- Montreal Accord Paper 9: Anonymization and Ethics Considerations for Capturing and Sharing Patient-Reported Outcomes
- Montreal Accord Paper 8: Patient Reported Outcomes (PRO) in Electronic Health Records Can Inform Clinical and Policy Decisions
- Montreal Accord Paper 6: Creating National Initiatives to Support Patient Reported Outcomes (PRO) Development and Use
- Montreal Accord Paper 5: Patient-Reported Outcomes Can Be Linked to Epidemiologic Measures to Monitor Populations and Inform Public Health Decisions
- Montreal Accord Paper 4: Patient-Reported Outcomes Can Inform Clinical Decision Making in Chronic Care
- Montreal Accord Paper 3: Patient Reported Outcomes (PRO) Can Facilitate Shared Decision-Making and Guide Self-Management
- Montreal Accord Paper 2: Terminology Proposed to Measure What Matters in Health
- Montreal Accord Paper 1: Pragmatic Trials and Real-World Evidence
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.
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