Choosing Your Partner for the PROM: A Review of Evidence on Patient-Reported Outcome Measures for Use in Primary and Community Care

Abstract

Patient-reported outcome measures (PROMs) are assessments of health status from the patient' s perspective. The systematic and routine collection and use of PROMs in healthcare settings adds value in several ways, including quality improvement and service evaluation. We address the issue of instrument selection for use in primary and/or community settings. Specifically, from the large number of available PROMs, which instrument delivers the highest level of performance and validity? For selected generic PROMs, we reviewed literature on psychometric properties and other instrument features (e.g., health domains captured). Briefly we summarize key strengths of the three PROMs that received the most favourable psychometric and overall evaluation. The Short-Form 36 has a number of strengths, chiefly, its strong psychometric properties such as responsiveness. The PROMIS/Global Health Scale scored highly on most criteria and warrants serious consideration, especially as it is free to use. The EQ-5D scored satisfactorily on many criteria and, beneficially, it has a low response burden. RésuméLes PROM (patient-reported outcome measures) sont des méthodes d' évaluation de l' état de santé du point de vue du patient. Le recours systématique et routinier aux PROM dans les établissements de santé apporte une valeur ajoutée de diverses façons, notamment en ce qui a trait à l' amélioration de la qualité et à l' évaluation des services. Nous nous penchons sur la question du choix d'instrument à utiliser dans les établissements de soins primaires et/ou de soins communautaires. Plus précisément, quel instrument parmi le vaste nombre de PROM disponibles obtient le meilleur rendement et offre la plus grande validité? Nous avons évalué la littérature sur les propriétés psychométriques et autres caractéristiques (par exemple, les domaines de santé saisis) de certains PROM génériques. Nous avons fait un bref sommaire des forces clés des trois PROM qui ont obtenu la meilleure évaluation psychométrique et générale. Le formulaire Short-Form 36 présente plusieurs points forts, notamment ses solides propriétés psychométriques telles que la réactivité. Le PROMIS/Global Health Scale a obtenu un score élevé pour la plupart des critères et mérite une attention particulière, particulière-ment en raison de sa gratuité. L'EQ-5D a obtenu un score satisfaisant pour plusieurs critères et présente un faible fardeau de réponse, ce qui est un avantage.

Validation of the Computerized Adaptive Test for Mental Health in Primary Care

“…40 The CAT-MH was developed using multidimensional item response theory, which permits measurement of complex traits such as depression and anxiety, and allows for much larger item banks than CATs based on unidimensional item response theory. These features offer advantages over other electronic tools that have been tested in primary care, such as the PsyScan e-tool, 59 Patient-Reported Outcome Measure Information System (PROMIS) symptom measures (for which CATs are available), 54,60,61 and the Adaptive Pediatric Symptom Checklist. 62 The potential impact of health-related technologies for improving mental health assessment may be tempered by their limited integration in EHRs, however, as EHRs in many health care systems are not yet capable of integrating stand-alone programs.…”

Adaptação transcultural e validação da escala de Saúde Global do PROMIS para a língua portuguesa

“…A escala de Saúde Global tem sido amplamente utilizada em diferentes contextos 38,39,40,41,42,43 , já que apresenta boas propriedades psicométricas e tempo reduzido para o preenchimento em relação às medidas tradicionais 44 .…”

Key methodological considerations for usability testing of electronic patient-reported outcome (ePRO) systems

“…The use of telehealth could therefore facilitate patient engagement with care which is a key element of delivering patient-centred care. It has also been demonstrated that patient reports of their health could complement clinical and laboratory parameters in routine clinical practice [11,12]. Recent research suggest that the use of ePRO systems could facilitate the remote monitoring of patients [13]; enhance efficiency by reducing the need for hospital appointments [14]; and improve patient outcomes such as quality of life and survival rates [15].…”