15 Patient-Reported Outcome Measures for Medical SLPs

Jul 19

Written By Katie Brown, MA, CCC-SLP, CBIS

What do you get when you mix assessment and person-centered care? Patient-reported outcome measures (PROMs)! PROMs must become an integral part of all speech therapy evaluations because they are an integral part of evidence-based practice. They provide a standardized way to take the patient’s perspective into account and an easy way to measure a change in personal factors over time.

I give at least one PROM in every. single. one. of my assessments because they provide such valuable information that may be missed. Oftentimes I even make goals about improving PROM scores, because that means there’s a direct improvement in confidence or ability. Here are some of my most-used PROMs in my clinical practice.

Cognitive Patient-Reported Outcome Measures

Mental Fatigue Scale

The Mental Fatigue Scale (MFS) is a 15 question reporting scale that is ideal for patients experiencing cognitive fatigue or “brain fog.” I especially like this one because it has a question about variations from day-to-day, which is a common symptom of cognitive fatigue.

Working Memory Questionnaire

The Working Memory Questionnaire is a 30 question inventory of various working memory tasks. It is divided up into 3 domains (short-term storage, executive function, and attention) and provides a score for each as well as an overall total. I like this one as it is quite thorough.

Everyday Memory Questionnaire-Revised

The Everday Memory Questionnaire-Revised (EMQ-R) includes 13 questions to determine how frequently everyday memory tasks may occur in your patient’s daily life. It’s a quick, easy way to determine which memory tasks are causing the greatest negative impact as reported by the patient.

Multifactoral Memory Questionnaire

The Multifactoral Memory Questionnaire (MMQ) is actually three PROMs in one! The forms include “How I Feel About My Memory,” “Memory Mistakes,” and “Use of Memory Strategies.” I particularly like the focus on strategy use as it can show insight into what your patient may be currently doing to compensate for their memory impairment. These are free to use and can be accessed by the publisher, Baycrest, here.

Job Performance Measure

The Job Performance Measure was developed by OTs from Washington University in St. Louis. This PROM is a must-complete for those patients looking to return to work. It uses a job description database to help create a baseline of job responsibilities then requires the patient to answer how frequently they perform that task and how well they can perform it. You can access the measure here.

Aphasia Patient-Reported Outcome Measures

Aphasia Impact Questionnaire

The Aphasia Impact Questionnaire (AIQ-21) is one of my favorite PROMs to use. There are so many positives to this measure including that it is aphasia-friendly with supports like pictures and bolded keywords, and it has many racial and gender representations! You can access this measure for free here.

Communication Confidence Rating Scale for Aphasia

The Communication Confidence Rating Scale for Aphasia (CCRSA) is a PROM that I think I give to every single one of my aphasia patients. In just 10 questions it helps patients convey just how much their communication impairment has affected their personal lives and ability to participate in social situations. This measure is a great one to use for person-centered goal setting as well.

Communication Outcome After Stroke Scale

The Communication Outcome After Stroke (COAST) Scale is validated as a tool for both patients and caregivers. It uses aphasia-friendly rating scales to assess quality of life and communication skills after stroke.

Communicative Participation Item Bank

The Communicative Participation Item Bank (CPIB) is a 10-question PROM dedicated to measuring the impact of communicative participation. Its general language allows it to be used with several different communication disorders including aphasia, dysarthria, and voice disorders. Access the measure here.

Social Activities Checklist

The Social Activities Checklist (SOCACT) is a checklist that aims to measure the range and frequency of various social activities. It includes how often you complete social activities and with whom to assist with collaborative and functional goal setting.

Communication Activities Checklist

The Communication Activities Checklist (COMACT) is a checklist that measures the frequency and the types of communicative activities engaged in by individuals with aphasia. It includes common communication activities across the four domains of language (speaking, listening, reading, and writing) to assist with collaborative and functional goal setting.

Dysphagia Patient-Reported Outcome Measures

Eating Assessment Tool

The Eating Assessment Tool (EAT-10) is a 10 question PROM that helps to measure swallowing difficulties as perceived by the patient. Questions vary from ability to go out to eat to meals to effort it takes to swallow solids and liquids. Overall, it is a quick and easy assessment tool that can be included in your clinical bedside swallowing evaluation. You can access the measure here.

PILL-5

The PILL-5 is the first validated tool to measure pill dysphagia. It is a simple, 5-item questionnaire that can be administered in just a few minutes and may be used to offer insight into if alternative forms of medication may be helpful for your patient.

Reflux Symptom Index

The Reflux Symptom Index (RSI) is a 9-question PROM used to assess the effects of reflux on voice and swallowing abilities. It can help identify the likelihood of reflux and assist with appropriate referrals to ENT/GI. Access the measure here.

The Syndey Swallow Questionnaire

The Sydney Swallow Questionnaire (SSQ) is a 17 question, self-report inventory, which was developed to measure symptomatic severity of oral-pharyngeal dysphagia as reported by the patient. The questionnaire uses a 100mm visual analogue scale (VAS) and can be used to assess improvement over time. Access the measure here.

Did you notice there were a few links missing? That’s because I couldn’t find them. Don’t worry though, I compiled them in one document that you can download for your clinical practice!

References:

Aujla, S., Botting, N., Worrall, L., Hickson L., & Cruice, M. (2016). Preliminary psychometric analyses of two assessment measures quantifying communicative and social activities: the COMACT and SOCACT, Aphasiology, 30:8, 898-921.

Babbitt, E. M., Heinemann, A. W., Semik, P., & Cherney, L. R. (2011). Psychometric properties of the Communication Confidence Rating Scale for Aphasia (CCRSA): Phase 2. Aphasiology, 25(6-7), 727–735.

Baylor, C., Yorkston, K., Eadie, T., Kim, J., Chung, H., & Amtmann, D. (2013). The Communicative Participation Item Bank (CPIB): item bank calibration and development of a disorder-generic short form. Journal of speech, language, and hearing research: JSLHR, 56(4), 1190–1208.

Belafsky, P.C., Mouadeb, D.A., Rees, C.J., Pryor, J.C., Postma, G.N., Allen J., & Leonard R.J. (2008). Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 117: 919-924.

Belafsky, P. C., Postma, G. N., & Koufman, J. A. (2002). Validity and reliability of the reflux symptom index (RSI). J Voice, 16(2), 274-277.

Johansson, B., Starmark A., Berglund P., Rödholm M., & Rönnbäck L. (2010) A self-assessment questionnaire for mental fatigue and related symptoms after neurological disorders and injuries, Brain Injury, 24:1, 2-12.

Long, A., Hesketh, A., Bowen, A., & ACT NoW Research Study (2009). Communication outcome after stroke: a new measure of the carer's perspective. Clinical rehabilitation, 23(9), 846–856.

Nativ-Zeltzer, N., Bayoumi, A., Mandin, V. P., Kaufman, M., Seeni, I., Kuhn, M. A., & Belafsky, P. C. (2019). Validation of the PILL-5: A 5-Item Patient Reported Outcome Measure for Pill Dysphagia. Frontiers in Surgery, 6.

Vallat-Azouvi, C., Pradat-Diehl, P., & Azouvi, P. (2012). The Working Memory Questionnaire: A scale to assess everyday life problems related to deficits of working memory in brain injured patients. Neuropsychological Rehabilitation, 22(4), 634–649.

Wallace, K. L., Middleton, S., & Cook, I. J. (2000). Development and validation of a self-report symptom inventory to assess the severity of oral-pharyngeal dysphagia. Gastroenterology, 118(4), 678–687.

ABOUT THE AUTHOR

Katie Brown, MA, CCC-SLP,CBIS

Katie is the owner and founder of Neuro Speech Solutions. She is passionate about providing person-centered treatment to her clients in order to meet their life participation goals. Katie is dedicated to helping other SLPs provide functional therapy through affordable materials and education courses.

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