A Prognostic System for Selecting Appropriate Level of Amputation

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DESCRIPTION (provided by applicant): Project Summary/Abstract Our current prospective multi-site study has led to the development of a robust prognostic model among transfemoral (TF), transtibial (TT), and transmetatarsal (TM) amputees that we call AMPREDICT. AMPREDICT was developed to be used pre-operatively for treatment decision making by correlating outcome success with baseline demographic, physical and psychosocial measures. The ultimate goal of the proposed research is to validate AMPREDICT so that it can be recommended for widespread clinical use for the following purposes: (1) providing surgeons, rehabilitation teams, and patients with information about patient prognosis; (2) assisting surgeons, rehabilitation teams, and patients in planning the most appropriate level of amputation; (3) providing an objective tool for validly comparing treatment and rehabilitation outcomes; (4) assisting in the communication and exchange of information among clinicians and patients; and (5) assisting in VA-wide policy decisions to ensure sound judgment regarding the best level of care for each individual patient. To accomplish this, we plan to assess the performance of the prognostic model AMPREDICT by assessing its accuracy in different populations than the one it has been developed in. This research is critical before AMPREDICT is recommended for widespread clinical use. The primary aim for this study is to assess our current prognostic model's (AMPREDICT) performance for predicting both physical and psychosocial outcomes among TT and TM amputees in the same institution during a different time period (temporal transportability) and in different institutions (geographic transportability) so that it can be recommended for widespread clinical use.