AT outcomes studies are needed that report data regarding (a) the impact of AT on participation, (b) costs of AT provision and (c) key elements in the AT service delivery process. Future studies will be further strengthened to the extent that their methodologies actively assimilate consumer perspectives. Implications for Rehabilitation Consumers highly value the impact of AT devices on their independence, subjective well-being and participation in work and school. The process of acquiring assistive technology devices is often lengthy and frustrating for consumers. Future AT outcomes research should report descriptive data regarding service delivery processes, as well as long-term impacts for consumers. Practitioners and researchers should avoid the use of potentially confusing professional jargon when administering surveys to consumers.

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The following suggestions are offered as researchers continue to develop increasingly sophisticated instruments and methods: (1) participation measures need to be device-specific; (2) measures ought to capture both 'capacity' and 'performance'; (3) methods need to be sensitive to those factors that impact mobility device use over time; (4) methods need to be sensitive to the complexities of both the social and physical environment as they impact device use; and (5) measures need to reflect the impact of multiple mobility device use.

The significance of this study lies in its methodological implications for future outcomes research. The complexities inherent in measuring interventions are discussed in terms of an instrument's constructs, research question(s), study design, subject population, and the practical considerations of collecting outcomes data within busy clinical practices.

The combination of objective and subjective data afforded by the application of PAMS reflects a complex relationship between wheelchair use and the role of mobility as people go about their daily home and community activities. PAMS can be adapted to a variety of research questions and may be used as an alternative or supplement to self-report assessments of activity and participation.

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Economic evaluation has become one of the principal methodologies in outcomes research within the health care field in general and specifically in assistive technology. Efforts to define and develop a consistent methodology for assistive technology economic evaluations have been hampered by lack of familiarity with the various terms and concepts associated with cost analysis, an essential aspect of economic evaluations. Adapting these concepts, which were constructed to suit a medical model, to the needs of the assistive technology field has been a challenge as well. This article outlines terms and concepts basic to cost analysis. The authors then consider five studies that relate costs to outcomes in order to illustrate the challenges, choices, and trade-offs researchers make when adapting this methodology to assistive technology. The article concludes by seeking to stimulate further discussion of the complexity inherent in assessing costs in assistive technology outcomes research and calling for the development of a standardized and consistent economic evaluation methodology.