Comparing consumer and clinician values for alternative functional states:Application of a new feature trade-off consensus building tool

Objective: To present the Features-Resource Trade-Off Game (Features Game) as a new method for comparing preferences for alternative outcomes among di fferent groups of people. Design: The Features Game is illustrated by comparing preferences for recov ery among the 18 functional status items making up the Functional Independe nce Measure. Methods involved trading levels of independence (resources) ac ross the different items (features). Setting: Ten community-dwelling consumers with physical disabilities and 10 rehabilitation clinicians participated in four separate expert panels-two in Houston and two in Philadelphia. Main Outcome Measures: Five sets of hierarchical stages defined by the four separate panels specifying the profiles of function believed to most foste r independent living. Results: Cognitive and communication skills were selected preferentially ov er the recovery of physical tasks by all panels, but, in comparison to clin icians, consumers were more willing to accept mild deficits in cognitive sk ills as trade for realizing earlier recovery of physical abilities. Conclusion: The overwhelming choice of cognitive and communication abilitie s over physical abilities suggests a need to enhance therapeutic efforts in those areas. More subtle differences in consumer and clinician preferences emphasize the importance of establishing consumer-oriented goals. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Acade my of Physical Medicine and Rehabilitation.