title: Health outcome after major trauma: what are we measuring?
abstract: OBJECTIVE
  Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.
  
  
  OBJECTIVE
  To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.
  
  
  METHODS
  MEDLINE, EMBASE, and CINAHL (from 2006-2012) were searched for studies evaluating health outcome after traumatic injuries.
  
  
  METHODS
  Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts.
  
  
  RESULTS
  34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%).
  
  
  CONCLUSIONS
  Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.
authors: Centre for Trauma Sciences, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
authors: Karen
authors: K
authors: Hoffman
authors: Centre for Trauma Sciences, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
authors: Elaine
authors: E
authors: Cole
authors: University College London (UCL) institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
authors: E Diane
authors: ED
authors: Playford
authors: Ludwig-Maximilians-Universität Munich, Institute for Medical Informatics, Biometry and Epidemiology (IBE), Munich, Germany.
authors: Eva
authors: E
authors: Grill
authors: Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.
authors: Helene L
authors: HL
authors: Soberg
authors: Centre for Trauma Sciences, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
authors: Karim
authors: K
authors: Brohi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D004185:Disability Evaluation; D006233:Persons with Disabilities; D006304:Health Status; D006801:Humans; D009104:Multiple Trauma / Q000175:diagnosis*; D017063:Outcome Assessment, Health Care / Q000379:methods*