9 - PROMs Flashcards
What are patient based outcomes?
What are patient reported outcome measures?
Tools or instruments used to measure PRO’s. Turn subjective experiences into numerical scores.
Comparing scores before and after treatment
When are patient based outcomes used?
When the aim is to manage not to cure
What are three ways of measuring health?
- Mortality
- Morbidity
- PROMs
Why should we measure health?
What is quality of life?
Quality of life in clinical medicine represents the functional effect of an illness and its consequent therapy upon a patient, as perceived by the patient
What is health related quality of life?
Imapct of treatment and disease on the holistic aspects of a persons life
What the criteria when measuring HRQOL?
What are the four types of PROMs?
- Generic (SF-36)
- Disease Specific (Oxford Hip Score)
- Multidimensional (EQ-5D)
- Unidimensional (BFI)
How would you use a generic instrument and what are the advantages and disadvantages of using them?
Used with any population, usually assess perceptions of overall health
+ Use for broad range of health problems
+ Used if no disease-specific instrument
+ Allows comparisons amongst treatment groups
- Less detailed
- Loss of relevance
- Not clinically relevant
How would you use a specific instrument and what are the advantages and disadvantages?
Evaluates a series of health dimensions specific to a disease
+ Very relevant content
+ Sensitive to change
+ Acceptable to patient
- Comparison is limited
- May not detect unexpected effects
- Cannot be used on any population
Why are PROMs important?
- Imporves patient doctor communication
- Symptom burden and psychosocial impact is under recognised
- Quality of life may be more important than quantity
What are PROMs used for in the NHS?
- Knee and Hip replacements
- Allows comparisons between hospitals
- Improves patient satisfaction
- Less frequent healthcare visits
What are the barriers to PROMs?
- Costs
- Time
- Patients may become distressed
- Missing information
- Language and capacity barriers
- Doctors may not be able to interpret
- Lack of consistent records
What is the selection criteria for a PROM?
- Appropriateness
- Acceptability
- Feasibility (easy to deliver and interpret)
- Precision
- Reliable
- Valid
