Outcome & Utilization Report Overview

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The Modus Trex™ Veteran Outcome Monitoring and Utilization reports incorporate seventeen important metrics, including those required by the VA, under the new contract template for prosthetics services. The following provides an explanation of key metrics in The Veteran Outcome Report.

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1. The Report tab displays the metric results for the days included in the analysis.

2. The Recording Summary Tab displays the StepWatch™ settings and graphically displays the number of steps per minute for each day.  This is useful for reviewing walking patterns and determining if any day was invalid (e.g. StepWatch™ not worn or worn upside down).  Invalid days can be excluded from analysis in the Edit Time tab.

3. The Edit Time Tab graphically displays the number of steps in each minute throughout the day.  You can double click on any day(s) to exclude it from the analysis.

4. Clinical Observation reflects your clinician’s opinion of your walking function.  This is based on clinical evaluation and your self-report.  You should select the level suggested by your clinician.  If you are unsure, select the level you think best reflects your typical walking function.  A level must be selected for metric results to populate this report.

5. Days to Include allows you to quickly select clusters of days for the metric calculations.  By selecting a cluster of first recorded days and then a cluster of last days allows a longitudinal comparison for tracking change in walking function.

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 Modus Index is your overall walking function.  Its value is on a 0 to 100 scale.  It is an average of your clinical observation score, ambulation energy index, Peak Performance Index™, and cadence variability index.

7. This area graphically displays the Modus Index score relative to the 50th percentile of healthy persons with unimpaired gait in the same decade of life.  Note: the normative data values excluded the clinical observation component.

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8. The Ambulation Energy Index makes up 1/4th of the overall functional level score.  Its algorithm incorporates ambulation energy requirements and intensity of continuous walking bouts.  It is displayed using the Modus Index scale.

9. The Peak Performance Index™ makes up 1/4th of the overall functional level score.  Its algorithm incorporates the fastest 1-minute walking spurts. It is displayed using the Modus Index scale.

10. The Cadence Variability Index makes up 1/4th of the overall functional level score. Its algorithm incorporates the proportion of walking at low (1 – 15 steps per minute), medium, (16 – 40 steps per minute) and high (41 or greater steps per minute) cadence values.  It is displayed using the Modus Index scale.
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 Daily Steps is the average steps per day taken on the prosthetic limb with the StepWatch™.  If you have a unilateral lower limb amputation, you can double this number to get an estimate of steps on both legs.  If you have bilateral lower limb amputations, you must add the steps from the StepWatch™ on your left and right prosthesis for an estimate of steps taken with both legs.

12. The Date Range shows the days included in the calculations on this report.  If a discontinuous range is select (e.g. 07/24/13 – 07/27/13 and 07/29/13 – 07/30/13), it will say “Custom date selection from Edit Time”.

13. Cadence is the average steps per minute when walking. Walking is defined as greater than or equal to 1 step per minute.  Very low cadence rates indicate slow walking and/or walking that does not often continue for a full minute. An increase in Cadence indicates you are walking at faster speeds and/or walking longer in continuous bouts.

14. Cadence Variability is the average daily standard deviation of cadence when walking.  Walking is defined as greater than or equal to 1 step per minute.  An increase in Cadence Variability means you have increased your range of walking cadences.  An increased Cadence Variability typically occurs when your cadence rates reach higher peak cadences than before.

15. Daily Distance is your average distance walked per day. Distance is based on Daily Steps and your entered stride length.  If a stride length is not entered, the value is 0.0 miles.

16. Stance / Swing Time is your average stride duration (time from foot contact of measured limb to foot contact of same limb) based on the fastest 1 minute of walking each day.  Very long stance/swing time estimates will occur if you do not walk for at least one continuous minute each day.  A decrease in stance/swing time means you are taking less time with each step.