A review of systematic reviews on the effects of patient‐reported outcome monitoring with clinical feedback systems on health‐related quality of life—implications for a novel technology in obesity treatment

Abstract

Patient-reported outcome monitoring with clinical feedback systems (PRO/CFS) has been employed in many disease states to measure and improve health-related quality of life (HRQOL). Exploring the role of PRO/CFS in treatment for obesity may prove valuable. Systematic reviews were summarized to determine the effectiveness of PRO/CFS on HRQOL in any disease area. Primary studies evaluating the effect of PRO/CFS on HRQOL in treatment for obesity were also considered for inclusion. Systematic searches were performed in The Cochrane Library, PROSPERO, Epistemonikos, HTA, DARE, CINAHL, Medline, Embase, PsycINFO, BMJ Clinical Evidence, PDQ-Evidence and PubPsych. Two reviewers independently screened references until final inclusion and critically appraised included reviews using PRISMA checklist. Five systematic reviews and no primary studies met inclusion criteria. Although results were inconsistent, effectiveness of PRO/CFS on HRQOL was demonstrated in some diseases/treatments (e.g. psychiatric treatment; symptom burden in cancer treatment). No trials using PRO/CFS in treatment for obesity were identified. In some trials, PRO/CFS was not fully integrated into consultations, thereby PRO/CFS was not extensively studied. General effectiveness of PRO/CFS on HRQOL is inconclusive due to heterogeneous and statistically insignificant findings, and lack of stringency in conceptualization and execution of PRO/CFS. There are no data relevant to treatment for obesity. Future studies should use rigorous methodology to examine the effectiveness of PRO/CFS in treatment for obesity.

Initial quantitative development of the Norse Feedback system: a novel clinical feedback system for routine mental healthcare

“…However, the DIF effect size was small: McFadden's R 2 change for uniform DIF was 0.01, and for non-uniform DIF this value was 0.003. 2 On the scale scores, these differences amounted to less than one scale point at most, and when weighted by density of responses, result in negligible changes to scores. The test characteristic curve using all items appears to be nearly unaffected by this difference.…”

A novel patient-reported outcome monitoring with clinical feedback system in bariatric surgery care: study protocol, design and plan for evaluation

“…Based on a systematic review of the PRO/CFS literature, the authors proposed three elements as being important for the successful implementation of PRO/CFS: (i) patient-reported outcomes should be routinely collected before all consultations, preferably digitally, (ii) the report should be available to both the patient and clinician during the consultation and (iii) patient-reported data and their implications should be discussed during the consultation. 3 Considering these suggestions for the current study, we argue that in addition patient-reported outcomes should be understood in the context of normative data-that is, how similar or different is this patient's scores from other patients with the same condition and/or the healthy population.…”

“…One strategy to structure the follow-up of patients after bariatric surgery is to implement a PRO/CFS to optimise HRQOL and mental health outcomes. 3 In a recent overview of systematic reviews assessing the effectiveness of PRO/CFS on HRQOL, the authors found that the understanding and use of a PRO/CFS was quite variable across the included studies in both somatic and mental health services. The authors recommended that future studies should include detailed descriptions on how the concept of PRO/CFS is understood by the researchers 3 to clarify if the actual phenomenon of PRO/CFS is being studied.…”

“…3 In a recent overview of systematic reviews assessing the effectiveness of PRO/CFS on HRQOL, the authors found that the understanding and use of a PRO/CFS was quite variable across the included studies in both somatic and mental health services. The authors recommended that future studies should include detailed descriptions on how the concept of PRO/CFS is understood by the researchers 3 to clarify if the actual phenomenon of PRO/CFS is being studied. Based on a systematic review of the PRO/CFS literature, the authors proposed three elements as being important for the successful implementation of PRO/CFS: (i) patient-reported outcomes should be routinely collected before all consultations, preferably digitally, (ii) the report should be available to both the patient and clinician during the consultation and (iii) patient-reported data and their implications should be discussed during the consultation.…”

“…2 PRO/CFSs have been implemented in several healthcare services to assess mental health, somatic symptoms and health-related quality of life (HRQOL). 3 A systematic review of qualitative studies found that healthcare professionals experienced clinical use of PROMS as useful when they were intended to guide patient management and when findings were presented clearly. Sufficient training in use and interpretation were also considered strengths and limitations of this study ► The involvement of patients and healthcare professionals in the design of the patient-reported outcome monitoring with a clinical feedback system (PRO/CFS) is a strength.…”