Patient-Reported Outcome Measures in Sports Medicine: A Concise Resource for Clinicians and Researchers

Abstract

Background Despite the importance of assessing patient outcomes during patient care, current evidence suggests relatively limited use of patient-reported outcome measures (PROMs) by athletic trainers (ATs). Major barriers to PROM use include lack of knowledge, navigating the intricate process of assessing a wide variety of PROMs, and selecting the most appropriate PROM to use for care. A concise resource for ATs to consult when selecting and implementing PROMs may help facilitate the use of PROMs in athletic health care. Objective To review the instrument essentials and clinical utility of PROMs used by ATs. Methods We studied 11 lower extremity region–specific, 10 upper extremity region–specific, 6 generic, and 3 single-item PROMs based on the endorsement of at least 10% of ATs who use PROMs, as reported in a recent investigation of PROM use in athletic training. A literature search was conducted for each included PROM that focused on identifying and extracting components of the instrument essentials (ie, instrument development, reliability, validity, responsiveness and interpretability, and precision) and clinical utility (ie, acceptability, feasibility, and appropriateness). Through independent review and group consensus, we also classified each PROM question by International Classification of Functioning, Disability and Health domain and health-related quality-of-life dimensions. Key Findings The PROMs contained in this report generally possessed appropriate instrument essentials and clinical utility. Moreover, the PROMs generally emphasized body structure and function as well as the physical functioning of the patient. Athletic trainers aiming to assess patients via a whole-person approach may benefit from combining different PROMs for use in patient care to ensure broader attention to disablement health domains and health-related quality-of-life dimensions.

A Tiered Approach for Integrating Patient Outcome Measures into the Curriculum

“…16 During the first tier, students should be able to recognize the criteria for selecting PROMs and identify the development process and validation of a PROM instrument. Background knowledge on instrument essential items such as instrument development, reliability, validity, responsiveness, interpretability, and precision 17,18 should be introduced by the educator when PROMs are initially taught. These elements can be useful in establishing whether or not the instrument is appropriate for identifying POEM.…”

“…In addition, knowledge of clinical utility measures, such as acceptability, feasibility, and appropriateness, is important when making decisions about the application of PROMs. 17,18 A recommended resource to accompany the theoretical components is the article by Lam et al 18 ; it is a great tool with which to enhance comprehension of PROMs essential elements and clinical utility. A concise summary of clinically relevant PROMs, which was previously published by Lam et al 18 (Table 1), is used as a quick reference guide and the basis for the 3 categories of PROMs (region specific, generic, and single item) students will be using throughout this tiered approach.…”

“…17,18 A recommended resource to accompany the theoretical components is the article by Lam et al 18 ; it is a great tool with which to enhance comprehension of PROMs essential elements and clinical utility. A concise summary of clinically relevant PROMs, which was previously published by Lam et al 18 (Table 1), is used as a quick reference guide and the basis for the 3 categories of PROMs (region specific, generic, and single item) students will be using throughout this tiered approach. The authors have found this content 18 useful in alleviating the overwhelming feeling that every PROM instrument must be discussed with students.…”

“…The scenario given to each student is that the injury has occurred at the end of practice and a reevaluation will occur the following day, which allows students time to select and research the PROMs they would like to utilize during the CBS experience. Students use the aforementioned content 18 in Table 1 as a framework for PROM selection, which must include both a generic and region-specific outcome measure. Students must return the following class period with all of the following: a brief explanation for the patient as to why they will be using the selected PROM, justification for selection of each PROM, and a plan for distribution (ie, frequency with which the PROM will be distributed).…”

Return-to-Sport Review for Current Cartilage Treatments

“…), but the RTS outcome is specific to individual athletes and focuses on their sport-specific goals. [5][6][7] This also means that there is significant variability in the measure in how it is reported in the literature currently. The RTS variable is potentially limited by patient factors such as age, overall activity level, competitive versus recreational status, professional versus amateur status, and scholarship status.…”