Patient-reported outcome
Patient-reported outcomes (PROs) are measures of health status, physical functioning, symptoms, and treatment experiences reported directly by patients, without interpretation from healthcare providers. These outcomes are typically captured through tools known as patient-reported outcome measures (PROMs), which include surveys, questionnaires, and diaries. Initially developed for medical research to evaluate treatment effectiveness, PROMs have become essential in clinical settings, enabling providers to gather valuable patient feedback and enhance care quality.
Patients use PROMs to communicate various aspects of their health, including symptoms, treatment satisfaction, and overall quality of life. Typically administered before and after treatment, these measures enable comparisons that assess the impact of interventions. Furthermore, PROMs facilitate communication between patients and clinicians by highlighting what patients prioritize regarding their conditions and treatments.
There are different types of PROMs, including disease-specific, condition-specific, and generic measures, each tailored to capture relevant patient experiences. The National Institutes of Health supports the patient-reported outcomes measurement information system (PROMIS), which aggregates national data to help clinicians evaluate treatment outcomes. Ultimately, PROs represent a shift towards recognizing patients as vital stakeholders in their healthcare, fostering a more patient-centered approach to medical treatment.
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Subject Terms
Patient-reported outcome
Patient-reported outcomes record the status of a patient’s health, physical functioning, symptoms, and treatment experience as reported by the patient without the interpretation of doctors or other health care professionals. Patient-reported outcome measures (PROMs), which include surveys, questionnaires, diaries, and other assessments, were initially developed for use in medical research to assess the efficacy of various treatment models. PROMs are also used to collect patient feedback for the purposes of clinical management.
Overview
Patient-reported outcome measures are increasingly used in medical research and health clinics to inform clinical treatments and improve patient care. With PROMs, patients can report their symptoms, side effects, activity limitations, functional status, levels of anxiety or depression, treatment satisfaction and compliance, and overall quality of life. PROMs are completed at least twice, typically before and after treatment, to enable comparisons and the measurement of a treatment plan’s benefits. PROMs also help to facilitate communication between patients and clinicians and to highlight what is most important to patients about a condition and its treatment. PROMs are useful in helping doctors and researchers to understand the effects of treatments that are not captured by traditional clinical measures, which include survival rates, disease indicators, clinician ratings, and physiological-based measures.
PROMs are typically used as a secondary outcome measure to supplement traditional clinical measures, but PROMs have occasionally been used as a primary outcome in clinical trials when there is no appropriate traditional measure. Patient-reported outcomes may be collected using a measure that is disease-specific, condition-specific, or generic. Condition-specific measures capture patient experiences related to a particular health condition, such as lower-back pain, and its related treatment, therapy, or surgery. Disease-specific measures focus on symptoms, severity, and activity limitations as well as patient compliance in taking the prescribed medications. Generic measures may be adapted for use with any disease, condition, or population sample.
PROMs are designed to measure a specific construct in a standardized way. With proper instrument development and testing, PROMs have a high degree of validity. PROMs are significant in that they provide a way to quantify qualitative information. The US National Institutes of Health has established the patient-reported outcomes measurement information system (PROMIS) to aggregate data at a national level and to provide open-source, public-domain access to PROMs. The aggregation of results from many patients allows clinicians to evaluate outcomes by age, gender, symptom severity, and other factors, facilitating the selection of the most appropriate treatment. The data collected from PROMs are also useful to patients, enabling them to make comparisons of various providers’ performances and the relative merits of various treatment options. PROMs reflect the growing trend in clinical management that recognizes patients as primary stakeholders in medical care.
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