Reflections on the national patient-reported outcome measures (PROMs) programme: Where do we go from here?

Kyte, Derek; Cockwell, Paul; Lencioni, Mauro; Skrybant, Magdalena; Hildebrand, Maria; Price, Gary; Squire, Katie; Webb, Shena; Brookes, Olivia; Fanning, Hilary; Jones, Tim; Calvert, Melanie

doi:10.1177/0141076816677856

Cited by 27 publications

(48 citation statements)

References 12 publications

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“…Emphasis is being placed on involving patients throughout the innovation pathway, including the appropriate collection of PROMs informed by FDA and EMA guidance 272825 and in the NHS PROMs initiative 229. Three PROMs (the PHQ9, HADS, and Beck Depression Inventory-II) were used as part of QOF to assess the severity of depression, to support clinical decision making, and to assess provider performance.…”

Section: Current Use and Benefitsmentioning

confidence: 99%

“…PROMs have been used to measure health gain in patients undergoing hip or knee replacement, among other procedures, based on responses to questionnaires before and after surgery. Patients and referrers can use PROM data to help decide where to receive treatment: NHS Choices publishes provider level outlier data for PROM eligible procedures as part of a “score card.”31 The evidence to support using PROMs in this way is, however, limited,32 and challenges with paper based “top down” PROM capture include high rates of missing data and lack of accessible feedback for use by clinicians and patients 29…”

Section: Current Use and Benefitsmentioning

confidence: 99%

“…Patients may be asked to complete multiple questionnaires, often with overlapping items, which can be burdensome and confusing. Furthermore, PROMs are often poorly or not reported, which limits their effects on patient care and is unethical 2938. Evidence shows that clinicians find that collecting PROMs improves clinical care and workflow and is “beneficial rather than burdensome.”4 But some clinicians think that these data are “subjective” and therefore biased or unimportant compared with laboratory findings.…”

Section: Challenges To Considermentioning

confidence: 99%

“…We have found that engagement from patients, senior management, nurses, consultants, and allied healthcare professionals is essential to successful delivery of PROM specific strategic goals 101329…”

Section: Integrated Approach To Promsmentioning

confidence: 99%

“…How the data will be used to maximise patient care has not always been fully considered, even in routine clinical practice29…”

mentioning

confidence: 99%

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Maximising the impact of patient reported outcome assessment for patients and society

Calvert

Kyte

Price

et al. 2019

BMJ

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229

233

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Section: Current Use and Benefitsmentioning

confidence: 99%

Section: Current Use and Benefitsmentioning

confidence: 99%

Section: Challenges To Considermentioning

confidence: 99%

Section: Integrated Approach To Promsmentioning

confidence: 99%

“…How the data will be used to maximise patient care has not always been fully considered, even in routine clinical practice29…”

mentioning

confidence: 99%

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Maximising the impact of patient reported outcome assessment for patients and society

Calvert

Kyte

Price

et al. 2019

BMJ

Self Cite

229

233

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The Role of Patient-Reported Outcomes (PROs) in the Improvement of Healthcare Delivery and Service

Aiyegbusi

Hughes

Calvert

2022

Handbook of Quality of Life in Cancer

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Implications of response shift for micro-, meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures

et al. 2021

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Purpose Results of patient-reported outcome measures (PROMs) are increasingly used to inform healthcare decision-making. Research has shown that response shift can impact PROM results. As part of an international collaboration, our goal is to provide a framework regarding the implications of response shift at the level of patient care (micro), healthcare institute (meso), and healthcare policy (macro). Methods Empirical evidence of response shift that can influence patients’ self-reported health and preferences provided the foundation for development of the framework. Measurement validity theory, hermeneutic philosophy, and micro-, meso-, and macro-level healthcare decision-making informed our theoretical analysis. Results At the micro-level, patients’ self-reported health needs to be interpreted via dialogue with the clinician to avoid misinterpretation of PROM data due to response shift. It is also important to consider the potential impact of response shift on study results, when these are used to support decisions. At the meso-level, individual-level data should be examined for response shift before aggregating PROM data for decision-making related to quality improvement, performance monitoring, and accreditation. At the macro-level, critical reflection on the conceptualization of health is required to know whether response shift needs to be controlled for when PROM data are used to inform healthcare coverage. Conclusion Given empirical evidence of response shift, there is a critical need for guidelines and knowledge translation to avoid potential misinterpretations of PROM results and consequential biases in decision-making. Our framework with guiding questions provides a structure for developing strategies to address potential impacts of response shift at micro-, meso-, and macro-levels.

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Reflections on the national patient-reported outcome measures (PROMs) programme: Where do we go from here?

Cited by 27 publications

References 12 publications

Maximising the impact of patient reported outcome assessment for patients and society

Maximising the impact of patient reported outcome assessment for patients and society

The Role of Patient-Reported Outcomes (PROs) in the Improvement of Healthcare Delivery and Service

Implications of response shift for micro-, meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures

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