Quantitative Functional Capacity Evaluation: QFCE DVD

by Steve Yeomans, DC, D.A.B.C.O.


Interest in outcomes assessment (OA) and functional testing is growing because physicians, insurance companies, medico-legal reviewers and managed care organizations are demanding a way to objectify patient status and document patient progress during the course of treatment. The QFCE represents an objective method used to measure a change in a patient's current or future health status that can be attributed to antecedent health care. This instrument is also capable of measuring treatment effectiveness regardless of methods utilized.

The primary objective of the QFCE is in the assessment of the functional status of a patient. That is, the strength, flexibility, lifting, cardiovascular, and motor control issues. The QFCE embraces both the SUBJECTIVE (patient driven) outcome assessment instruments such as the SF-36, the Owestry Low Back Pain Questionnaire, the VAS and others, but also introduces for the first time, an OBJECTIVE (doctor/therapist driven) outcomes assessment instrument where the functional status of a patient is reliably measured.

Based on literature reviews, there are five issues which must be addressed in selection and use of any functional test in a patient population. These issues, presented in hierarchical order, are:

1. Safety - Given the known characteristics of the patient, the procedures should not be expected to lead to injury. 2. Reliability - The test score should be dependable across the evaluators, patients, and the date or time of administration. 3. Validity - The interpretation of the test score should be able to predict or reflect the patient's performance in a target work setting. 4. Practicality - The cost of the test procedure should be reasonable and customary. Cost is measured in terms of direct expense of the test procedure plus the amount of time required of the patient, plus the delay in providing the information derived from the procedure to the referral source. 5. Utility - The usefulness of the procedure is the degree to which it meets the needs of the patient, referrer and payer.

The QFCE meets these criteria by offering a cost effective, time efficient (35 minute exam) OA tool by measuring the functional status of a patient which can be compared to repeated, serial trials thus documenting change over time, and/or to normative data if only assessed at one particular time. Therefore, the QFCE offers a "low-tech" (low cost) answer for the doctor/therapist who does not have access to "high-tech" (high-cost) equipment.