A global measure of patient-reported outcomes after injury – life back on track

Abstract

Purpose

Assess the psychometric properties of the Life Back on Track (LBoT) measure, a novel self-reported single-item global measure of the trajectory of wellbeing after a transport accident.

Materials and methods

Evaluated the validity, reliability, sensitivity, and responsiveness using four survey waves (n = 1556 in wave 1), and two repeated cross-sectional surveys (n = 5238) and (n = 1964), of individuals injured in a transport accident in Victoria.

Results

There were statistically significant differences in the distribution of the LBoT scores by the respondent depression or pain scores, return to work status, financial ability to get by, ability to cope, and ability to bounce back (all p < 0.001). The LBoT measure was a statistically significant (p < 0.001) and reasonable predictor of future work status, and was moderately correlated (>0.67) with the EQ-5D-3L (concurrent validity). Retest reliability (ICC ≥0.76) and sensitivity (effect sizes >1.52) were supported, and it was moderately responsive to change (standard response mean statistics 0.4–0.8).

Conclusions

LBoT is a valid measure to track the individual’s trajectory of subjective wellbeing in the context of recovery after a trauma, and is potentially useful as an indicator to track the performance of commissioned providers, and to monitor or evaluate the value of service outcomes.

Implications for Rehabilitation

• There is a demand to develop a simple metric to measure the impact of injury, the effectiveness of rehabilitation and the degree of recovery from trauma.

• Life Back on Track (LBoT) is a valid single-item measure to track an individual’s trajectory of subjective wellbeing after trauma.

• It has the potential to complement clinical measures where a routine collection of a simple measure is desirable.

• It is suitable as an indicator of service outcomes for organisations that commission services.

Keywords:

• Subjective wellbeing
• patient-reported outcome
• quality of life
• injury
• transport accident

Ethical approval

Ethics approval was granted by the Monash University Human Research Ethics Committee, Monash University, Australia (Reference no. 18278). The study adhered to the principles outlined in the Declaration of Helsinki.

Disclosure statement

Nina Ellis and Cassie Citroen are employed by the Transport Accident Commission. All other authors have no competing interests.

GC designed the quantitative analysis and contributed to writing the manuscript. MW performed the quantitative analysis and contributed to writing the manuscript. KLS reviewed the literature and contributed to the writing of the manuscript. NE and CS were responsible for the data collection and initial instrument development with clients. AH analysed the qualitative data and contributed to the writing of the manuscript. All authors read and approved the final manuscript.

Data availability statement

Survey data used in the study contain confidential information and not released publicly

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Funding

The study is funded by the TAC Research Project (T019). We are grateful to the survey participants from the TAC Longitudinal Study, the Client Outcomes Survey (COS), and the Client Experience Survey (CES).