Responsiveness to Change of Functional Limitation Reporting: Cross-sectional Study Using the Intermountain ROMS Scale in Outpatient Rehabilitation

Physical Therapy
Gerard P BrennanKate I Minick

Abstract

The Centers for Medicare and Medicaid Services (CMS) require physical therapists document patients' functional limitations. The process is not standardized. 
A systematic approach to determine a patient's functional limitations and responsiveness to change is needed. The purpose of this study is to compare patient-reported outcomes (PROs) responsiveness to change using 7-level severity/complexity modifier scale proposed by Medicare to a derived scale implemented by Intermountain Healthcare's Rehabilitation Outcomes Management System (ROMS). This was a retrospective, observational cohort design. 165,183 PROs prior to July 1, 2013, were compared to 46,334 records from July 1, 2013, to December 31, 2015. Histograms and ribbon plots illustrate distribution and change of patients' scores. ROMS raw score ranges were calculated and compared to CMS' severity/complexity levels based on score percentage. Distribution of the population was compared based on the 2 methods. Sensitivity and specificity were compared for responsiveness to change based on minimal clinically important difference (MCID). Histograms demonstrated few patient scores placed in CMS scale levels at the extremes, whereas the majority of scores placed in 2 middle levels...Continue Reading

References

May 15, 1998·The Journal of Orthopaedic and Sports Physical Therapy·M D WestawayJ M Binkley
Sep 27, 2005·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Jeffrey K Aronson, Robin E Ferner
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Jun 13, 2009·The Journal of Orthopaedic and Sports Physical Therapy·Joy C MacDermidCharlie H Goldsmith
Mar 10, 2012·The Journal of Orthopaedic and Sports Physical Therapy·Valerie J WilliamsG Kelley Fitzgerald
Mar 14, 2013·The Journal of Hand Surgery·Amelia A SorensenRyan P Calfee

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