Evidence-Based Occupational Therapy and Basic Elements for Conducting Assessments

Abstract

This chapter reports about evidence-based interventions and the underpinning methodology for evaluating the effectiveness of occupational therapy interventions (OTIs). The content and the steps that compose evidence-based OTIs are described as well as the various methods for conducting quality assurance. Assessment instruments represent the prerequisites for conducting evaluations of intervention effectiveness. Therefore, their possible aims, psychometric functions, the process of collecting data, and interpreting the results are reported in broad terms. An overview of the various available methods, e.g., the Goal Attainment Scale for evaluating a single client’s progress when participating in therapeutic sessions, is presented. Statements for evaluation of OTIs and recommendations for future advances are suggested.

Appendix 1

A checklist of clinical decisions to make in choosing an assessment instrument
1	The assessment instrument entitled:
	Version?
2	The source of the assessment instrument:
	Author(s)?
	Reference(s)?
3	References with:
	(a) Clinical applications?
	(b) Evidence of the psychometric functions of the assessment instrument?
4	Theory or model that constitutes the base of the assessment instrument?
5	Is a manual, a computer program, recording forms, and other equipment for administration of the assessment instrument available?
6	How is the assessment instrument administered? How are the data collected? How are results given to the client?
7	What is the focus of the assessment instrument? (global, diagnosis-specific, etc.)
8	For what is the assessment instrument intended? (diseases, diagnoses, disability, impairment, age, language)
9	What is the aim of the assessment instrument? (describe, predict, evaluate)
10	Describe the construction of the assessment instrument? (e.g., number and titles of items and factors).
11	What measurement scale is used? (nominal, ordinal, interval, quote)
12	What type of scale is used for the assessment?
13	What is known about the reliability of the assessment instrument? (internal consistency, observer-/test–retest reliability)
14	How sensitive is the assessment instrument (suitable for application to describe, evaluate, predict)?
15	How appropriate (sensitive) is the assessment instrument for performing repeated measures?
16	What reliability coefficients are known that correspond to a group of people with the same prerequisites as the client who would take the assessment?
17	What standard deviation is known according to the group of people with the same prerequisites as the client who would take the assessment?
18	What is known about the validity of the assessment instrument? (content, concurrent, criterion)
19	With what method are the results calculated?
20	Is there enough psychometric information for calculating the results and is the specific formula for calculating the results stated?
21	Are guidelines for interpretation of the clients’ performance available?
22	Are cut-off scores, criteria, or other limits for the clients’ performance stated that make the result interpretable for making clinical decisions or evaluating intervention results?
23	What is known about the cost-benefit of the assessment instrument?
24	Does the administrator (therapist) need specific knowledge?
25	What are the positive and negative experiences of using the assessment instrument (preferably based on scientific publications) for similar situations as for the actual client?