Creating adjusted scores targeting mobility empowerment (CASTLE 2): Using response probabilities to expand interpretation of prosthetic limb users survey of mobility (PLUS-M) scores for individuals with lower limb amputation.

This was a database review of routine care responses, not a treatment study, so it does not show that using the maps improves patient outcomes. The maps cover only below-knee and above-knee amputation due to trauma or diabetes/dysvascular disease, not other amputation levels or causes. The PLUS-M 12-item short form showed possible ceiling effects in below-knee trauma and floor effects in above-knee diabetes/dysvascular disease, with 9.6% of responses at the maximum T-score of 71.4 and 8.8% at the minimum T-score of 21.8. The frequency-response method can make adjacent T-scores predict different answers when two response options were nearly equally common in the training data. Participants were from private prosthetic clinics in the United States, so the maps may not apply to other settings.

The supplied text does not state a funding source. Dr Hafner reports consulting fees for projects unrelated to this work from Liberating Technologies and Apple, and honoraria for presenting at an unrelated online symposium. The other authors have nothing to disclose.

Do not read the maps as proof that using them improves mobility. The study showed that predicted PLUS-M answers matched actual answers well in a large database; it did not test a rehabilitation intervention or measure patient outcomes.