Clinicians’ perspectives on the integration of electronic patient-reported outcomes into dermatology clinics: a qualitative study

Taliercio, Vanina; Snyder, Ashley; Biggs, Allison M; Kean, Jacob; Hess, Rachel; Duffin, Kristina Callis; Cizik, Amy M.; Secrest, Aaron M.

doi:10.1007/s11136-021-03030-w

Cited by 14 publications

(22 citation statements)

References 35 publications

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“…Importantly, OPGA scores of 0 and 4 were much more common in the cross-sectional cohort than Skindex-16 scores of 0 or 100 (n = 279, 27.1% and n = 60, 5.82% respectively) illustrating how PROs can add information beyond CROs, regardless of disease severity. (9) In this cohort, only about 1% of patients fell into discordant groups where PROM and CRO scores were highly mismatched.…”

Section: Discussionmentioning

confidence: 72%

“…(5-8) Despite advantages and increasing adoption, many clinicians remain unacquainted with PROMs or skeptical of implementing PROMs for their patients in routine practice. (9) To be useful, PROMs must be well-validated, have favorable measurement properties across a broad spectrum of patients and disease severities, and offer interpretable and actionable data. (9)(10)(11)(12) Construct validity, or the evaluation of how well designed a measure is to evaluate its target area, HRQL, is vital to this goal.…”

Section: Introductionmentioning

confidence: 99%

“…(9) To be useful, PROMs must be well-validated, have favorable measurement properties across a broad spectrum of patients and disease severities, and offer interpretable and actionable data. (9)(10)(11)(12) Construct validity, or the evaluation of how well designed a measure is to evaluate its target area, HRQL, is vital to this goal. While the Dermatology Life Quality Index (DLQI) and the adapted DLQI-Relevant (DLQI-R) instruments have been evaluated in psoriasis, (13)(14)(15)(16)) construct validity testing for Skindex-16 remains sparse in psoriasis.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Skindex-16 construct validity in routinely collected psoriasis data: a retrospective analysis of the relationship between overall physician global assessment scores and Skindex-16 and measure discordance

et al. 2022

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Patient-reported outcome measures (PROMs) capture disease severity metrics from the patient's perspective, including healthrelated quality of life (HRQL). Disease-speci c validation of PROMs improves their clinical utility. We evaluated construct validity (HRQL) for Skindex-16 in routinely seen psoriasis patients and characterized instances of discordance between Skindex-16 scores and clinician reported outcome measure of disease severity. We retrospectively studied psoriasis patients seen by University of Utah Dermatology from 2016 to 2020. Cross-sectional construct validity was assessed using quantile regression and Spearman correlation between overall physician global assessment (OPGA) score and Skindex-16 scores.Longitudinal, within-subject correlation was performed using linear mixed models. Discordance (10th percentile or lower OPGA and 90th percentile or higher poor HRQL; cspHRQL] or the reverse [severe skin, good HRQL; ssgHRQL]) was characterized descriptively. 681 rst-visit patients with psoriasis were included. Median overall Skindex-16 score varied by ≥ 10 points across all levels of OPGA scores. OPGA and Skindex-16 domain scores were moderately correlated (emotions ρ = 0.54, functioning ρ = 0.47, and symptoms ρ = 53). Longitudinal correlations were similar (emotion ρ xy = 0.54, functioning ρ xy = 0.65, symptoms ρ xy = 0.47). Visits with cspHRQL discordance occurred for each Skindex-16 domain (emotions = 7, functioning = 13, symptoms = 12). The ssgHRQL group was observed within the emotions (n = 1) and functioning (n = 23) domains. Median Skindex-16 scores are different between different levels of OPGA and show moderate cross-sectional and longitudinal correlation. This supports construct validity in patients with psoriasis. Severe discordance was rare and most often for those with clear skin but poor HRQL. These discordances can prompt further patient-clinician conversation.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Skindex-16 construct validity in routinely collected psoriasis data: a retrospective analysis of the relationship between overall physician global assessment scores and Skindex-16 and measure discordance

et al. 2022

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“…The full details of the study’s characteristics are presented in Table 1 . All studies were published after 2012, and conducted in eight countries: Netherlands [ 8 , 31 , 33 – 35 ], Finland [ 42 ], Denmark [ 26 ], United Stated of America [ 7 , 9 , 24 , 27 , 28 , 30 , 32 , 38 , 40 , 41 , 43 ], Italy [ 4 ], Canada [ 25 , 27 , 36 , 37 ], Germany [ 39 ], and the United Kingdom [ 29 ]. The majority of studies (22/24) investigated ePROMs in isolation, one study investigated only ePREMs [ 4 ], and one study investigated both ePROMs/ePREMs [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Study designs were primarily qualitative (13/24) or mixed methods (7/24), but also included four observational quantitative studies. Across both qualitative and mixed-methods study designs, qualitative data were collected through interviews in 12 studies [ 24 – 26 , 28 – 30 , 32 – 34 , 38 – 40 , 43 ], focus groups in six studies [ 7 , 9 , 25 , 29 , 32 , 36 ], and open-ended survey questions in five studies [ 4 , 8 , 31 , 35 , 38 ]. In studies that included a quantitative component, quantitative data were collected via close-ended survey questions in 11 studies [ 8 , 27 , 31 – 38 , 40 ], a workflow audit in only one study [ 40 ], and Q-sorting in only one study [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

Facilitators and barriers to implementing electronic patient-reported outcome and experience measures in a health care setting: a systematic review

Glenwright

Simmich

Cottrell

et al. 2023

J Patient Rep Outcomes

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Objective This systematic literature review aimed to identify factors that influence the implementation of electronic patient-reported outcome measures (ePROMs) and patient-reported experience measures (ePREMs) in healthcare settings. Introduction Improvements in health care through increased patient engagement have gained traction in recent years. Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are tools used to improve the quality of care from the patient perspective. The influence of implementing PROMs and PREMs using electronic information systems (ePROMs and ePREMs) is not well understood. Inclusion criteria Studies with information related to the implementation of ePROMs and/or ePREMs with a focus on health-related services, irrespective of provider type, were included. Methods A literature search of peer-reviewed databases was conducted on the 24th of January 2022 for articles about barriers and facilitators of the implementation of ePROMs/ePREMs in healthcare settings. Two reviewers independently extracted relevant findings from the included studies and performed a descriptive code-based synthesis before collaboratively creating a final consensus set of code categories, which were then mapped to the consolidated framework of implementation research (CFIR). Study quality was appraised using a mixed-methods appraisal tool (MMAT). Results 24 studies were eligible for inclusion in the screening of 626 nonduplicate studies. Quality assessment using the MMAT revealed that 20/24 studies met at least 60% of the MMAT criteria. Ninety-six code categories were identified and mapped to the constructs across all CFIR domains. Conclusion To guide the effective implementation of ePROMs/ePREMs in healthcare settings, factors shown to influence their implementation have been summarised as an implementation checklist for adoption and use by clinicians, organisations, and policymakers.

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Patient-Reported Outcome Measures for Health-Related Quality of Life in Patients With Acne Vulgaris

et al. 2022

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ImportanceMultiple patient-reported outcome measures (PROMs) for health-related quality of life (HRQoL) exist for patients with acne. However, little is known about the content validity and other measurement properties of these PROMs.ObjectiveTo systematically review PROMs for HRQoL in adults or adolescents with acne.Data SourcesEligible studies were extracted from PubMed and Embase (OVID).Study SelectionFull-text articles published in English or Spanish on development, pilot, or validation studies for acne-specific, dermatology-specific, or generic HRQoL PROMs were included. Development studies included original development studies, even if not studied in acne patients per Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) recommendations. If a study included several diagnoses, the majority (ie, over 50%) of patients must have acne or acne-specific subgroup analyses must be available. Abstract and full-text screening was performed by 2 independent reviewers.Data Extraction and SynthesisTwo independent reviewers assessed study quality applying the COSMIN checklist and extracted and analyzed the data. For each distinctive PROM, quality of evidence was graded by measurement property.Main Outcomes and MeasuresPROM properties (target population, domains, recall period, development language), PROM development and pilot studies, content validity (relevance, comprehensiveness, comprehensibility), and remaining measurement properties (structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, construct validity, and responsiveness). Quality of evidence was assigned for each measurement property of included PROMs. An overall recommendation level was assigned based on content validity and quality of the evidence of measurement properties.ResultsWe identified 54 acne PROM development or validation studies for 10 acne-specific PROMs, 6 dermatology-specific PROMs, and 5 generic PROMs. Few PROMs had studies for responsiveness. The only acne-specific PROMs with sufficient evidence for content validity were the CompAQ and Acne-Q. Based on available evidence, the Acne-Q and CompAQ can be recommended for use in acne clinical studies.Conclusions and RelevanceTwo PROMs can currently be recommended for use in acne clinical studies: the Acne-Q and CompAQ. Evidence on content validity and other measurement properties were lacking for all PROMs; further research investigating the quality of remaining acne-specific, dermatology-specific, and generic HRQoL PROMs is required to recommend their use.

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Clinicians’ perspectives on the integration of electronic patient-reported outcomes into dermatology clinics: a qualitative study

Cited by 14 publications

References 35 publications

Evaluation of Skindex-16 construct validity in routinely collected psoriasis data: a retrospective analysis of the relationship between overall physician global assessment scores and Skindex-16 and measure discordance

Evaluation of Skindex-16 construct validity in routinely collected psoriasis data: a retrospective analysis of the relationship between overall physician global assessment scores and Skindex-16 and measure discordance

Facilitators and barriers to implementing electronic patient-reported outcome and experience measures in a health care setting: a systematic review

Patient-Reported Outcome Measures for Health-Related Quality of Life in Patients With Acne Vulgaris

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