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Mao S, Liu L, Miao C, Wang T, Chen Y, Jiang Z, Hua C, Li C, Cao Y. Electronic symptom monitoring for home-based palliative care: A systematic review. Palliat Med 2024:2692163241257578. [PMID: 38835179 DOI: 10.1177/02692163241257578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
BACKGROUND Coordination and communication challenges in home-based palliative care complicate transitions from hospital care. Electronic symptom monitoring enables real-time data collection, enhancing patient-provider communication. However, a systematic evaluation of its effectiveness in home-based palliative care is lacking. AIM To analyze the feasibility, effectiveness, and limitations of electronic symptom monitoring in home-based palliative care, assess the evidence quality, identify the evidence gap, and suggest implications for future research and practice. DESIGN This study uses systematic review, meta-analysis, and narrative synthesis (CRD42023457977) to analyze relevant studies until September 2023. DATA SOURCES Electronic searches in MEDLINE, CENTRAL, and Embase until September 2023, complemented by hand-searching of references and citations. RESULTS This study included twenty studies. The majority of patients positively engage in electronic symptom monitoring, which could improve their quality of life, physical and emotional well-being, and symptom scores without a significant increase in costs. However, firm conclusions about the effects of electronic symptom monitoring on outcomes like survival, hospital admissions, length of stay, emergency visits, and adverse events were limited due to significant variability in the reported data or inadequate statistical power. CONCLUSION Introducing electronic symptom monitoring in home-based palliative care holds potential for enhancing patient-reported outcomes, potentially decreasing hospital visits and costs. However, inconsistency in current studies arising from diverse monitoring systems obstructs comparability. To advance, future high-quality research should employ standardized follow-up periods and established scales to better grasp the benefits of electronic symptom monitoring in home-based palliative care.
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Affiliation(s)
- Suning Mao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Cheng Miao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tianyi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhishen Jiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chengge Hua
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Dental Emergency and General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Evidence-Based Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chunjie Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Evidence-Based Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yubin Cao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Evidence-Based Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Terwee CB, Roorda LD. Country-specific reference values for PROMIS ® pain, physical function and participation measures compared to US reference values. Ann Med 2023; 55:1-11. [PMID: 36426680 PMCID: PMC9704075 DOI: 10.1080/07853890.2022.2149849] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Patient-Reported Outcomes Measurement Information System (PROMIS®) is commonly used across medical conditions. To facilitate interpretation of scores across countries, we calculated Dutch reference values for PROMIS Physical Function (PROMIS-PF), Pain Interference (PROMIS-PI), Pain Behavior (PROMIS-PB), Ability to Participate in Social Roles and Activities (PROMIS-APSRA), and Satisfaction with Social Roles and Activities (PROMIS-SSRA), as compared to US reference values. PATIENTS AND METHODS A panel completed full PROMIS-PF (n=1310), PROMIS-PI and PROMIS-PB (n=1052), and PROMIS-APSRA and PROMIS-SSRA (n=1002) item banks and reported their level of health per domain (no, mild, moderate, severe limitations). T-scores were calculated by sample and subgroups (age, gender, self-reported level of domain). Distribution-based and anchor-based thresholds for mild, moderate, and severe scores were determined. RESULTS Mean T-scores were close to the US mean of 50 for PROMIS-PF (49.8) and PROMIS-APSRA (50.6), lower for PROMIS-SSRA (47.5) and higher for PROMIS-PI (54.9) and PROMIS-PB (52.0). Distribution-based thresholds for mild, moderate, and severe scores were comparable to US recommended cut-off values (except for PROMIS-PI) but participants reported limitations 'earlier' than suggested thresholds. CONCLUSION Dutch reference values were close to US reference values for some PROMIS domains but not all. We recommend country-specific reference values to facilitate worldwide PROMIS use.KEY MESSAGESPROMIS offers universally applicable IRT-based efficient and patient-friendly measures to assess commonly relevant patient-reported outcomes across medical conditions.To support the use of PROMIS in daily clinical practice and research across the world, country-specific general population reference values should be obtained.More research is necessary to obtain reliable and valid cut-off values for what constitutes mild, moderate and severe scores from the patients' perspective.
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Affiliation(s)
- Caroline B Terwee
- Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
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Ciani O, Meregaglia M, Battaglia MA, Brichetto G, Conte A, Gasperini C, Sansone V. Patient-reported outcome measures in drugs for neurological conditions approved by European Medicines Agency 2017-2022. Neurol Sci 2023:10.1007/s10072-023-06825-6. [PMID: 37145229 DOI: 10.1007/s10072-023-06825-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Regulatory agencies have been responsive to public demand for inclusion of the patient experience in evaluating and approving therapies. Over the years, patient-reported outcome measures (PROMs) have become increasingly prevalent in clinical trial protocols; however, their influence on regulators, payers, clinicians, and patients' decision-making is not always clear. We recently conducted a cross-sectional study aimed at investigating the use of PROMs in new regulatory approvals of drugs for neurological conditions between 2017 and 2022 in Europe. METHODS We reviewed European Public Assessment Reports (EPARs) and recorded on a predefined data extraction form whether they considered PROMs, their characteristics (e.g., primary/secondary endpoint, generic/specific instrument) and other relevant information (e.g., therapeutic area, generic/biosimilar, orphan status). Results were tabulated and summarized by means of descriptive statistics. RESULTS Of the 500 EPARs related to authorized medicines between January 2017 and December 2022, 42 (8%) concerned neurological indications. Among the EPARs of these products, 24 (57%) reported any use of PROMs, typically considered as secondary (38%) endpoints. In total, 100 PROMs were identified, of which the most common were the EQ-5D (9%), the SF-36 (6%), or its shorter adaptation SF-12, the PedsQL (4%). CONCLUSIONS Compared to other disease areas, neurology is one where the use of patient-reported outcomes evidence is inherently part of the clinical evaluation and for which core outcome sets exist. Better harmonization of the instruments recommended for use would facilitate the consideration of PROMs at all stages in the drug development process.
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Affiliation(s)
- Oriana Ciani
- Government, Health & Not-for-Profit Division, Center for Research On Health and Social Care Management, SDA Bocconi School of Management, Health Economics & HTA, MEO Building, Room W210, II Floor, Via Sarfatti 10, 20136, Milan, Italy.
| | - Michela Meregaglia
- Government, Health & Not-for-Profit Division, Center for Research On Health and Social Care Management, SDA Bocconi School of Management, Health Economics & HTA, MEO Building, Room W210, II Floor, Via Sarfatti 10, 20136, Milan, Italy
| | | | - Gianpaolo Brichetto
- Associazione Italiana Sclerosi Multipla (AISM) Rehabilitation Center, Genoa, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
- Italian Society of Neurology (SIN), Siena, Italy
| | - Claudio Gasperini
- Italian Society of Neurology (SIN), Siena, Italy
- Department of Neurosciences, S. Camillo Forlanini Hospital, Rome, Italy
| | - Valeria Sansone
- NeMO Clinical Center, Neurorehabilitation Unit, University of Milan, Milan, Italy
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van Zyl C, Mokkink LB, Derman W, Hanekom S, Heine M. Patient-Reported Outcome Measures in Key Sub-Saharan African Languages to Promote Diversity: A Scoping Review. Value Health Reg Issues 2023; 34:86-99. [PMID: 36621214 DOI: 10.1016/j.vhri.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/12/2022] [Accepted: 11/24/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Sub-Saharan Africa is a world region rich and diverse in cultures and languages; yet, it is also challenged with regard to resources that may facilitate the cultural adaptation or development of patient-reported outcome measures (PROMs). Systematic exclusion of patients' "voices," because of gaps in the availability of PROMs, may perpetuate health inequity. Hence, the objective is to describe the availability of PROMs in the non-English, sub-Saharan African languages. METHODS A scoping review was conducted to identify PROMs that had been translated, validated, or developed for use in 32 selected, non-English, sub-Saharan African languages pertaining to health outcomes. Four databases were searched (May 7, 2021), and additional articles were identified through reference screening and via corresponding authors. Data were extracted in terms of country, language, population, construct, and PROM characteristics (eg, number of items). RESULTS A total of 220 unique articles were included from 7451 records, leading to the identification of 126 unique PROMs. Most studies were conducted in either Ethiopia, Nigeria, or South Africa. As such, prevalent languages included Amharic, Yoruba, and non-English languages common to South Africa (eg, Setswana, Xhosa, and Zulu). No PROMs were identified in any of the languages for 27 sub-Saharan African countries or 10 of the 32 included languages. CONCLUSIONS There are significant gaps in the availability of PROMs across the non-English African languages included. Nevertheless, the PROMs that were identified largely align with core outcome sets relevant to the prevalent disease burden in this world region. Consensus-based priority setting may inform the most pertinent gaps to be addressed.
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Affiliation(s)
- Chanel van Zyl
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lidwine B Mokkink
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa; IOC Research Center, Cape Town, South Africa
| | - Susan Hanekom
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Martin Heine
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa; Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
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Oude Voshaar M, Terwee CB, Haverman L, van der Kolk B, Harkes M, van Woerden CS, van Breda F, Breukink S, de Hoop I, Vermeulen H, de Graaf E, Hazelzet J, van Leiden B, Stienen J, Hoekstra M, Bart H, van Bommel H, Determann D, Verburg M, van der Wees P, Beurskens AJ. Development of a standard set of PROs and generic PROMs for Dutch medical specialist care : Recommendations from the Outcome-Based Healthcare Program Working Group Generic PROMs. Qual Life Res 2023; 32:1595-1605. [PMID: 36757571 PMCID: PMC10172289 DOI: 10.1007/s11136-022-03328-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE The added value of measuring patient-reported outcomes (PROs) for delivering patient-centered care and assessment of healthcare quality is increasingly evident. However, healthcare system wide data collection initiatives are hampered by the proliferation of patient-reported outcome measures (PROMs) and conflicting data collection standards. As part of a national initiative of the Dutch Ministry of Health, Welfare and Sport we developed a consensus-based standard set of generic PROs and PROMs to be implemented across Dutch medical specialist care. METHODS A working group of mandated representatives of umbrella organizations involved in Dutch medical specialist care, together with PROM experts and patient organizations worked through a structured, consensus-driven co-creation process. This included literature reviews, online expert and working group meetings, and feedback from national patient- and umbrella organizations. The 'PROM-cycle' methodology was used to select feasible, valid, and reliable PROMs to obtain domain scores for each of the PROs included in the set. RESULTS Eight PROs across different domains of health were ultimately endorsed: symptoms (pain & fatigue), functioning (physical, social/participation, mental [anxiety & depression]), and overarching (quality of life & perceived overall health). A limited number of generic PROMs was endorsed. PROMIS short forms were selected as the preferred instruments for all PROs. Several recommendations were formulated to facilitate healthcare system level adoption and implementation of the standard set. CONCLUSIONS We developed a consensus-based standard set of Generic PROMs and a set of recommendations to facilitate healthcare system wide implementation across Dutch medical specialist care.
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Affiliation(s)
- Martijn Oude Voshaar
- National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands.
- Department of Medical Cell BioPhysics & TechMed Center, University of Twente, Enschede, The Netherlands.
| | - Caroline B Terwee
- National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit, Amsterdam, the Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Lotte Haverman
- National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands
- Dutch Society of Medical Specialists, Amphia Hospital, Utrecht, The Netherlands
- Dutch Nurses' Association, Amphia Hospital, Utrecht, The Netherlands
| | - Bas van der Kolk
- National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands
| | - Marleen Harkes
- Dutch Society of Medical Specialists, Amphia Hospital, Utrecht, The Netherlands
| | | | - Fenna van Breda
- Dutch Society of Medical Specialists, Amphia Hospital, Utrecht, The Netherlands
| | - Stephanie Breukink
- Dutch Society of Medical Specialists, Amphia Hospital, Utrecht, The Netherlands
| | - Irma de Hoop
- Dutch Nurses' Association, Amphia Hospital, Utrecht, The Netherlands
| | - Hester Vermeulen
- Dutch Nurses' Association, Amphia Hospital, Utrecht, The Netherlands
| | - Evelien de Graaf
- Dutch Nurses' Association, Amphia Hospital, Utrecht, The Netherlands
| | - Jan Hazelzet
- Dutch Federation of University Medical Centres, Utrecht, The Netherlands
| | | | - Jozette Stienen
- Dutch Hospital Association &, Amphia Hospital, Breda, The Netherlands
| | | | - Hans Bart
- The Netherlands Patients Federation, Utrecht, The Netherlands
| | - Hester van Bommel
- Pharos - Dutch Centre of Expertise On Health Disparities, Utrecht, The Netherlands
| | - Domino Determann
- National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands
| | - Mariët Verburg
- National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands
| | - Philip van der Wees
- National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare and Department of Rehabilitation, Nijmegen, The Netherlands
| | - Anna J Beurskens
- National Health Care Institute (Zorginstituut Nederland), Diemen, The Netherlands
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Thrush A, Steenbergen E. Clinical Properties of the 6-Clicks and Functional Status Score for the ICU in a Hospital in the United Arab Emirates. Arch Phys Med Rehabil 2022; 103:2404-2409. [PMID: 35613651 DOI: 10.1016/j.apmr.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/14/2022] [Accepted: 04/02/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine measurement properties of the Activity Measure for Post-Acute Care Inpatient Mobility Short Form (6-clicks) and Functional Status Score for the Intensive Care Unit (FSS-ICU). DESIGN Retrospective analysis of scores from a cohort of patients over 24 months. Outcome measures were administered to patients referred to physical therapy on admission and discharge. SETTING Tertiary care hospital in the United Arab Emirates. PARTICIPANTS 2793 adults referred to physical therapy; 62% were male, with a median age of 58 (interquartile range=44-70) and the median length of stay was 14 days (interquartile range=8-28). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Instruments' clinical measurement properties: (1) responsiveness as per mean change and effect size; (2) floor and ceiling effects; and (3) minimal important difference. Results were analyzed for the whole group as well as 3 subgroups: patients with stroke as primary diagnosis (n = 644), discharged from heart and vascular floors (n = 642), and discharged from medical floors (n = 554). RESULTS The mean change and effect size (Cohen's d) for the 6-clicks were +8.3 (±8.6) and 0.97, and for the FSS-ICU they were +6.8 (±7.8) and 0.87, respectively. 6-Clicks had a floor effect on admission among patients with stroke (16.9%) and patients discharged from medical floors (19.3%), as well as a ceiling effect on discharge (25.5% in the whole group). The FSS-ICU had a ceiling effect on discharge (23.2% in whole group). The estimated minimal important difference for the 6-clicks was 4.3, and for the FSS-ICU it was 3.9. CONCLUSION Both instruments demonstrate good responsiveness in adults hospitalized in the United Arab Emirates. The FSS-ICU exhibited several advantages in performance that suggest greater clinical utility than the 6-clicks. Minimal important differences were generated, which has not been previously reported for the 6-clicks.
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Affiliation(s)
- Aaron Thrush
- Cleveland Clinic Abu Dhabi, Department of Inpatient Therapies and Rehabilitation, Abu Dhabi, United Arab Emirates.
| | - Emma Steenbergen
- Cleveland Clinic Abu Dhabi, Department of Inpatient Therapies and Rehabilitation, Abu Dhabi, United Arab Emirates
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Metz C, McCracken P, Hanmer J. Common Patient-Reported Outcomes Within the Food and Drug Administration Voice of the Patient Reports. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1743-1751. [PMID: 35577642 DOI: 10.1016/j.jval.2022.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/08/2022] [Accepted: 03/29/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Proponents of disease-specific patient-reported outcome measurements (PROMs) often argue disease-agnostic measures do not adequately capture their patient population's experience. Patient-Reported Outcomes Measurement Information System (PROMIS) provides a disease-agnostic domain set that may adequately cover many diseases. This study seeks to investigate whether PROMIS's quality of life domain coverage can span patient-reported outcomes (PROs) elicited from patients across unrelated diseases. METHODS The Food and Drug Administration Voice of the Patient reports were an initiative to elevate patient voices regarding their condition and associated treatments. Two reviewers extracted patient-reported health-related (quality of life) domains from the reports and categorized them into PROMIS domains or non-PROMIS domains. Domain coverage was summarized for each report. Any extracted PROs not covered by PROMIS domains were placed in an "other" category and analyzed for common themes. RESULTS Across 26 reports, PROMIS covered 216 of 374 (70%) of the reports' PRO domains. The heritable bleeding disorders report had the highest coverage (82%). Human immunodeficiency virus had the lowest coverage (50%). The most common PROMIS domain, "ability to participate in social roles," appeared in 25 reports (96%). The most common domains not included in PROMIS were stigma, sensitivities, and sensory deficits as evident in 19 (73%), 18 (69%), and 18 reports (69%), respectively. If the top 3 unincluded domains were amended into PROMIS, the total domain coverage would increase to 84%. CONCLUSIONS PRO domains elicited in the Food and Drug Administration Voice of the Patient reports were widely captured by PROMIS, suggesting domains patients experience contain enough overlap to be recorded by appropriate PROMIS domains. PROMIS could increase its coverage by adding domains.
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Affiliation(s)
- Cameron Metz
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Polly McCracken
- Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Janel Hanmer
- Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Linking Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form and PROMIS Physical Function. J Am Acad Orthop Surg 2022; 30:e1043-e1050. [PMID: 35476824 DOI: 10.5435/jaaos-d-21-00736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 03/27/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Linking scores on patient-reported outcome measures can enable data aggregation for research, clinical care, and quality. We aimed to link scores on the Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (HOOS-PS) and the Patient-reported Outcomes Measurement Information System Physical Function (PROMIS PF). METHODS A retrospective study was conducted from 2017 to 2020 evaluating patients with hip osteoarthritis who received routine clinical care from an orthopaedic surgeon. Our sample included 3,382 unique patients with 7,369 pairs of HOOS-PS and PROMIS PF measures completed at a single nonsurgical, preoperative, or postoperative time point. We included one randomly selected time point of scores for each patient in our linking analysis sample. We compared the accuracy of linking using four methods, including equipercentile and item response theory-based approaches. RESULTS PROMIS PF and HOOS-PS scores were strongly correlated ( r = -0.827 for raw HOOS-PS scores and r = 0.820 for summary HOOS-PS scores). The assumptions were met for equipercentile and item response theory approaches to linking. We selected the item response theory-based Stocking-Lord approach as the optimal crosswalk and estimated item parameters for the HOOS-PS items on the PROMIS metric. A sensitivity analysis demonstrated overall robustness of the crosswalk estimates in nonsurgical, preoperative, and postoperative patients. CONCLUSION These crosswalks can be used to convert scores between HOOS-PS and PROMIS PF metric at the group level, which can be valuable for data aggregation. Conversion of individual patient-level data is not recommended secondary to increased risk of error.
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Newman C, Kgosidialwa O, Dervan L, Bogdanet D, Egan AM, Biesty L, Devane D, O'Shea PM, Dunne FP. Quality of patient-reported outcome reporting in trials of diabetes in pregnancy: A systematic review. Diabetes Res Clin Pract 2022; 188:109879. [PMID: 35483543 DOI: 10.1016/j.diabres.2022.109879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 11/24/2022]
Abstract
AIMS Patient-reported outcomes (PROs) are reports of the patient's health status that come directly from the patient without interpretation by the clinician or anyone else. They are increasingly used in randomised controlled trials (RCTs). In this systematic review we identified RCTs conducted in women with diabetes in pregnancy which included PROs in their primary or secondary outcomes. We then evaluated the quality of PRO reporting against an internationally accepted reporting framework (Consolidated Standards of Reporting Trials (CONSORT-PRO) guidelines). METHODS We searched online databases for studies published 2013-2021 using a combination of keywords. Two authors reviewed all abstracts independently. Data on study characteristics and the quality of PRO reporting were extracted from relevant studies. We conducted a multiple regression analysis to identify factors associated with high quality reporting. RESULTS We identified 7122 citations. Thirty-five articles were included for review. Only 17% of RCTs included a PRO as a primary or secondary outcome. Out of a maximum score of 100 the median score was 46, indicating sub-optimal reporting. A multiple regression analysis did not reveal any factors associated with high quality reporting. CONCLUSIONS Researchers should be mindful of the importance of PRO inclusion and reporting and include reliable PROs in trials.
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Affiliation(s)
- C Newman
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland.
| | - O Kgosidialwa
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - L Dervan
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - D Bogdanet
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - A M Egan
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - L Biesty
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, Ireland
| | - D Devane
- HRB-Trials Methodology Research Network, National University of Ireland Galway, Galway, Ireland; INFANT Centre and Department of Paediatrics & Child Health, University College Cork, Cork, Ireland
| | - P M O'Shea
- Department of Clinical Biochemistry, Galway University Hospital, Galway, Ireland
| | - F P Dunne
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
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10
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The patient-reported outcomes measurement information systems (PROMIS®) physical function and its derivative measures in adults: a systematic review of content validity. Qual Life Res 2022; 31:3317-3330. [PMID: 35622294 DOI: 10.1007/s11136-022-03151-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aims to systematically review and critically appraise the content validity of the adult versions of the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) item bank and its derivative measures in any adult population. METHODS MEDLINE and EMBASE were searched in October 2021 for studies on measurement properties of PROMIS-PF measures in an adult population. Studies were included if the study described the development of a PROMIS-PF measure or investigated its relevance, comprehensiveness, or comprehensibility. Assessment of the methodological quality of eligible studies, rating of results, and summarizing evidence was performed following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology for assessing content validity. A modified GRADE approach was used to determine the level of evidence. RESULTS Three development studies and eight studies on the content validity of one or more of the PROMIS-PF measures were identified. The methodological quality of most studies was rated doubtful. There was low to high level evidence for sufficient relevance, comprehensiveness, and comprehensibility of most PROMIS-PF measures for healthy seniors and various disease populations. We found low to moderate level evidence for insufficient relevance of PROMIS-PF measures for patients with conditions that affected only one body part, and insufficient comprehensibility of the PROMIS-PF measures for minority elderly. CONCLUSION Most PROMIS-PF measures demonstrate sufficient content validity in healthy seniors and various disease populations. However, the quality of this evidence is generally low to moderate, due to limitations in the methodological quality of the studies.
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Kersting C, Hülsmann J, Weckbecker K, Mortsiefer A. Patients' perspective on supposedly patient-relevant process and outcome parameters: a cross-sectional survey within the 'PRO patients study'. BMC Health Serv Res 2022; 22:72. [PMID: 35031052 PMCID: PMC8759763 DOI: 10.1186/s12913-021-07437-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To be able to make informed choices based on their individual preferences, patients need to be adequately informed about treatment options and their potential outcomes. This implies that studies measure the effects of care based on parameters that are relevant to patients. In a previous scoping review, we found a wide variety of supposedly patient-relevant parameters that equally addressed processes and outcomes of care. We were unable to identify a consistent understanding of patient relevance and therefore aimed to develop an empirically based concept including a generic set of patient-relevant parameters. As a first step we evaluated the process and outcome parameters identified in the scoping review from the patients' perspective. METHODS We conducted a cross-sectional survey among German general practice patients. Ten research practices of Witten/Herdecke University supported the study. During a two-week period in the fall of 2020, patients willing to participate self-administered a short questionnaire. It evaluated the relevance of the 32 parameters identified in the scoping review on a 5-point Likert scale and offered a free-text field for additional parameters. These free-text answers were inductively categorized by two researchers. Quantitative data were analyzed using descriptive statistics. Bivariate analyses were performed to determine whether there are any correlations between rating a parameter as highly relevant and patients' characteristics. RESULTS Data from 299 patients were eligible for analysis. All outcomes except 'sexuality' and 'frequency of healthcare service utilization' were rated important. 'Confidence in therapy' was rated most important, followed by 'prevention of comorbidity' and 'mobility'. Relevance ratings of five parameters were associated with patients' age and gender, but not with their chronic status. The free-text analysis revealed 15 additional parameters, 12 of which addressed processes of care, i.e., 'enough time in physician consultation'. CONCLUSION Patients attach great value to parameters addressing processes of care. It appears as though the way in which patients experience the care process is not less relevant than what comes of it. Relevance ratings were not associated with chronic status, but few parameters were gender- and age-related. TRIAL REGISTRATION Core Outcome Measures in Effectiveness Trials Initiative, registration number: 1685.
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Affiliation(s)
- Christine Kersting
- Chair of General Practice II and Patient-Centeredness in Primary Care, Institute of General Practice and Primary Care, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany.
| | - Julia Hülsmann
- Chair of General Practice I and Interprofessional Care, Institute of General Practice and Primary Care, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany
| | - Klaus Weckbecker
- Chair of General Practice I and Interprofessional Care, Institute of General Practice and Primary Care, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany
| | - Achim Mortsiefer
- Chair of General Practice II and Patient-Centeredness in Primary Care, Institute of General Practice and Primary Care, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany
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van der Kluit MJ, Tent S, Dijkstra GJ, de Rooij SE. Goal-based outcomes of hospitalisation of older adults are predicted by gender, confidence, quality of life and type of goals. Eur Geriatr Med 2022; 13:1377-1389. [PMID: 36203080 PMCID: PMC9722898 DOI: 10.1007/s41999-022-00698-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/13/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE Although patient-reported outcome measures (PROMs) might reflect relevant outcomes from patient perspective, they do not always reflect what the individual patient finds important. Our objectives were to assess which PROM was best suited to evaluate patient-relevant outcomes of hospitalisation and to assess which factors predicted this PROM. METHODS A longitudinal study was conducted among hospitalised older patients. Three PROMs were compared with the anchor question 'How much have you benefited from the admission?': a general quality of life measure: EQ-5D; a measure of daily functioning: Katz-15 and a goal-based measure: achievement of self-defined goals. Predictors were examined using logistic regression analyses. RESULTS We had 185 cases with baseline and follow-up. Accomplishment of self-defined goals showed a large correlation with the anchor question, whereas EQ-5D and Katz-15 showed no significant correlations. The final regression model had four predictors: being man, having higher confidence in goal achievement and good/excellent quality of life increased the odds for goal accomplishment, while having goals in the category alleviating complaints reduced the odds. CONCLUSION Accomplishment of individual goals represented the benefit experienced by participants best. Subjective indicators of health and functioning are better predictors of goal accomplishment than objective ones. According to participant experience, the hospital appeared successful in managing disease-specific problems, but less successful in ameliorating complaints. Medical decision-making should not only be based on medical indicators, but the input of the patient is at least as important. Quality of life, goals and confidence should be discussed. More attention is needed for symptom experience.
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Affiliation(s)
- Maria Johanna van der Kluit
- University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine, Hanzeplein 1, 9700 RB Groningen, Netherlands
| | - Sanne Tent
- University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine, Hanzeplein 1, 9700 RB Groningen, Netherlands
| | - Geke J. Dijkstra
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands ,Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Sophia E. de Rooij
- University of Groningen, University Medical Center Groningen, University Center for Geriatric Medicine, Hanzeplein 1, 9700 RB Groningen, Netherlands ,Amstelland Hospital, Amstelveen, Netherlands
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Tovey D, Tugwell P. On outcomes. J Clin Epidemiol 2021; 136:A4-A5. [PMID: 34489051 PMCID: PMC8413902 DOI: 10.1016/j.jclinepi.2021.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kersting C, Barzel A, Mortsiefer A. Mixed-methods approach to develop an agreed concept on patient relevance: study protocol for the 'PRO patients study'. BMJ Open 2021; 11:e047679. [PMID: 34244269 PMCID: PMC8273474 DOI: 10.1136/bmjopen-2020-047679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION With respect to patient-centred care and shared decision-making, measuring care effects based on outcomes relevant to patients is becoming increasingly important. Recently, a scoping review of the international literature revealed a wide range of supposedly patient-relevant outcomes and found that there is neither a sound definition of patient relevance nor a consistent set of outcomes relevant to patients. To close this gap, this study aims to develop an agreed concept on patient relevance including a set of outcomes relevant to patients irrespective of diseases, which grades outcomes according to their importance. METHODS AND ANALYSIS This prospective mixed-methods study will integrate the perspectives of patients across diseases, healthcare professionals and researchers. The consensus process will consist of four phases. Based on the results of the recent scoping review, a patient survey will be conducted first, followed by a multiprofessional group discussion. Finally, a two-round online Delphi approach based on data from the previous phases will be applied to agree on a concept. ETHICS AND DISSEMINATION Ethics approval for the study was granted on 26 August 2020 by the Ethics Commission of Witten/Herdecke University (reference number: 156/2020). In the long run, the implementation of an agreed concept on patient relevance will help improve the comparability of study results regarding the patient benefit and thereby strengthen the role of patients in the decision-making process. Also, the experiences regarding grading outcomes according to importance will help to develop a method on how to individualise clinical trial outcomes according to each patient's individual specifics and priorities in order to more adequately represent the patient perspective in clinical research. TRIAL REGISTRATION NUMBER Core Outcome Measures in Effectiveness Trials Initiative (registration number: 1685).
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Affiliation(s)
- Christine Kersting
- Chair of General Practice II and Patient-Centredness in Primary Care, Witten/Herdecke University, Witten, Germany
- Chair of General Practice I and Interprofessional Care, Witten/Herdecke University, Witten, Germany
| | - Anne Barzel
- Department of General Practice and Primary Care, Ulm University, Ulm, Germany
| | - Achim Mortsiefer
- Chair of General Practice II and Patient-Centredness in Primary Care, Witten/Herdecke University, Witten, Germany
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