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Other important issues in developing outcome indicators are the availability of valid, reliable treatment information and the cost of data collection.
Even though the importance of the patients' perspective in choosing outcomes and in developing outcome measures has been recognized, the choice of outcomes is rarely grounded in a conceptual framework [ 11, 12].
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The modified Delphi process was effective in developing outcomes and indicators that were then used in the development of content for a course in rational prescribing.
To meet these new demands for understanding the process-outcomes relationship, there exists a tremendous need for physician involvement in developing outcomes assessment programs.
The three round Delphi process proved to be effective in developing outcomes and indicators that were then used in the definition of eHealth content and ranking key priorities in PC eHealth development.
Identifying additional relevant dimensions to measure and the context of use will become increasingly important in selecting and developing outcome measurements for nutrition interventions.
It is concluded that a coordinated response is now required to develop outcome measurement in eol care.
Dr. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology, and receives arms-length funding from 36 companies.
In addition to this, recently developed outcome measures such as the "forgotten joint score" can be used (Behrend et al. 2012).
The DASH and LEFS were chosen because they provided the best 'fit' at the time, but future research is needed to develop outcome measures in this area.
However, advances have been made in developing reliable outcome measures for clinical research.
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