Collection and use of EQ-5D for follow-up, decision-making, and quality improvement in health care - the case of the Swedish National Quality Registries

Ernstsson, Olivia; Janssen, Mathieu F.; Heintz, Emelie

doi:10.1186/s41687-020-00231-8

Cited by 25 publications

(17 citation statements)

References 31 publications

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“…Many healthcare systems around the world have been increasingly using patient-reported outcome measures (PROMs) in routine outcome measurement to enhance patient-centered care and incorporate the patient's perspective in health system performance evaluation [1][2][3][4][5][6]. Hundreds of PROMs are available and there are many more in development [7].…”

Section: Introductionmentioning

confidence: 99%

“…The EQ-5D is used as a generic PROM across all surgeries, alongside a condition-specific PROM for each clinical area. In Sweden, national quality registers use EQ-5D as a generic PROM across all registers, alongside condition-specific PROMs in some registers [ 6 ]. In Canada, the Edmonton Symptom Assessment Scale, a generic PROM of symptom burden, is used across all cancer care centers [ 9 ], and a modified version for renal care is collected in many hemodialysis units [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Selection of patient-reported outcome measures (PROMs) for use in health systems

Sayah

Jin

Johnson

2021

J Patient Rep Outcomes

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Many healthcare systems around the world have been increasingly using patient-reported outcome measures (PROMs) in routine outcome measurement to enhance patient-centered care and incorporate the patient’s perspective in health system performance evaluation. One of the key steps in using PROMs in health systems is selecting the appropriate measure(s) to serve the purpose and context of measurement. However, the availability of many PROMs makes this choice rather challenging. Our aim was to provide an integrated approach for PROM(s) selection for use by end-users in health systems.The proposed approach was based on relevant literature and existing guidebooks that addressed PROMs selection in various areas and for various purposes, as well as on our experience working with many health system users of PROMs in Canada. The proposed approach includes the following steps: (1) Establish PROMs selection committee; (2) Identify the focus, scope, and type of PROM measurement; (3) Identify potential PROM(s); (4) Review practical considerations for each of the identified PROMs; (5) Review measurement properties of shortlisted PROMs; (6) Review patient acceptance of shortlisted PROMs; (7) Recommend a PROM(s); and (8) Pilot the selected PROM(s). The selection of appropriate PROMs is one step in the successful implementation of PROMs within health systems, albeit, an essential step. We provide guidance for the selection of PROMs to satisfy all potential usages at the micro (patient-clinician), meso (organization), and macro (system) levels within the health system. Selecting PROMs that satisfy all these purposes is essential to ensure continuity and standardization of measurement over time. This is an iterative process and users should consider all the available information from all presented steps in selecting PROMs. Each of these considerations has a different weight in diverse clinical contexts and settings with various types of patients and resources.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Selection of patient-reported outcome measures (PROMs) for use in health systems

Sayah

Jin

Johnson

2021

J Patient Rep Outcomes

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“…Rationales for GHC and EAU selecting the EQ-5D-5L include the widespread use of the instrument worldwide in cost-utility analysis [10], and its acceptance by key HTA bodies for use in evidence submitted to their decision-making processes [11][12][13]. The EQ-5D-5L is also suitable for use in population health studies, and in routine outcomes measurement in health-care systems (such as the English NHS PROMs programme and Swedish National Quality Registers) [14,15]. A further rationale for selecting the EQ-5D-5L is the availability of an international protocol to support and guide the generation of a value set.…”

Section: Introductionmentioning

confidence: 99%

EQ-5D-5L Health-State Values for the Mexican Population

Gutiérrez-Delgado

Galindo-Suárez

Cruz-Santiago

et al. 2021

Appl Health Econ Health Policy

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Objective To generate a value set for the Mexican adult general population to support and facilitate the inclusion of qualityadjusted life years (QALYs) into the health technology assessment process of the Mexican healthcare authorities. Methods A representative sample of the Mexican adult population stratified by age, sex and socio-economic status was used. Following version 2.0 of the EuroQol EQ-5D-5L valuation protocol, trained interviewers guided participants in completing composite time trade-off (cTTO) and discrete-choice experiment (DCE) tasks included in the EQ-VT software. Generalized least squares, Tobit and Bayesian models were used for cTTO data. The choice of value set model was based on criteria that included: theoretical considerations, parsimony, logical ordering of coefficients, and statistical significance. Results Based on quality control criteria and interviewer judgment, 1000 out of 1032 participants provided useable responses. Participants' demographic characteristics were similar to the 2010 Mexican Population Census and followed the socioeconomic structure defined by the Mexican Association of Marketing Research and Public Opinion Agencies (AMAI). The predicted index values in the final cTTO model (a heteroscedastic censored model with Bayesian estimation) ranged from − 0.5960 to 1, with 19.7% of all predicted health state scores less than 0 (i.e., worse than dead). Conclusion This study has generated the first value set representing the stated preferences of the Mexican adult population for use in estimating QALYs. The resulting EQ-5D-5L value set is technically robust and will facilitate health economic analyses as well as quality-of-life studies.

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“…Globally, there is a growing body of literature on the routine use of PROMs within the rehabilitation context [ 4 ]; however, consistent and standardized use of PROMs in rehabilitation has not been extensively adopted [ 5 ]. In a recent systematic review, Briggs and colleagues report more barriers than facilitators to PROMs use in this setting [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Implementation of EQ-5D-5L as a routine outcome measure in Community Outpatient and Specialized Rehabilitation Services

Churchill

Warner

Keogh

et al. 2021

J Patient Rep Outcomes

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Rehabilitation is a person-centred approach that optimizes functioning to reduce impairments in individuals with illness, injury or disability. Patient-reported outcome measures (PROMs) have a role in rehabilitation to inform clinical practice, enhance patient-centered care, support health services programming, direct performance measurement, and contribute to quality improvement. A Canadian provincial health system implemented a Rehabilitation Model of Care that provides a real-world perspective on the adoption of a standardized PROM, the EuroQol EQ-5D-5L, in the community rehabilitation setting. This article will provide an overview of PROMs implementation in the community rehabilitation context, and discuss key facilitators and challenges to implementation within the 18 early adopter sites and with the spread and scale to 152 urban and rural sites. A change management approach, contextualized local coaching and strong leadership support were facilitators in the initial phases of implementation. Adequate resources and infrastructure from technological platforms for electronic data capture and visualization were assets in addition to clinical teams that had existing strong quality improvement cultures to collect PROMS in existing workflows. Challenges to implementation include the clinical relevance of the PROM, difficulty with contextualization to suit diverse clinical and programmatic teams, and the need for further knowledge sharing activities to build readiness for adoption. The implementation of PROMs in community rehabilitation has added value at the clinical (micro), programmatic (meso) and health system level (macro). Clinically, it has promoted the importance of incorporating the patients’ voice into outcome measurement. At the program level, the cultivation of a data informed learning community was fostered as teams make improvements and use data to inform future program growth or service changes. Finally, at the health system level, data visualization promotes transparency and accountability with performance across the province and the standardized use of the EQ-5D-5L provides a consistent language to promote measurement throughout the health system.

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Collection and use of EQ-5D for follow-up, decision-making, and quality improvement in health care - the case of the Swedish National Quality Registries

Cited by 25 publications

References 31 publications

Selection of patient-reported outcome measures (PROMs) for use in health systems

Selection of patient-reported outcome measures (PROMs) for use in health systems

EQ-5D-5L Health-State Values for the Mexican Population

Implementation of EQ-5D-5L as a routine outcome measure in Community Outpatient and Specialized Rehabilitation Services

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