Re: Patient reported outcome measures could help transform healthcare
In his thorough analysis about the potential contribution to transform healthcare of the routine use of patient reported outcome measures (PROMs),[1] Black does not acknowledge that PROMs can be similar to traditional, clinician-rated measures unless they really incorporate, during their development process, the patient’s perspective and not merely the researchers’, clinicians’ and administrators’ perspectives.[2, 3]
The term ‘patient-reported’ only implies that the instrument is filled out by the patient. It should not be automatically inferred that the information so obtained actually reflects patient concerns and priorities.[2, 4] Therefore, whether a PROM is patient-generated, patient-centred, patient-valued or patient-irrelevant is not an idle or futile question.[2]
It is very likely that the transformative potential attributable to the routine use of PROMs will largely depend on whether these PROMs genuinely incorporate and measure the patient’s perspective. Fortunately, an increasing number of both patient-generated and patient-centred PROMS have been developed in recent years [2, 3] and some studies have already begun to explore patients’ views on the relevance of some of the commonly used PROMS (most of which were mainly developed without direct patient participation).[5-7]
References
[1] Black N. Patient reported outcome measures could help transform healthcare. BMJ 2013;346:f167.
[2] Trujols J, Portella MJ, Iraurgi I, Campins MJ, Siñol N, Pérez de los Cobos J. Patient-reported outcome measures: Are they patient-generated, patient-centred or patient-valued? J Ment Health 2013; doi:10.3109/09638237.2012.734653.
[3] Rose D, Evans J, Sweeney A, Wykes T. A model for developing outcome measures from the perspectives of mental health service users. Int Rev Psychiatry 2011;23:41-6.
[4] Doward LC, McKenna SP. Defining patient-reported outcomes. Value Health 2004;7(suppl 1):4-8.
[5] Paterson C. Seeking the patient's perspective: a qualitative assessment of EuroQol, COOP-WONCA charts and MYMOP. Qual Life Res 2004;13:871-81.
[6] Crawford MJ, Robotham D, Thana L, Patterson S, Weaver T, Barber R, et al. Selecting outcome measures in mental health: the views of service users. J Ment Health 2011;20:336-46.
[7] Apfelbacher C, Weiß M, Saur J, Smith H, Loerbroks A. Patients' views on asthma-specific quality of life questionnaires: qualitative interview study in Germany. J Asthma 2012;49:875-83.
Competing interests:
No competing interests
14 February 2013
Joan Trujols
Clinical Psychologist
Maria J. Portella
Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), CIBERSAM
Sant Antoni Maria Claret 167, 08025 Barcelona, Spain
Rapid Response:
Re: Patient reported outcome measures could help transform healthcare
In his thorough analysis about the potential contribution to transform healthcare of the routine use of patient reported outcome measures (PROMs),[1] Black does not acknowledge that PROMs can be similar to traditional, clinician-rated measures unless they really incorporate, during their development process, the patient’s perspective and not merely the researchers’, clinicians’ and administrators’ perspectives.[2, 3]
The term ‘patient-reported’ only implies that the instrument is filled out by the patient. It should not be automatically inferred that the information so obtained actually reflects patient concerns and priorities.[2, 4] Therefore, whether a PROM is patient-generated, patient-centred, patient-valued or patient-irrelevant is not an idle or futile question.[2]
It is very likely that the transformative potential attributable to the routine use of PROMs will largely depend on whether these PROMs genuinely incorporate and measure the patient’s perspective. Fortunately, an increasing number of both patient-generated and patient-centred PROMS have been developed in recent years [2, 3] and some studies have already begun to explore patients’ views on the relevance of some of the commonly used PROMS (most of which were mainly developed without direct patient participation).[5-7]
References
[1] Black N. Patient reported outcome measures could help transform healthcare. BMJ 2013;346:f167.
[2] Trujols J, Portella MJ, Iraurgi I, Campins MJ, Siñol N, Pérez de los Cobos J. Patient-reported outcome measures: Are they patient-generated, patient-centred or patient-valued? J Ment Health 2013; doi:10.3109/09638237.2012.734653.
[3] Rose D, Evans J, Sweeney A, Wykes T. A model for developing outcome measures from the perspectives of mental health service users. Int Rev Psychiatry 2011;23:41-6.
[4] Doward LC, McKenna SP. Defining patient-reported outcomes. Value Health 2004;7(suppl 1):4-8.
[5] Paterson C. Seeking the patient's perspective: a qualitative assessment of EuroQol, COOP-WONCA charts and MYMOP. Qual Life Res 2004;13:871-81.
[6] Crawford MJ, Robotham D, Thana L, Patterson S, Weaver T, Barber R, et al. Selecting outcome measures in mental health: the views of service users. J Ment Health 2011;20:336-46.
[7] Apfelbacher C, Weiß M, Saur J, Smith H, Loerbroks A. Patients' views on asthma-specific quality of life questionnaires: qualitative interview study in Germany. J Asthma 2012;49:875-83.
Competing interests: No competing interests