Graphical displays of patient-reported outcomes (PRO) for use in clinical practice: What makes a pro picture worth a thousand words?

Bantug, Elissa; Coles, Theresa; Smith, Katherine Clegg; Snyder, Claire; Rouette, Julie; Brundage, Michael

doi:10.1016/j.pec.2015.10.027

Cited by 75 publications

(80 citation statements)

References 35 publications

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“…However, as recently stated by Tolbert and colleagues, no single format seems to be best for all patients in all situations. Studies comparing presentation formats of quantitative information for treatment decisions in general have often depicted bar charts as a suitable presentation format . Bar charts are known to especially support the ease of making relatively simple comparisons between groups, which may well explain why they resulted in correct interpretation in our study.…”

Section: Discussionmentioning

confidence: 77%

Using PROMs during routine medical consultations: The perspectives of people with Parkinson’s disease and their health professionals

Damman

Verbiest

Vonk

et al. 2019

Health Expectations

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BackgroundThe use of patient‐reported outcomes measures (PROMs), such as quality of life or symptoms like pain or fatigue, is increasingly embraced within patient‐centred care and shared decision making.ObjectivesTo investigate: (a) how patients and health professionals think about using PROMs during routine medical consultations; (b) for which purpose(s), patients and health professionals want to use PROMs during those consultations; and (c) how patients interpret PROMs information presented in various formats. People with Parkinson's disease and their health professionals served as case example.MethodsWe performed semi‐structured interviews with patients (N = 13) and professionals (N = 7 neurologists; N = 7 physiotherapists). We also used a survey in which patients (N = 115) were shown six figures displaying different information types. Presentation formats of this information varied (line/bar graphs). Interpretation by patients, perceived usefulness of information, attitude towards using information during routine medical consultations and (hypothetical) decisions were assessed.FindingsPatients and professionals were generally positive about using PROMs during medical consultations. Professionals stressed the opportunity to monitor changes in individual PROMs over time. Patients were primarily positive about aggregated PROMs to make treatment decisions. This information was also most often interpreted correctly, especially when presented through a line graph (90.1% correct). Professionals thought patients should take the initiative in discussing PROMs, whereas patients thought professionals should do so.Conclusion/DiscussionWhen used in routine medical consultations, PROMs seem to have potential to support shared decision making and facilitate patient‐professional communication. However, training seems needed for both patients and professionals to facilitate actual discussion and proper interpretation.

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Section: Discussionmentioning

confidence: 77%

Using PROMs during routine medical consultations: The perspectives of people with Parkinson’s disease and their health professionals

Damman

Verbiest

Vonk

et al. 2019

Health Expectations

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“…Responses to PRO tools can be captured on mobile platforms within minutes, immediately scored, and made available to clinicians through electronic health record. 26 Our study results indicate that use of the EQ-5D instrument may help providers and potential LVAD candidates engage in more meaningful, patientcentric discussions on choices of treatments for advanced HF and the timing of their implementation. Along the same lines, our results could be used to help current investigative efforts aimed at exploring VAD placement earlier in the trajectory of HF.…”

Section: Discussionmentioning

confidence: 81%

Patient-Reported Health-Related Quality of Life Is a Predictor of Outcomes in Ambulatory Heart Failure Patients Treated With Left Ventricular Assist Device Compared With Medical Management

Stehlik

Estep²,

Selzman

et al. 2017

Circ: Heart Failure

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Background— The prospective observational ROADMAP study (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management) demonstrated that ambulatory advanced heart failure patients selected for left ventricular assist device (LVAD) were more likely to be alive at 1 year on original therapy with ≥75-m improvement in 6-minute walk distance compared with patients assigned to optimal medical management. Whether baseline health-related quality of life (hrQoL) resulted in a heterogeneity of this treatment benefit is unknown. Methods and Results— Patient-reported hrQoL was assessed with EuroQol questionnaire and visual analogue scale (VAS). We aimed to identify predictors of event-free survival and survival with acceptable hrQoL (VAS≥60). LVAD patients had significant improvement in 3 of 5 EuroQol dimensions ( P <0.05), but no significant changes were observed with optimal medical management. Among patients with baseline VAS<55, survival on original treatment was lower for optimal medical management patients compared with those assigned to LVAD (58±7% versus 82±5%; P =0.004). No such difference was seen if baseline VAS was ≥55 (70±7% versus 75±9%; P =0.79). Survival on original therapy with acceptable quality of life was also more likely with LVAD versus optimal medical management if baseline VAS was <55, whereas outcomes in patients with higher baseline VAS scores were similar regardless of treatment assignment ( P =0.046 for treatment arm and baseline VAS interaction). Conclusions— LVAD therapy resulted in improvement of patient health status in heart failure patients with low self-reported hrQoL, but not in patients with acceptable quality of life at the time of LVAD implantation. Patient-reported hrQoL should be integrated into decision making concerning the use and timing of LVAD therapy in heart failure patients who are symptom limited but remain ambulatory. Clinical Trial Registration— URL: http://www.ClinicalTrials.gov . Unique identifier: NCT01452802.

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“…A body of implementation research has developed around the use of PROs in other areas of oncology (182, 183), covering issues such as data display (184, 185), mode of data capture (186), adjudication of patient vs clinician PRO assessment (187, 188), the use of PROs for decision-making (189, 190), and the use of PROs as performance measures (191). This body of research should be applied to the use of patient generated health data in the setting of transplantation.…”

Section: Resultsmentioning

confidence: 99%

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Patient-Centered Outcomes Working Group Report

Bevans

El‐Jawahri

Tierney

et al. 2017

Biology of Blood and Marrow Transplantation

145

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In 2015 the National Institutes of Health (NIH) convened six working groups to address the research needs and best practices for patient-centered late effects of hematopoietic stem cell transplantation (HCT) survivors. The Patient-Centered Outcomes Working Group, charged with summarizing the HRQOL evidence base, used a scoping review approach to efficiently survey the large body of literature in adult and pediatric HCT survivors over 1 year after transplantation. The goals of this paper are to 1) summarize the current literature describing patient-centered outcomes (PCO) in survivors including the various dimensions of healthrelated quality of life affected by HCT and describe interventions tested to improve these outcomes; 2) highlight areas with sufficient evidence allowing for integration into standard practice; 3) address methodological issues that restrict progress in this field; 4) identify major gaps to guide future research; and 5) specify priority research recommendations. PCOs were summarized within physical, psychological, social and environmental domains, as well as for adherence to treatment, and health behaviors. Interventions to improve outcomes were evaluated for evidence of efficacy, although few interventions have been tested in long-term HCT survivors. Methodologic issues defined included lack of consistency in the selection of PCO measures, along with the absence of a standard for timing, frequency, and mode of administration. Recommendations for HCT survivorship care included: integration of annual screening of PCOs; use of evidence based practice guidelines; and provision of treatment summaries and survivorship care plans after HCT. Three priority research recommendations included: 1) Design and test risk-targeted interventions with dose intensity modulation matching the needs of HCT survivors with priority domains including sexual dysfunction, fatigue, sleep disruption, non-adherence to medications & recommended health care, health behaviors including physical inactivity and healthy eating, and psychological dysfunction, with particular consideration of novel technologies to reach HCT survivors distant from their transplant centers, 2) Design a consensus based methodologic framework for outcomes evaluation, and 3) Evaluate and compare existing practices for integrating PCOs screening and interventions across HCT survivorship programs.

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Graphical displays of patient-reported outcomes (PRO) for use in clinical practice: What makes a pro picture worth a thousand words?

Cited by 75 publications

References 35 publications

Using PROMs during routine medical consultations: The perspectives of people with Parkinson’s disease and their health professionals

Using PROMs during routine medical consultations: The perspectives of people with Parkinson’s disease and their health professionals

Patient-Reported Health-Related Quality of Life Is a Predictor of Outcomes in Ambulatory Heart Failure Patients Treated With Left Ventricular Assist Device Compared With Medical Management

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Patient-Centered Outcomes Working Group Report

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