There are two ways to call methods with out or ref parameters from IronPython.
In the first case, the call is processed by automatic sorting. The return value and the modified refs are wrapped in a tuple and (if there is 15.1 as an example of a double to be passed) can be used as:
(returned, referenced) = GetValue(15.1)
clr-:
refParam = clr.Reference[System.Double](15.1)
result = GetValue(refParam)