Patient-reported outcomes. How important are they?

Abstract

Outcome after surgical treatment has been based predominantly on objective criteria (biomedical model) and has largely ignored, until recently, the expectations, personal feelings, satisfaction, and quality of life of patients (outcomes model). The importance of this derives from considerations that the viewpoints and priorities of patients may not be the same as those of their surgeons. Furthermore, there is often little correlation between symptom severity and disease severity. Measures of quality of life and patient satisfaction are, thus, important in valid assessment of the results of surgical treatment. Global assessment based on both the biomedical and outcomes models constitutes the ideal. Questionnaires designed to measure both quality life (generic and specific) and patient satisfaction with treatment require careful development and validation by appropriate studies.

Impact of laparoscopic anterior 270° fundoplication on the quality of life and symptoms profile of neurodevelopmentally delayed versus neurologically unimpaired children and their parents

“…This is consistent with the literature for neurologically impaired and healthy pediatric GERD patients [5,18,19]. A considerable discrepancy may exist between the evolution of objective data and subjectively experienced well-being [6][7][8]. Therefore, QoL has been used as the major end point in the treatment of GERD in adults [20].…”

The impact of strabismus on quality of life in adults with and without diplopia: a systematic review

“…Despite assumptions by the medical community, the relationship between symptom or disease severity and QoL is not consistent. 25 Not all patients experiencing severe symptoms or illness report poor QoL, but those with minor symptoms may. 6 This highlights not only the personal evaluative nature of the concept but also the need to make individual assessments.…”

Laparoscopic Nissen versus Toupet fundoplication: objective and subjective results of a prospective randomized trial

“…However, from the patient's point of view, the so-called heuristic end points such as symptom resolution, duration of convalescence, patient satisfaction, well-being, and quality of life (QoL) are at least as important as the ''classical'' outcomes [9]. These subjective outcomes are particularly relevant in LARS for GERD because one of the goals of the procedure is to improve the patient's GERD symptoms and QoL, providing subjective satisfaction with the treatment [10]. In previous studies, objective surgical outcome after LARS was evaluated by esophageal manometry and 24-h pH monitoring.…”