Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice

Gibbons, Chris; Porter, Ian; Gonçalves‐Bradley, Daniela C; Stoilov, S; Ricci‐Cabello, Ignacio; Tsangaris, Elena; Gangannagaripalli, Jaheeda; Davey, Antoinette; Gibbons, Elizabeth; Kotzeva, Anna; Evans, Jonathan P; Wees, Philip J. van der; Kontopantelis, Evangelos; Greenhalgh, Joanne; Bower, Peter; Alonso, Jordi; Valderas, José M

doi:10.1002/14651858.cd011589.pub2

Cited by 95 publications

(90 citation statements)

References 242 publications

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“…Implementation of the set could improve patient care by using innovative and multipurpose approaches, including clinical encounters, electronic health records, patient-reported outcome measures feedback, and others [38][39][40]. However, in practice, the utility of the standard set is still to be determined through ongoing evaluation of its implementation [41].…”

Section: Discussionmentioning

confidence: 99%

A Standard Set of Value-Based Patient-Centered Outcomes and Measures of Overall Health in Adults

Gangannagaripalli

Albagli²,

Myers³

et al. 2021

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Background The definition of population-specific outcomes is an essential precondition for the implementation of value-based health care. We developed a minimum standard outcome set for overall adult health (OAH) to facilitate the implementation of value-based health care in tracking, comparing, and improving overall health care outcomes of adults across multiple conditions, which would be of particular relevance for primary care and public health populations. Methods The International Consortium for Health Outcomes Measurement (ICHOM) convened an international panel (patients, clinicians, and topic experts). Following the development of a conceptual framework, a modified Delphi method (supported by public consultations) was implemented to identify, in sequence, the relevant domains, the best instruments for measuring them, the timing of measurement, and the relevant adjustment variables. Findings Outcomes were identified in relation to overall health status and the domains of physical, mental, and social health. Three instruments covering these domains were identified: PROMIS Scale v1.2—Global Health (10 items), WHO Wellbeing Index (5 items), and the WHO Disability Assessment Schedule 2.0 (12 items). Case-mix variables included a range of sociodemographic and biometric measures. Yearly measurement was proposed for all outcomes and most case-mix variables. Interpretation The ICHOM OAH Standard Set has been developed through consensus-based methods based on predefined criteria following high standards for the identification and selection of high-quality measures The involvements of a wide range of stakeholders supports the acceptability of the set, which is readily available for use and feasibility testing in clinical settings. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-021-00554-8.

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Section: Discussionmentioning

confidence: 99%

A Standard Set of Value-Based Patient-Centered Outcomes and Measures of Overall Health in Adults

Gangannagaripalli

Albagli²,

Myers³

et al. 2021

Patient

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“…PROs are direct reports from patients about symptoms, function or well-being with respect to a condition or treatment without interpretation by a clinician or anyone else [2]. Evidence suggests that using PROs in routine care may improve patient-clinician communication, quality of life, symptom burden, patient satisfaction and even survival [3][4][5][6][7]. In these cases, PROs are essentially used as screening tools to help identify problems for further discussion with a clinician that might otherwise go unaddressed.…”

Section: Introductionmentioning

confidence: 99%

Identifying health-related quality of life cut-off scores that indicate the need for supportive care in young adults with cancer

et al. 2022

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Purpose Using patient-reported outcomes in routine cancer care may improve health outcomes. However, a lack of information about which scores are problematic in specific populations can impede use. To facilitate interpretation of the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30), we identified cut-off scores that indicate need for support by comparing each scale to relevant items from the Supportive Care Needs Survey (SCNS-LF59) in a young adult (YA) population. Methods We conducted a cross-sectional survey amongst YAs with cancer ages 25–39 at diagnosis. Participants completed the EORTC QLQ-C30 and SCNS-LF59. Patient, clinician and research experts matched supportive care needs from the SCNS-LF59 to quality of life domains of the EORTC QLQ-C30. We evaluated the EORTC QLQ-C30 domain score’s ability to detect patients with need using receiver operator characteristic (ROC) analysis, calculating the area under the ROC curve and sensitivity and specificity for selected cut-offs. Cut-offs were chosen by maximising Youden’s J statistic and ensuring sensitivity passed 0.70. Sensitivity analyses were conducted to examine the variability of the cut-off scores by treatment status. Results Three hundred and forty-seven YAs took part in the survey. Six experts matched SCNS-LF59 items to ten EORTC QLQ-C30 domains. The AUC ranged from 0.78 to 0.87. Cut-offs selected ranged from 8 (Nausea and Vomiting and Pain) to 97 (Physical Functioning). All had adequate sensitivity (above 0.70) except the Financial Difficulties scale (0.64). Specificity ranged from 0.61 to 0.88. Four of the cut-off scores differed by treatment status. Conclusion Cut-offs with adequate sensitivity were calculated for nine EORTC QLQ-C30 scales for use with YAs with cancer. Cut-offs are key to interpretability and use of the EORTC QLQ-C30 in routine care to identify patients with supportive care need.

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“…Clinicians’ and patients’ perceived benefits of using PROMs for individual patient management include patient involvement and personalized, holistic care [ 14 ]. Patient-facing PROM digital tools may support patient-clinician communication [ 15 ] and improve management of THA/TKA expectations [ 16 ], potentially increasing patient satisfaction with care experiences and health outcomes [ 17 ]. However, one study of a PROM-based feedback report in patients with hip or knee osteoarthritis found no meaningful between-group differences in patient activation, satisfaction, or perceptions of the physician–patient relationship [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, one study of a PROM-based feedback report in patients with hip or knee osteoarthritis found no meaningful between-group differences in patient activation, satisfaction, or perceptions of the physician–patient relationship [ 18 ]. A Cochrane review on PROM feedback across multiple clinical conditions also identified limited to no improvements in patient perceptions of self-efficacy, unmet needs, or satisfaction [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Patients’ perspectives on the benefits of feedback on patient-reported outcome measures in a web-based personalized decision report for hip and knee osteoarthritis

Stern

Pila

Joseph

et al. 2022

BMC Musculoskelet Disord

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Background Applications of patient-reported outcome measures (PROMs) for individual patient management are expanding with the support of digital tools. Providing PROM-based information to patients can potentially improve care experiences and outcomes through informing and activating patients. This study explored patients’ perspectives on the benefits of receiving feedback on PROMs in the context of a web-based personalized decision report to guide care for their hip or knee osteoarthritis. Methods This qualitative descriptive interview study was nested in a pragmatic clinical trial of a personalized report, which includes descriptive PROM scores and predicted postoperative PROM scores. Patients completed a semi-structured interview within 6 weeks of an office visit with an orthopaedic surgeon. Only patients who reported receiving the report and reviewing it with the surgeon and/or a health educator were included. Data were iteratively analyzed using a combination of deductive and inductive coding strategies. Results Twenty-five patients aged 49–82 years (60% female, 72% surgical treatment decision) participated and described three primary benefits of the PROM feedback within the report: 1. Gaining Information About My Health Status, including data teaching new information, confirming what was known, or providing a frame of reference; 2. Fostering Communication Between Patient and Surgeon, encompassing use of the data to set expectations, ask and answer questions, and facilitate shared understanding; and 3. Increasing My Confidence and Trust, relating to the treatment outcomes, treatment decision, and surgeon. Conclusions Patients identified actual and hypothetical benefits of receiving feedback on PROM scores in the context of a web-based decision report, including advantages for those who had already made a treatment decision before seeing the surgeon. Findings provide insight into patients’ perspectives on how digital PROM data can promote patient-centered care. Results should be considered in the context of the homogeneous sample and complex trial. While participants perceived value in this personalized report, questions remain regarding best practices in patient-facing data presentation and engagement. Trial registration ClinicalTrials.gov, NCT03102580. Registered on 5 April 2017.

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Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice

Abstract: DC et al. (14 more authors) (2021) Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice. Cochrane Database of Systematic Reviews, 2021 (10). ARTN CD011589.

Cited by 95 publications

References 242 publications

A Standard Set of Value-Based Patient-Centered Outcomes and Measures of Overall Health in Adults

A Standard Set of Value-Based Patient-Centered Outcomes and Measures of Overall Health in Adults

Identifying health-related quality of life cut-off scores that indicate the need for supportive care in young adults with cancer

Patients’ perspectives on the benefits of feedback on patient-reported outcome measures in a web-based personalized decision report for hip and knee osteoarthritis

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