%0 Journal Article
%T TEFTOM: A Promising General Trauma Expectation/Outcome Measure〞Results of a Validation Study on Pan-American Ankle and Distal Tibia Trauma Patients
%A Michael Suk
%A Monica Daigl
%A Richard E. Buckley
%A Cleber A. J. Paccola
%A Dean G. Lorich
%A David L. Helfet
%A Beate Hanson
%J ISRN Orthopedics
%D 2013
%R 10.1155/2013/801784
%X Background. In orthopedics, there is no instrument specifically designed to assess patients＊ expectations of their final surgery outcome in general trauma populations. We developed the Trauma Expectation Factor Trauma Outcome Measure (TEFTOM) to investigate the fulfilment of patients＊ expectations one year after surgery as a measure of general trauma surgical outcomes. The aim of this paper was to assess the psychometric characteristics of this new general trauma outcome measure. Methods. The questionnaire was tested in 201 ankle and distal tibia fracture patients scheduled for surgery. Patients were followed up for twelve months. The TEFTOM questionnaire was evaluated for its criterion validity, internal consistency, reproducibility, and responsiveness. Results. TOM showed good criterion validity against the American Academy of Orthopaedic Surgeons Foot and Ankle Scale (Pearson＊s correlation coefficient = 0.69每0.77). Internal consistency was acceptable for TEF (Cronbach＊s alpha = 0.65每0.76) and excellent for TOM (Cronbach＊s alpha = 0.76每0.85). Reproducibility was moderate to very good (intraclass coefficient correlation (ICC) ) for TEF and very good (ICC ) for TOM. TOM also proved to be responsive to changes in patients＊ condition over time (Wald test; ). Conclusions. TEFTOM is a promising tool for measuring general trauma outcomes in terms of patients＊ expectation fulfilment that proved to be valid, internally consistent, reproducible, and responsive to change. 1. Background Ministries of health and healthcare providers from various countries are shifting their focus from clinical processes to outcomes, that is, concentrating on the quality rather than quantity of healthcare [1每3]. How much hospitals get paid for a procedure may soon depend in part on such measurements of outcome [4]. Furthermore, patient-reported outcomes in addition to clinical quality indicators [5] are becoming more popular [6每8]. It is therefore essential to have valid and reliable outcome measures tailored to each field of application. Generic measures have been proposed for chronic disease or injury [9, 10] to assess provider performance in improving the patient＊s condition. However, these measures are inappropriate for evaluating trauma outcomes, as no reliable baseline function measurements are available for trauma patients. While a baseline measurement of condition is neither possible nor helpful, a baseline expectation measurement of condition is achievable. Discovering this information may be the key to a new outcome paradigm that considers patients＊ expectations in light
%U http://www.hindawi.com/journals/isrn.orthopedics/2013/801784/