Through its lower-limb Consensus Outcome Measures for Prosthetic and Amputation Services (COMPASS), the International Society of Prosthetics and Orthotics (ISPO) produced a recommended list of outcome measures to be actively promoted for routine use within clinical practice before and after an episode of care.
ISPO noted that a lack of routine use of outcome measures can lead to clinicians not using the most appropriate measures in clinical decisions, limiting quality improvement, and difficulty in making fully informed policy-level decisions.
To establish the consensus, 46 participants, including clinicians, researchers, managers, policymakers, and prosthetic users met virtually in May and June 2021. A three-step process was implemented: a systematic review to identify outcome measures used with individuals with lower-limb amputations and to identify their psychometric properties; implementation of an expert panel to evaluate the psychometric properties of the outcome measures and determine whether the psychometric properties were of sufficient standard to allow the outcome measures to be recommended for widespread use; and a modified Delphi and consensus process consisting of a pre-consensus survey, followed by a consensus conference.
The ISPO lower-limb COMPASS resulted in the following six recommendations:
- Amputee Mobility Predictor; Timed Up and Go; Two-Minute Walk Test; Prosthetic Evaluation Questionnaire-Residual Limb Health; Prosthetic Evaluation Questionnaire-Utility; and Trinity Amputation and Prosthesis Experience Scales-Revised make up the ISPO lower-limb COMPASS
- The Comprehensive High-Level Activity Mobility Predictor and Six-Minute Walk Test, additional outcome measures recommended for people at a higher activity level, make up the COMPASS+
- The Patient-Specific Function Scale makes up the COMPASS Adjunct
- A generic health-related quality of life outcome measure such as the European Quality of Life-5D-5L or Patient-Reported Outcomes Measurement Information System-29 item can be used to supplement the COMPASS
- Outcome measures suited to low- and middle-income countries need to be developed with a focus on activities such as sitting cross-legged, kneeling, squatting, and other culturally important mobility-related activities
- Translation, validation, and open sharing of translated outcome measures included in the COMPASS, COMPASS+, and COMPASS Adjunct needs to occur
The open-access study, “Recommendations from the ISPO lower-limb COMPASS: Patient-reported and performance-based outcome measures,” was published in Prosthetics and Orthotics International.
