DOI: 10.3886/icpsr39571
title: Better Rehabilitation Through Better Characterization of Treatments: Development of the Manual for Rehabilitation Treatment Specification [Methods Study], United States, 2014-2018
title: Archival Version

description: Many people have health problems that affect how well they can do normal activities, either for a short time or for their lifetime. These problems may be present from birth or result from illness, injury, or aging. Rehabilitation, or rehab, can help patients regain the ability to do normal activities. Rehab providers include doctors, nurses, psychologists, and physical, occupational, speech, or language therapists.
Rehab treatments often lack a common definition. Rehab providers often name treatments by the type of professional who delivers them or the problem they treat, rather than by the content of the treatment. Also, treatments can vary across rehab providers. Using a standard way to define rehab treatments may help researchers compare these treatments.
In this study, the research team created and tested a manual to help rehab providers use standard ways to define rehab treatments.
description: "To incorporate the conceptual framework of the rehabilitation treatment taxonomy (RTT) into standardized operational procedures so that clinicians, educators, and researchers across all rehabilitation disciplines could define and specify rehabilitation treatments according to their immediate effects, mechanisms of action, and hypothesized active ingredients.
description: In this study, researchers used a formative qualitative design to develop and test a manual describing how to specify rehabilitation treatments based on their ingredients. Researchers used treatment theory, which outlines three elements:

Targets, which are specific, measurable aspects of patient function
Ingredients, which include clinician actions, behaviors, and verbalizations; medications; and procedures
Mechanism of action, which is how the treatment works. Because mechanisms of action were not typically visible, the manual focused on identifying specific ingredients and dosing parameters needed to achieve a measurable change in patient function.

Researchers held focus groups with physical therapists, occupational therapists, speech-language pathologists, rehabilitation nurses, and rehabilitation psychologists. Using input from the focus groups, researchers developed clinical vignettes for testing treatment specification rules. Two research team members independently specified targets and ingredients for every vignette. Comparing these specifications allowed researchers to identify ambiguities in the rules that needed clarification. After coming to consensus on specification rules, the researchers developed the draft manual and a training curriculum.
Researchers held training sessions on how to use the manual with 40 clinicians from around the country who worked in different types of rehabilitation settings and with different patient populations. These clinicians then tried to specify three treatments each. They then provided feedback to the researchers on both the specification process and on use of the manual.
An advisory board made up of clinicians, educators, professional association representatives, researchers, journal publishers, and patients provided guidance throughout the study.
description: Datasets: 
DS1: Better Rehabilitation Through Better Characterization of Treatments: Development of the Manual for Rehabilitation Treatment Specification [Methods Study], United States, 2014-2018
description: Rehabilitation professionals based in United States.