Outcome related to impact on daily living: preliminary validation of the ORIDL instrument.
BACKGROUND
The challenge of finding practical, patient-rated outcome measures is a key issue in the evaluation of health care systems and interventions. The ORIDL (Outcome in Relation to Impact on Daily Living) instrument (formerly referred to as the Glasgow Homoeopathic Hospital Outcomes Scale or GHHOS) has been developed to measure patient's views of the outcome of their care by asking about change, and relating this to impact on daily life. The aim of the present paper is to describe the background and potential uses of the ORIDL, and to report on its preliminary validation in a series of three studies in secondary and primary care.


METHODS
In the first study, 105 patients attending the Glasgow Homoeopathic Hospital (GHH) were followed-up at 12 months and changes in health status were measured by the EuroQol (EQOL) and the ORIDL. In the second study, 187 new patients at the GHH were followed-up at 3, 12, and 33 months, using the ORIDL, the Short Form 12 (SF-12), and the Measure Yourself Medical Outcome Profile (MYMOP). In study three, 323 patients in primary care were followed for 1 month post-consultation using the ORIDL and MYMOP. In all 3 studies the Patient Enablement Instrument (PEI) was also used as an outcome measure.


RESULTS
Study 1 showed substantial improvements in main complaint and well-being over 12 months using the ORIDL, with two-thirds of patients reporting improvements in daily living. These improvements were not significantly correlated with changes in serial measures of the EQOL between baseline and 12 months, but were correlated with the EQOL transitions measure. Study 2 showed step-wise improvements in ORIDL scores between 3 and 33 months, which were only weakly associated with similar changes in SF-12 scores. However, MYMOP change scores correlated well with ORIDL scores at all time points. Study 3 showed similar high correlations between ORIDL scores and MYMOP scores. In all 3 studies, ORIDL scores were also significantly correlated with PEI-outcome scores.


CONCLUSIONS
There is significant agreement between patient outcomes assessed by the ORIDL and the EQOL transition scale, the MYMOP, and the PEI-outcome instrument, suggesting that the ORIDL may be a valid and sensitive tool for measuring change in relation to impact on life.
Reilly
David
D
AdHom Academic Department, Centre for Integrative Care, Glasgow Homoeopathic Hospital, 1053 Great Western Road, Glasgow G12 OXQ, Scotland, UK. davidreilly1@compuserve.com
Mercer
Stewart W
SW
Bikker
Annemieke P
AP
Harrison
Tansy
T
D000203:Activities of Daily Living; D005500:Follow-Up Studies; D006705:Homeopathy / Q000592:standards; D006782:Hospitals, Special / Q000592:standards; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011594:Psychometrics / Q000295:instrumentation*; D012017:Referral and Consultation; D012606:Scotland; D012647:Self-Assessment; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires