Clinical content governance
What has to be independently true before an outcome measure can be administered in ArkCloud Rehab.
Current state: no measure is published. The requirements below are a conjunction - every one has to hold independently, and none is currently satisfied for any measure. That is a statement about rights clearance, not about the software.
This is not the same as recording a score. Separately from this pathway, a clinic's clinical lead can choose instruments from a catalogue and attest that the clinic holds any licence; clinicians then administer the instrument outside ArkCloud and enter only the score. ArkCloud shows no item wording, computes no total and applies no threshold on that path. See outcome measures.
Rights
An explicit, written determination from the rights holder covering each permission separately: naming the measure, storing its metadata, reproducing its item wording, administering it electronically, capturing responses, implementing its scoring, displaying results, making it available to customer organisations, and doing all of that commercially. A general “yes, you may use it” is not a determination - the permissions genuinely differ, and a licence commonly grants some and withholds others.
Source
An authoritative source, read in full, that actually covers the content being published. A blog, a clinic website, a vendor page, a copied score sheet, a search-result snippet, an encyclopaedia entry or a secondary summary is not sufficient authority for a clinical fact, however plausible the value looks. Where a source is ambiguous, the value is held rather than guessed.
Version
One exact version. Measures are revised, items change, and a score is only interpretable against the version it was collected under. Content is bound to a version, and a published version is sealed - its items cannot be edited afterwards, because those items define what an already-recorded response means.
Scoring
A scoring definition naming an implementation that exists in the running build, and a set of golden vectors derived from the source. Both are required: a database row marked validated is a claim somebody wrote, and a row cannot make code correct. Eligibility is re-derived on every request and the vectors are executed, so a scorer that stops reproducing them stops being usable immediately.
Evidence
Any interpretive value - a cut-off, a minimal detectable change, a clinically important difference, a normative figure - carries its own bound evidence. A measure can be perfectly scoreable and still have nothing published about what its numbers mean, and ArkCloud reports those as separate facts rather than collapsing them.
Review
Independent review before publication. Drafting, reviewing and publishing are separate capabilities held by different people, so no single person can move content from an idea to something a clinician is shown.
Why availability is derived, not stored
ArkCloud does not keep a flag saying a measure is usable. It answers five separate questions every time it is asked - may we say the measure exists, may we show its items, may we compute a score, may we say what a score means, may the selector propose it - and each answer carries its own reason.
A stored flag is a claim someone wrote, and it can go stale the moment a licence changes. A derivation is recomputed from the underlying facts, so withdrawing a right takes effect immediately rather than when someone remembers to update a column.
The most common real state is not “available” or “unavailable”: it is that we can name a measure, describe it, and score responses if given them, while not being permitted to reproduce a single one of its items. Collapsing that into one boolean is how copyrighted content ends up displayed by software that was never licensed to show it.
Withdrawal
Rights can be withdrawn, a source can be retracted, and a scorer can be found defective. Any of those makes a measure unavailable for future use immediately.
None of them alters history. Assessments, responses, scores and the audit trail are preserved exactly, and nothing is rescored or reinterpreted - a record that can be silently rewritten is a record that cannot be relied on. A withdrawn version stays readable so that an assessment collected under it remains explicable.
If you hold rights to an outcome measure and would like it considered for ArkCloud Rehab, get in touch. We will ask for an explicit determination on each permission above rather than a general grant.