The recent book, patientreported outcomes, measurement, implementation and interpretation, by cappelleri and his colleagues is a timely synthesis of the current thinking and practice of psychometrics applied to patient reported outcomes pros, and pro data analysis. The validation and use of patient reported outcome and. This book addresses the major methodological issues related to choosing, administering, and. Patientreported outcomes in performance measurement kindle. The second paper, patientreported outcomes in performance measurement, 9 dealt with issues relating to processes for endorsing performance measures that reflect the end results ultimate outcomes of health care. Patient reported outcomes means the measurement of any aspect of a patients health status that comes directly from the patient. Several canadian initiatives are in place, including the canadian partnership against cancers efforts, in conjunction with other partners, to develop common quality. The patient reported outcomes measurement information system promis david cella,phd northwestern university, chicago, il, usa. Browse the amazon editors picks for the best books of 2019, featuring our favorite reads in more. It can be used with the general population and with individuals living with chronic conditions.
Pros are reports, usually on questionnaires, about a patients health conditions, health behaviors, or experiences with health care that individuals report directly, without modification of responses by clinicians or others. The development took a systematic approach, drawing from instruments already in use. Our international study showed that experts in clinical practice and performance measurement supported the integrated collection of pro data for use in both clinical care and performance measurement. Only title to exclusively introduce, explain and show how pros can be best used to improve healthcare and patient outcomes includes real life examples and case studies of pros in practice assesses the growing evidence base for pros in practice editor. Jul 16, 2019 patient performance status is routinely used in oncology to estimate physical functioning, an important factor in clinical treatment decisions and eligibility for clinical trials. A headtohead comparison of the psychometric performance and patient acceptability of the catprom5 and catquest9sf selfreport questionnaires. The patientreported outcomes measurement information system promis is an nihfunded initiative to develop and validate patient reported outcomes pros for clinical research and practice. Lohr this book addresses the major methodological issues related to choosing, administering, and using patientreported outcomes pros, particularly in clinical practice settings. Hi, my name is david victorson and this talk will focus on patient reported outcomes tools for measurement of healthrelated quality of life. Understanding patient perspective is integral to delivering highvalue patient centered care. Patientreported outcome pro a measurement based on a report that comes directly from the patient i.
Patient reported outcome measures in rare diseases. Health outcomes core library recommendations, 2011. This publication is part of the rti press book series. The patient reported outcomes measurement information. Compiled by academyhealth funded by the national library of medicine. Us payer perspectives may be changing based on changes in the us healthcare. Patient reported outcome measures in the clinical setting. Pdf cataract surgery patientreported outcome measures.
Patient reported outcome measures proms have the potential to systematically incorporate patient input for improvement in both quality and cost of care. These outcomes are intended to assess the goodness of life from the patients perspective. The responsiveness of the promis instruments and the qdash in. Patientreported outcomes rethinking clinical trials. Designed to fill information gaps in traditional clinical quality measures, this data serves to measure how a treatment impacted a patients quality of life. Integrating the use of patientreported outcomes for both. Using patient reported outcomes to improve health care.
Patientreported outcomes for performance measurement. It stands in contrast to an outcome reported by someone else, such as a physicianreported outcome, a nursereported outcome, and so on. Patientreported outcomebased performance measures for. An introduction patient reported outcome measures proms. Pro methods, such as questionnaires, are used in clinical trials or other clinical settings, to help better understand a treatments efficacy or. Promis aims to enhance and standardize measurement of several selected pros through both computer adaptive testing and traditional paper and pencil instruments. In addition, patients completed the patient reported outcomes measurement information system10 promis10 and hip disability and osteoarthritis outcomes score junior hoosjr assessments.
This transnih initiative aims to use irt, item banks, and computer adaptive testing to measure patientreported symptoms such as pain and fatigue and aspects of health related quality of life across a wide variety of chronic diseases and conditions. Patient reported outcome measurement system promis valid. By 2004, the battle to give patientreported outcomes pros their due place in the assessment of copd patients for research studies and trials had been won. No part of this book may be reproduced in any form by any electronic or. Performance of a patient reported outcomes measurement. Patient reported outcomes in performance measurement. Table 1, definitions and key concepts for patientreported. The increasing integration of health care delivery systems provides an opportunity to manage entire episodes of care in a patientfocused manner and to assess the impact of care on patient outcomes, including patientreported outcomes pros.
In other words, without the interpretation of the patients responses by a specialist or anyone else. Only title to exclusively introduce, explain and show how pros can be best used to improve healthcare and patient outcomes. Patient reported outcomes pros tools for measurement of. The role of patientreported outcome measures in value. Pros are reports, usually on questionnaires, about a patients. Statistical topics in health economics and outcomes research. Standards for patientreported outcomebased performance. Patientreported outcomes in performance measurement ebook.
Qol is an important indicator of quality of care and a major dimension when assessing patient reported outcomes, particularly in older people as global outcome measure for interventions. Research to develop a patientreported outcomes measurement information system promis network. Social function dexterity physical function cognitive function pain the charge. With patient reported outcomes pros becoming more common in clinical trials and fda accepting pros to be included in the labeling claims of a new drug or medical device, it is essential that health care providers should have a basic knowledge in developing pro instruments. Patientreported outcomes pros are measures of how patients feel or what they. Patientreported and proxyreported outcome measures for the. Northwestern university feinberg school of medicine. Patientreported outcomes pros are defined as any report of the status of a patient s health condition that comes directly from the patient, without interpretation of the patient s response by a clinician or anyone else. One example is the percentage of patients in an accountable care organization with an improved depression score as measured by a standardized tool such as the phq9. All patients undergoing tha during this time period were eligible for inclusion.
New publication promis health organization pho, il. Patientreported outcomes in performance measurement david cella, elizabeth a. Jul 06, 2010 an introduction to the key concepts of patient reported outcome measures, including reliability and validity, generic versus disease specific,selection criteri slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Us payers have traditionally not viewed pros as relevant in determining patient access to a drug. Promis addressed a need in the clinical research community for a rigorously tested patient reported outcome pro measurement tool that uses recent advances in information technology. A patientreported outcome pro is a health outcome directly reported by the patient who experienced it. Patient reported and proxy reported outcome measures are also used in the context of enteral feeding. Patientreported outcomes in performance measurement ncbi. Improving quality, service, and patient outcomes is an important focus for health care providers. Proms capture the patients perspective of the impact of care on quality of life and ability to function.
Patientreported outcome measures proms have the potential to systematically incorporate patient input for improvement in both quality and cost of care. However, validity and reliability data for ratings of performance status have not been optimal. Sep 21, 2015 to get a sense of the power of patientreported outcomes data thats collected on a large scale, consider the spine patient outcomes research trial. Cappelleri, phd, mph, ms is executive director in the statistical research and data science center at pfizer inc. Pro data are used to inform and guide patient centered care, clinical decisionmaking, and health.
The impact of measuring patientreported outcome measures on. Even before earnest codman introduced the idea of the end result in 1917, orthopedic surgeons were tracking and publishing the outcomes of their surgical interventions. Lohr this book addresses the major methodological issues related to choosing, administering, and using patient reported outcomes pros, particularly in clinical practice settings. David f cella patientreported outcomes pros are measures of how patients feel or what they are able to do in the context of their health status. View and listen to the powerpoint presentation 60mb transcript. Patientreported outcome measures and patientreported. The thoughts or feelings about self and the world in the context of environmental or internal challenges. Patientreported outcomes measurement information system. Developed and validated with stateofthescience methods to be psychometrically sound and. Pdf patientreported outcomes in performance measurement. Performance measures are important tools for guiding, assessing, and incentivizing improvements in health care delivery and outcomes. The following measures are examples of focus areas to achieve these goals. Patient reported outcomes can improve performance status.
Transform clinical research with crosscutting pros. At the request of the national information center for health services research and health care technology nichsr at the national library of medicine nlm, academyhealth has updated a list of books, journals, and websites intended to serve as the basis of a. Performance based measures and patient reported measures both capture a current status. The initial results may help determine the course of treatment intervention.
Patientreported outcome measures proms are hot topics in both research and practice. Use of patientreported outcome measures in nontuberculous. The role of patientreported outcome measures in valuebased. Jan 01, 2018 patient reported outcome measures proms are becoming more prevalent, with emerging evidence to suggest that their measurement improves outcomes that are important to patients. Patient reported outcomes healthpartners institute. Interpreting clinically significant changes in patient. Patient reported outcomes in performance measurement ebook. Pros are measures of how patients feel or what they are able to do as they are dealing with chronic diseases or conditions. Patientreported outcomes pros are measures of how patients feel or what they are able to do in the context of their health status.
Clinicians understanding of the effect of disease and treatment on patients daily lives is poor. Collection and analysis of patientreported outcome pro measures is. The patient reported outcome pro is a standardized method for measuring patients views of their health status. Standards for patientreported outcomebased performance measures article pdf available in jama the journal of the american medical association 3102. Payers outside of the us view patient reported outcomes pros as relevant in determining patient access to a drug. To assess reliability, validity, and responsiveness of a 29item shortform version of the patient reported outcomes measurement information system promis and a novel impact score calculated from those measures. Patientreported outcomes pros are defined as any report of the status of a patients health condition that comes directly from the patient, without interpretation of the patients response by a clinician or anyone else. The nci supports the development of the patient reported outcomes measurement information system promis, most recently funding a study to validate promis measures in diverse populations of patients with cancer. A childs momentary positive or rewarding affective experiences, such as feelings and mood associated with pleasure, joy, elation, contentment, pride, affection, happiness, engagement, and excitement. Patientcentered outcomes in copd journal of the copd.
It is not new, nor soft, nor subjective in the negative sense with which that term is used to describe the data. Patientreported outcomes in performance measurement. How hospitals are using patientreported outcomes to. Patientreported data can help people make better health care. An outcome measure is a tool used to assess a patients current status1.
Quality measurement and incentives have been instrumental in improving the quality of care. Exploring patient reported outcomes measures in healthcare. Patientcenteredness is a national interest in medicine. July 05, 2017 patientreported outcomes measures proms are a fledgling clinical quality measure in the healthcare industry. How hospitals are using patientreported outcomes to improve care. A performance measure that is based on patient reported outcomes assessed through data often collected through a prom and then aggregated for an accountable health care entity. Cleveland clinic health system uses a systematic approach to performance improvement while simultaneously pursuing 3 goals. The strengths and limitations of forced expiratory volume in 1 second fev 1 measurement had become recognized and even the terminology was being used. Patient performance status is routinely used in oncology to estimate physical functioning, an important factor in clinical treatment decisions and eligibility for clinical trials. Outcome measures may provide a score, an interpretation of results and at times a risk categorization of the patient.
Patientreported outcome measures proms are defined as standardized, validated questionnaires which are also called instruments completed by patients to measure their perception of their functional wellbeing and health status national health service, 2009. The common funds patientreported outcomes measurement information system promis program created new paradigms for how clinical research information is collected, used, and reported. The nhs outcomes framework to improve quality of care can be broadly divided into clinical effectiveness, safety, and patient experience. They are, however, based on subjectively collected data with potential for invalid unreliable measurement and may experience uncontrolled sampling response bias that is not always fully understood. David cella, elizabeth hahn, sally jensen, zeeshan butt, cindy nowinski, nan rothrock, kathleen lohr. Patientreported outcome measures proms and patientreported experience measures prems, provide information about patients perspectives of their quality of life qol and healthcare experiences without prior interpretation by a clinician or any other person.
This study recruited oncology patients who were about to begin emetogenic palliative or adjuvant chemotherapy for. Discussion among conference participants echoed previous expert opinions that evaluation of a proposed prom for performance measurement must take into account the intended context of use. Methods for developing patientreported outcomebased. Rather, effective pro assessment stems from a conceptual framework that explains and predicts patient behavior. Additional databases include the patient reported outcomes measurement information system promis which is a cooperative group program of research which aims to develop, validate and standardise item banks to capture prom data across a wide range of conditions and domains for use in a range of chronic disorders and conditions. Prior to providing any intervention, an outcome measure provides baseline data. David f cella patient reported outcomes pros are measures of how patients feel or what they are able to do in the context of their health status. These measures do not typically equate with each other.
A performance measure that is based on patientreported outcomes assessed through data often collected through a prom and then aggregated for an accountable health care entity. A practical, introductory guide to the best use of patient reported outcomes pros to improve the quality of health care and patient health. Written primarily by statisticians drawn from the same large multinational pharmaceutical company, the book is squarely aimed at health economists, outcomes researchers and statisticians in the industry who may require a. Performance based measures tend to bring to light physiologic factors. Patient reported outcome measures may capture a patient s perception, beliefs, social factors andor health factors. Introduction patientreported outcomes in performance.
More recently, focus has turned to patientreported outcome measures proms, especially given the increased attention to value in health care. Nov 28, 2017 the patient reported outcomes measurement information system promis health measure improvement initiative was funded by the national institutes of health with the purpose of improving the quality of pros. Patients rate their health by scoring the severity or difficulty in completing certain tasks or routine activities. The second paper, patient reported outcomes in performance measurement, 9 dealt with issues relating to processes for endorsing performance measures that reflect the end results ultimate outcomes of health care. Many argue that a key feature of pro data is that they are not interpreted by a clinician or any other person. This book addresses the major methodological issues related to choosing, administering, and using patientreported outcomes pros, particularly in clinical practice settings. We may not be able to make you love reading, but patient reported outcomes in performance measurement will lead you to love reading starting from now. Includes real life examples and case studies of pros in practice. Using patient reported outcomes to improve health care wiley. Cataract surgery patient reported outcome measures. Patient reported outcome measures in practice the bmj. Value and use of patient reported outcomes pros in.
The second paper, patientreported outcomes in performance measurement. Patient reported outcomes typically include information about healthrelated quality of life hrqol, symptoms, function, satisfaction with care or symptoms, adherence to prescribed medications or other therapy, and perceived value of treatment. A pro is, a measurement based on a report that comes directly from the patient i. A wide variety of both generic and conditionspecific proms are used. Patientreported outcomes pros are selfreported measures of a patients health or healthcare experience. Ispor patient reported outcomes instrument development.
Probased performance measure propm a performance measure that is based on patientreported outcomes assessed through data often collected through a prom and then aggregated for an accountable health care entity. Its primary focus was on accountable health care organizations. However, the measurement of true outcomes, including patientreported outcomes patients own accounting of their symptoms, functional status, and quality of life can and should be a. A study at hospital for special surgery hss evaluating the patient reported outcomes measurement information system promis in patients with lupus finds that the questionnaire is valid in. Patient reported outcomes in performance measurement david cella, elizabeth a. The role of patientreported outcome measures in valuebased payment reform. Methods for integrating pros into performance measurement are available. Oct 23, 2017 however, the measurement of true outcomes, including patientreported outcomes patients own accounting of their symptoms, functional status, and quality of life can and should be a.