Participants were asked on which days they used their prosthesis and for one day of normal activity how long they wore the prosthesis, how many sit to stands they performed, and the duration they performed prosthetic walking

and standing activities. Prosthetic non-users did not use their prosthesis for locomotor activities on any days. Individuals who only wore their prosthesis for cosmesis were classified as non-users. Non-users were asked their reasons for prosthetic non-use and to recall how Akt inhibitor many months after physiotherapy discharge they stopped using their prosthesis. Important calendar events (eg, last amputee outpatient clinic, birthday, Christmas) were used as verbal prompts to assist with recall accuracy. Participants were interviewed with a previously piloted survey on their prosthetic use from 4 months onwards after discharge and re-interviewed approximately at 2-monthly intervals until data were collected for 12 months. The procedure used for clinical prediction rules validation were the same as for the development procedure, except

that data were prospectively collected during the participants’ rehabilitation using a physiotherapy assessment form. This form was developed and implemented by the senior physiotherapist during clinical prediction rules development. The statistical models used in the present study are consistent with clinical Selleck AZD9291 prediction rules reports27, 28, 29 and 30 and are not equivalent to a regression analysis. The primary outcome variable was prosthetic non-use at 4, 6, 8 and 12 months post-discharge. Descriptive statistics were generated. The univariate relationship between categorical variables and prosthetic users and non-users was analysed using the chi-square test. For each of the continuous variables,

ROC inhibitors curves were used to determine the threshold at which specificity and sensitivity were equal to generate dichotomous classification for the univariate analyses. Univariate contingency tables were used to identify a smaller subset of variables related to Mephenoxalone prosthetic non-use that had a significance level of 10% (chi-square p < 0.10). This conservative significance level was selected to avoid missing critical variables. Sensitivity, specificity, and positive and negative likelihood ratios were calculated for the variables. A backwards stepwise logistic regression model was used to reduce these variables to a set of flags or key variables that contributed to predicting non-use. To generate clinical prediction rules for the time frames, the set of variables from the regression was used to establish cumulative numbers of items present for any one individual at discharge. A list of likelihood ratios (negative and positive, 95% CI) were calculated to determine the cumulative effect of having a number of these predictors (1, 2, 3, etc) on non-use.