Patient-based outcome measures in acupuncture clinical research: How do we choose?

Outcome assessment can support the therapeutic process by providing a way to track symptoms and functionality over time, providing insights to clinicians and patients, as well as offering a common language to discuss patient behavior/functioning. The integration of such measures not only informs therapy, but can also inform programmatic decisions as well as further the field of acupuncture health care research. Outcome measures therefore are both a research tool and an aid to patient care. In this paper we examine the measures that have been used to measure outcomes in acupuncture clinical research and suggest those measures that are feasible, practical, economical, reliable, valid and responsive to clinical change. This study's objectives were to: (1) identify patient-based outcomes assessments (PBOA) used in published acupuncture studies, (2) describe a framework for identifying appropriate sets of measures, and (3) address the challenges associated with these measures relevant to acupuncture. METHODS: This study was a literature review to identify and evaluate the most commonly used to outcome measures in acupuncture research. Instruments were evaluated in terms of feasibility, practicality, economy, reliability, validity and responsiveness to clinical change. A total of 629 abstracts were reviewed using PubMed (from inception to June 2008). RESULTS: A total of 1,147 citations were identified. Of these, 582 were selected as relevant. The most common PBOA instruments identified were pain scales/questionnaires such as the VAS, NRS, Sf-36 and WOMAC.