We typically bring the patient to the clinical trial, but mobile health signals the opportunity of bringing the trial to the patient

This webinar draws on experience in validating a select group of PerfO assessments in orthopaedics, an area with a strong history of performance measurement, with the intention of supporting future labelling claims. The PerfO assessments were Timed Up and Go, Stair Climbs and Repeated Chair Stands which were administered in hip fracture and elective hip and elective knee replacement patients in a multi-site study.​

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The webinar will present conceptual and logistical challenges of both qualitative and quantitative studies to assess the content validity and measurement properties of these PerfO assessments in these patient groups, and the results from these studies. We will also reflect on the value of FDA Guidance on the use of PRO measures (FDA/SEALD Guidance for Industry 2009) for PerfOs, and review the FDA Clinical Outcome Assessment Compendium and other sources for indication of the extent and nature of use of PerfOs to support labelling claims in conditions more widely.

The objectives of this webinar are to:

  • Briefly describe PerfOs and related terminology
  • Describe how PerfO assessments compare with other COAs and the breadth of PerfOs
  • Provide an in-depth orthopedic case study
  • Highlight practical and logistical issues of assessing select physical PerfO assessments
  • Demonstrate the approach taken to validating selected PerfO assessments
  • Share validation study results
  • Provide clear take-away messages to help inform approach to selecting and validating PerfO assessments for physical mobility-type conditions
  • Provide an indication as to the extent and nature of PerfOs used to support labelling claims more widely


With the introduction of sensors, wearables and apps there is the real possibility to engage patients more fully and in real time to increase the quality of data. Although not entirely new, use of these types of technologies is gaining momentum and senior decision makers need to be aware of the potential of this growth area and also the issues and challenges.

As a type of Clinical Outcome Assessment (COA), Performance Outcome assessments (PerfOs) specifically refer to task(s) performed by a patient according to instructions administered by a health care professional. They thus require patient cooperation and motivation (FDA, COA Glossary of terms).

While PerfO assessments such as walk and stair climbing tests are widely used to assess the effectiveness of interventions, and there is some evidence on the measurement properties of the tests, there is no regulatory guidance in terms of assessment development and validation specific to PerfOs. While the Patient Reported Outcome guidance (FDA/SEALD Guidance for Industry 2009) provides a useful framework, PerfOs do present specific challenges.

Key speakers

Elizabeth (Nicki) Bush

Research Scientist, Eli Lilly and Company

Nicki has been with Eli Lilly and Company’s Global Patient Outcomes and Real World Evidence (GPORWE) group for five years. In this role, she is responsible for developing and executing patient focused outcomes and health economics strategies in a number of therapeutic areas including pain and psychiatry. Prior to joining Lilly, Ms. Bush was a researcher at United BioSource Corporation’s Center for Health Outcomes Research, specializing in developing and validating instruments to measure patient reported outcomes in various disease states.  Ms. Bush earned her BA degree in the liberal arts (philosophy) from St. John’s College, her master’s degree in epidemiology from Johns Hopkins Bloomberg School of Public Health, and is currently pursuing her PhD in epidemiology at Indiana University’s Fairbanks School of Public Health.

Rachel Ballinger

Lead Outcomes Researcher, ICON

Rachel has been with ICON since 2011 and has worked on a large range of COA studies, including validation of physical performance outcomes in a multi-site study. Before joining ICON, Rachel worked as a Research Fellow at the Psychosocial Oncology Group at the University of Sussex, where she conducted numerous quality of life studies including assessment of patient and clinical decision making. She has also undertaken an extensive study of public policy and carcinogenic risk assessment of pharmaceuticals. She received her PhD in medical sociology and her BSc in Psychology and Sociology from Brunel University, West London. 

Target audience

  • COA scientists and those working in orthopaedics with interest in PerfOs
  • Outsourcing
  • Late Phase Research
  • HEOR
  • Project Management
  • Patient Registries
  • Risk Management
  • Market Access
  • Regulatory Affairs