheet1
PatientAmputation DateRD/RRDWeek 1Week 2Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10
CarruthersYes37353132302928
Zvirgzdins3/10/06Yes36.5323431.5
Dove2/3/06Yes363633.531.530.530313131
Saunders5/25/07Yes363432.533323433
AlwanYes36.533.333.533.53028.52926.5
Cahill3/3/06Yes40.5383635.53332.5
whitely3/11/06Yes323228
Tleige1/9/06Yes35.5333332.52626262627
LopezYes37333633.53127.527.5
CraigYes37.53534
Downey3/15/07Yes383634323231313331.532.5
WhittikerYes38.5363535.533.533.532.532.532.5
FarquharsonYes3232333032
GrimaYes29.52927
Millar3/2/07Yes3332303031292828
DaviesYes33.5343432313031
Clarke10/20/06Yes4142413534.5
Moulds5/17/07Yes373434333230.5
Haszczywnyk2/27/07Yes363534
SkaliarisYes4339.535.53332.5
SkaliarisYes38383534.534353434.5
FlackYes403735.535
Spiteri9/25/07Yes343232313131.530.531.00
Roop11/12/07Yes3737
Carroll11/16/07Yes33
36.4834.6733.5233.1631.2931.2330.45
PatientAmputation DateRD/RRDWeek 1Week 2Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10
Hanna, Mark2/2/07No434240
RosikNo40.538.538
Palmer6/12/07No4342403839.539.536.5
Lanyon5/16/07No43.5424240.538394039
Baldwin12/1/06No44383436
Mantoufeh5/23/07No4037.537.5343333.532.53333
Tia TiaNo39.538373532.5333231.5
Palangas1/5/07No4041383735353230.53230.5
Smith, E2/15/07No343630
AzzopardiNo34322726.526.525.526.526
40.0738.6737.9435.6733.8634.5033.7532.75
Mean36.4834.6733.5233.1631.2931.2330.4530.55
StDev3.162.752.862.282.172.452.173.08
Mean40.0738.6737.9435.6733.8634.5033.7532.75
StDev3.103.784.934.843.924.695.154.59
12345678
RD SD high39.6437.4136.3835.4433.4633.6832.6233.62
RD Mean36.4834.6733.5233.1631.2931.2330.4530.55
RD SD low33.3231.9230.6730.8829.1228.7828.2827.47
Crepe SD high43.1742.4542.8740.5137.7839.1938.9037.34
Crepe Mean40.0738.6737.9435.6733.8634.5033.7532.75
Crepe SD high36.9734.8833.0230.8329.9329.8128.6028.16
Sheet1
0000000000000000000000
0000000000000000000000
0000000000000000000000
0000000000000000000000
0000000000000000000000
0000000000000000000000
0000000000000000000000
0000000000000000000000
0000000000000000000000
0000000000000000000000
Weeks Post Op
Stump Circumference (cm)
Post Operative Stump Measurements with RRD
Sheet2
Weeks
Stump Circumference (cm)
Post Operative Stump Measurements without RRD
Sheet3
RD Mean + SD
RD Mean
RD Mean - SD
Soft Dressing Mean + SD
Soft Dressing Mean
Soft Dressing Mean - SD
Weeks Post Operatively
Stump Measurements End of Tibia (cm)
Comparison of Stump Measurements Post Operatively 2006/2007Rigid Dressing vs Soft Dressing
RRD PROGRAMMEAt JHH those patients who had an RRD applied within 7 days were fitted with an interim prosthesis on average 9 days sooner than those who were not.Furthermore, there stump had matured to be ready for a definitive on average 3 months sooner than those who had soft dressings.
MILESTONE DATES
Chart4
52.250.44
44.652
John Hunter
Westmead
Level of Amputation
Days
Time from Amputation to Interim Fitting
Sheet1
Unilateral BK's2006/2007
NO.PatientAmp DateCause ofSideRehab AdmissionRehab AdmissionRehab D/CDischargeHospital LOSRehab LOSInterim legAMP to InterimStartDefinativeInterim toDischarge fromAgeAMP No ProK- ClassAmpProK ClassTGUAG10m walk2min WalkLCISATPRO
AmputationFIMFIMhomeafter AmputationPhysiolegDefinitivephysio
1Tleige, Khatib1/9/06DM/PVDLeft2/8/0630TFA otherside
2Dove, Peter2/3/06PVDLeft3/3/06283/1/06267/11/0613262Moved back to rural area data incomplete
3Whiteley, Ray3/11/06DMRight4/5/06253/31/062048RIP
4Cahill, Jeanine3/3/06DMLeft4/13/06414/5/06337/13/0699372523738.637.9311239.0018.0057.00
5Bernardinis, John2/8/06DMLeft3/20/06404/12/06634/3/0612/8/0624010/27/06513630.00
6Fayle, Bill2/8/06PVDLeft3/2/063/30/06505/24/061054/11/0711/29/061892/12/077530240315.2813.256345.0025.0050.00
7Shawkey, Mohamed6/16/06DMLeft6/26/061021168/15/0660507/31/064511/30/06122702223529.308.208650.0022.0053.00
8Davies, RogerTraumaLeft08/18/0637383
9Flahey, Paul8/16/06PVDRight8/25/061141209/12/0627189/27/064210/4/063/1/071557/18/077014.2312.656542.0033.0042.00
10Porter, Eric10/22/07PVDRight11/21/073011/17/072611/23/0662Moved back to rural area definitive limb made elsewear
11Hales, Margaret10/1/06PVDRight10/24/061001181/28/071199611/23/06531/31/075/11/071697127236321.0020.854045.0026.0049.00
12Clarke, Ruth10/20/06DMRight11/30/0674811/27/07995812/5/06465/17/071637813124125.3018.0030
13Hanna, Sam8/29/06PVDRight9/6/06812/15/0644Ulcer on leg nil definitive yet
14Iskander, SamDMLeft2/7/0661191
15McGrath, Daniel12/12/06DMRight1/10/07292/12/07621/29/076/21/0712941222
16Palangas, Steve1/5/07PVDLeft1/19/07911133/30/0784702/15/07416/7/071128620241313.5312.227052.0025.0050.00
17Hanna, Mark2/2/07PVDRight2/20/071201212/28/072683/14/07403/5/078/16/071553337356.0026.0049.00
18Smith, Eric2/15/07PVDLeft3/6/07803/21/0734153/14/07276/20/0798653634337.577.2511052.0022.0053.00
19Baldwin, Bill12/1/06DMRight12/15/06143/27/0711612/18/065/23/07574818130240.8031.706020.0023.0052.00
20Haszcnyzyk, Michael2/27/07PVDLeft3/13/073/22/072394/4/07364/4/07503634038.347.1011252.0019.0056.00
21John Downey3/15/07DMRight4/3/071121186/1/0778594/23/07396/4/079/20/071507419135213.8010.808749.0016.0059.00
22Michael Mantoufeh5/23/07DM/PVDLeft5/23/07701097/20/0758586/15/07237/24/0710/11/071187219131220.2015.605633.0033.0042.00
23Mark Moulds4/17/07DMLeft7/21/07956/14/07588/27/0712/13/071824922225128.0016.404532.0017.0058.00
24Michael Lanyon5/16/07DMRight5/29/071071227/13/0758456/18/07337/18/07402224338.977.5712553.0022.0053.00
25Ilma Saunders5/25/07PVDRight6/19/0783957/19/0755306/27/07337/27/0773141
26Thomas Palmer6/12/07DMRight6/28/0779917/20/0738227/9/07277/25/0710/31/07114711814039.408.7013051.0015.0060.00
27Pat Smith1/30/07PVDLeft4/19/0760765/16/07106277/26/071775/23/0766101
28Anthony Hutchinson10/4/06PVDLeft10/24/06798711/29/0656367/9/0712/6/0658343
29William Millar3/2/07PVDRight5/11/07704/2/07315/15/077/3/0710/18/077020238311.809.809531.0022.0053.00
30Boot, Maria7/10/07PVDRight9/12/07648/30/075111/15/071/15/087213118170.1076.1013.00=
31Tia Tia, Peter5/23/07DMRight7/13/0765658/31/07100498/30/07991/14/081376021232219.1012.9062.0030.0016.00
32Farquarson8/23/07DMLeft10/26/076412/3/0769732223739.888.34117
33Smith, Jeff9/26/07TraumaLeft10/29/073310/28/0732423734348.435.38160.00
34Spiteri9/25/07PVDRight10/15/079612312/13/07795910/30/07357033216.808.65100.0054.0015.0060.00
35Darnely, Kathleen8/31/07PVDRight10/18/077511311/15/07762810/26/075656
36Bowen, Lesley10/11/07DMLeft10/13/07211/20/074074
37McCormack, FionaTraumaLeft
38Whittiker, RichardPVDRight
39Balangue, MichealTraumaLeft
89104524150.44140Mean61.2023.291.8834.672.3918.7715.7082.2643.8822.0052.6087.67
40Standard Deviation14.018.510.807.090.8515.0415.9038.2011.075.705.67
Median65.0021.502.0035.502.5013.8010.8086.0049.5022.0053.00
Range37-8610-371-335-432-37.57-70.17.25-76.113-13020-5615-33
homeInterim legDefinativedaysto definative
AV = (59)AV=(85.43)Av=(151)Av=(160)Av=(79.68)
Median = (33.5)Median=(57)Median=(132)Median=(147)Median=(57.5)
Amp DateDischargeInterim legStartDefinativeDischarge from
homePhysiolegphysio
1George Congerton10/6/06PVDLeft11/1/069311212/22/067711/17/06421/9/077718125173681862451.00
2Wayne Fensom7/10/06TraumaLeft7/14/0649/9/06618/19/064239342310.728.683532154.00
3Jozo Jedinak3/20/06PVDLeft4/11/06901045/4/06454/28/06395/11/067518122112132451.00
4Aleksy Paszyn6/2/06PVDLeft7/27/068911310/22/0614210/4/0612411/6/067827230238.231.432292253.00
5Max Richards4/10/06PVDLeft4/19/06921195/24/06447/10/06916/14/067/10/067125239312.611.564422253.00
6Alex Sarkany1/12/07PVDLeft1/12/0771982/10/07292/15/07342/13/077230231253.56515222253.00
7Bernie Walsh8/24/06PVDRight9/22/069410010/17/06549/29/063610/23/07393834439.36.1112561857.00
8Noel Wasson5/4/07PVDLeft5/16/0780956/20/07476/4/07316/26/0774222
9Robert Boulter3/27/07TumorLeft4/11/071071144/27/07314/25/07295/1/077528242.130.630293441.00
10Graham WhitehallotherRight
11Saula ArkarvellaPVDLeft
12Kubelka, Eddie2/3/06PVDLeft2/27/063/8/0633Mean67.0027.222.0033.292.1434.2031.6045.7531.2523.3851.6386.04
5352.00Standard Deviation15.207.630.718.520.9024.4825.9036.6518.004.69
Median74.0027.002.0031.002.0038.2030.6031.0029.0022.00
Range39-7818-391-322-441-39.3-53.56.1-6.512-1126-5618-24
Male41
Female10
TFA11John HunterWestmeadJohn HunterWestmead
TTA39TTA52.250.44TTA3139
Bilateral TTA3TFA44.652TFA2211
OTHER43
MALE4241
FEMALE1512
653230
PVD2426
DM1218
TRAUMA65
22 rightTUMOR51
30 leftOTHER112
LEFT3431
RIGHT2322
Sheet1
39
45
50
42
45
30
52
56
52
20
52
49
33
32
53
51
31
13
30
LCI
Sheet2
John Hunter
Westmead
Demographic
COMPARISON OF DEMOGRAPHICS
Sheet3
John Hunter
Westmead
Level of Amputation
Days
Time from Amputation to Interim Fitting
299
132
390.00
99
240
164
189
109
122
132
264
215
155
173
124
194
180
49
163
36
129
128
112
155
98
162.04
8Mar20062Apr2007Jan200631
Feb200628
Mar200631
Apr200630
May200631
Jun200630
Jul200631
Aug200631
Sep200630
Oct200631
Nov200631
Dec200631
Jan200731
Feb200728
Mar200731
Apr200730
May200731
Jun200730
Jul200731
Aug200731
Sep200731
Oct200731
Nov200730
Dec200731
EARLY PROSTHETIC FITTINGAt both Westmead and JHH it has been evident that fitting of mechanical interim prosthesis made by a prosthetist has allowed earlier fitting for some patientsAt Westmead 2004/2005 mean time from amputation to fitting of plaster temporary = 86 days compared to 51 days for interim legs in 2006/2007. 37 days difference. At JHH some patients with significant wounds were fitted with a interim prosthesis.
EARLY PROSTHETIC FITTING
MILESTONE DATES
MILESTONE DATES
Slightly shorter rehabilitation LOS at Westmead hospital. Large difference between sites regarding admission and discharge motor FIM scores.Large difference between FIM scores due to patient population or ? different calculation of motor component of FIM between sites.Improved % change in motor FIM score for JHH compared to 2 years prior to interim programme.
MEAN FUNCTIONAL OUTCOME MEASURES AT DEFINITIVE
COMPARISON OF FUNCTIONAL OUTCOME MEASURESSignificant difference between mean TGUAG, 10m walk and 2min walk between sites. Nil difference on the LCI between sites, despite differences in above measures.SATPRO slightly higher at Westmead.? reason for the difference in outcome between sites:Patient populationRehabilitation process Requires more detailed statistical analysis.
EXPERIENCE WITH OUTCOME MEASURES
Numerous outcome measures were used in this pilot trial
The therapists felt that some were easier to administer and gave more relevant and useful information than others.
EXPERIENCE WITH OUTCOME MEASURES: AMPnoPRO/AMPPROThe AMPnoPro and AMPPRO were relatively easy to administer, however its predictive capacity was questioned by both sitesAt JHH it was found that 39% of the time the predicted K classification by the AMPnoPRO did not match the clinicians prediction.The AMPPRO did not match the observed K classification 29% of the time. At Westmead an identical result was found with 39% of the time, the AMPnoPro failed to predict the final K classificationDiscrepancy may be due to the fact the co-morbidity score should have been factored in, however it was not clear how this should be done.
RECOMMENDATIONS FOR USE OF OUTCOME MEASURESThe LCI, SATPRO and TGUAG were quick and easy for the therapist to administer and gave a fair indication of the patients functional ability.It is therefore recommended that these should be used as standard measurements at clinics to assess change of function when prescribing new prostheses. The 2min or 6min walk takes longer to administer but is a useful indicator of endurance and ability to community ambulate.
SUMMARYFurther analysis of data to determine causes/reasons for differences in outcome measures between the two sitesUse the extensive data collected to develop more specific research projects in the future.Recommendations regarding implementation at other sites.
QUESTIONS/COMMENTS