Abstract
Despite significant advances in measuring the outcomes of rehabilitation interventions,
little progress has been made in specifying the therapeutic ingredients and processes
that cause measured changes in patient functioning. The general approach to better
clarifying the process of treatment has been to develop reporting checklists and guidelines
that increase the amount of detail reported. However, without a framework instructing
researchers in how to describe their treatment protocols in a manner useful to or
even interpretable by others, requests for more detail will fail to improve our understanding
of the therapeutic process. In this article, we describe how the Rehabilitation Treatment
Specification System (RTSS) provides a theoretical framework that can improve research
intervention reporting and enable testing and refinement of a protocol’s underlying
treatment theories. The RTSS framework provides guidance for researchers to explicitly
state their hypothesized active ingredients and targets of treatment as well as for
how the individual ingredients in their doses directly affect the treatment targets.
We explain how theory-based treatment specification has advantages over checklist
approaches for intervention design, reporting, replication, and synthesis of evidence
in rehabilitation research. A complex rehabilitation intervention is used as a concrete
example of the differences between an RTSS-based specification and the Template for
Intervention Description and Replication checklist. The RTSS’s potential to advance
the rehabilitation field can be empirically tested through efforts to use the framework
with existing and newly developed treatment protocols.
Keywords
List of abbreviations:
POC (point of care), RTSS (Rehabilitation Treatment Specification System), TIDieR (Template for Intervention Description and Replication)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 26, 2018
Footnotes
Supported by the Patient-Centered Outcomes Research Institute (contract number ME-1403-14083) awarded to John Whyte, MD, PhD, FACRM, at Moss Rehabilitation Research Institute and the National Institutes of Health (NIH) National Institute on Deafness and Other Communication Disorders and Office of Behavioral and Social Sciences Research (grant numbers R21 DC016124 and OD016124).
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
