Montreal Accord on PROs
This article is part [part not set] of 8 in the series Montreal Accord on Patient-Reported Outcomes Use Series

Patient Reported Outcomes (PRO)

Paper 4: Informing Clinical Decision Making in Chronic Care

Clifton O. Bingham III, Vanessa K. Noonan, Claudine Auger, Debbie E. Feldman, Sara Ahmed, Susan J. Bartlett

 

Background

Providing patient-centered health care requires that patient needs, preferences, and valued outcomes are more fully integrated into all decisions. Patient-reported outcome (PRO) measures provide unique information from the patient perspective on overall health, symptoms, burden, and treatment response.

 

Objective

We sought to describe applications of PROs in clinical settings and considerations for implementation from the perspectives of PRO researchers, clinicians, administrators, policy makers, and patients attending a multidisciplinary meeting.

 

Discussion

Clinical applications of PROs include individual level use for medical decision making and aggregate use for comparative effectiveness research, program evaluation, quality improvement, and performance assessments. Considerations of feasibility on workflow impact and patient burden, display of results, and administration frequency are important. PROs with strong psychometric properties, actionable thresholds, and interpretable results should be selected. We provide current exemplars of PRO use in various clinical applications, initial lessons learned, and highlight conceptual, logistical, and consequential considerations of PRO data collection. A research agenda is proposed to address critical knowledge gaps. In conclusion, PROs can be used in clinical settings to support patient-centered care. This requires an assessment of feasibility in the intended setting of use, measurement considerations, and process measures to optimize integration and use.

2017 Apr 20. pii: S0895-4356(17)30410-9. doi: 10.1016/j.jclinepi.2017.04.014

I'm a specialist in clinical outcome measurement and its impact on treatment effects and patients' quality of life across cultural boundaries. I help physicians and clinical researchers improve patients' lives by teaching best practices in measuring psychiatric and neurological states and traits, with thoughtful focus on specificity.

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