Quality Reporting: Trials Lack Citations of Indices and Scales to Assess Disability
amy hoang-kim
toronto, Canada 
15 slide(s) – 00:06:30 – English – 2010-06-20
to understand the importance of using disability scales in current research and how citing the correct indices can increase our confidence in the reporting of outcomes
Title: Quality Reporting: Trials lack Citations of Indices and Scales to Assess Disability
Summary/Conclusion:
The lack of standardized instruments to assess function can be attributed not only to an evidence gap in validation studies but also to poor citations of indices and scales.
Introduction: Today, numerous functional outcome tools exist to assess the patient\'s ability to carry out basic and instrumental activities of daily living. Furthermore, the increase in range of mobility measures reflect differences in rating scales, scores, administration and scoring options which make outcome results difficult to assess across trials. Because of the lack of consensus among investigators, we wanted to identify the citation patterns of the functional outcomes tools used by investigators in hip fracture RCTs. We believed that the lack of proper citation is an underlying factor in the diverse usage of outcome tools.
Methods: We extracted the citations of disability tools from 59 Level 1 hip fracture RCTs. Disability was defined using the WHO classification (ICF). We excluded measures assessing body structure. The text and reference lists of the identified articles were screened in order to compile relevant literature on the instrument used in the RCT. Disability tools which were cited in the references were also compared to original development articles.
Results: Overall 68 different instruments were identified that measured disability in the hip fracture literature. According to ICF, 47 tools measured body function alone, 13 tools evaluated activity limitations and participation restriction and 8 were composite scoring systems. We found that 34.2% of the trials did not provide any citations to the tools assessing body function. In trials measuring activity and participation, 23.2% provided instrument citations. In trials using composite scoring systems, 19.4% of the trials provided instrument citations. All of the instrument citations when provided by the investigators were found to correspond to original development articles or trials.
Discussion and Conclusion: The appropriate choice of a functional outcome instrument is fundamental in order to ensure that the results that are obtained reflect the patient. However, if citations of the indices and scales themselves are lacking, trial methodology and results could be informative but not replicated. In the future, we recommend that rigor in quality reporting include proper instrument citations.
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