HaDSoc 5.2 patient reported outcomes Flashcards

1
Q

Why should we measure health?

A
  • Have an idea of the health needs
  • helps with resource allocation
  • can look at effectiveness of interventions
  • monitor progress
  • look at quality of health services (Are people happy with the service?)
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2
Q

What are some commonly used measures of health?

A
  • mortality
  • morbidity
  • patient reported outcomes
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3
Q

What are some pros and cons of using mortality as a measure of health?

A

-it is easily defined

  • its not always recorded properly (wont know the cause of death)
  • not a good measure of outcome (death shouldn’t really be an outcome)
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4
Q

What are some pros and cons of using morbidity as a measure of health?

A

-its already widely collected (general health checks etc)

  • collection isnt always accurate
  • not easy to evaluate
  • no insight into the patients experiences.
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5
Q

why use a patient-based outcome?

A

To attempt to assess well being from the patients perspective.

  • good for conditions where there is no cure, just management.
  • good for looking at iatrogenic effects of care (are certain parts of the treatment affecting the patient negatively?)
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6
Q

What does PROMs stand for?

A

Patient reported outcomes measure.

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7
Q

What are some uses of patient reported outcomes?

A
  • used in audit
  • used to evaluate quality of care
  • used to look at effectiveness and benefits associated with cost
  • used to measure health status of populations
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8
Q

What happens to the data collected by proms?

A
  • it’s published
  • comparisons can be made between trusts
  • patients can use it to help them make decisions
  • of interest to commissioners
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9
Q

What are some drawbacks of PROMs?

A
  • take a lot of time to collect, analyse and publish
  • difficult to get everyone to participate (introduces bias)
  • need to make sure they arent being misused
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10
Q

Define health related quality of life.

A

‘the functional effects of an illness and its consequent therapy upon a patient, as percieved by that patient.’

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11
Q

How do we measure HRQoL?

A
  • qualitative methods
  • quantitative methods
    - specific or generic instruments
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12
Q

What 2 properties must a quatitative instrument be, in order to be a good PROM?

A
  • validity (does it measure what it should measure?)
  • reliability (is it accurate over time and internally consistant, are any changes recorded due to a change in the condition, instead of the way the questions are asked etc)
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13
Q

What are some advantages of using published instruments instead of unpublished, for PROMs?

A

-they’ve been proven to be reliable and valid
-you can compare across different groups becuase they are widely used.
-

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14
Q

What are some advantages of generic instrument use for PROMs?

A
  • you can use them on any population, including healthy people
  • good for a broad range of problems
  • can detect unexpected effects of interventions
  • can assess the health of populations
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15
Q

What are some disadvantages of generic instrument use for PROMs?

A
  • Patients may not feel they’re relevant so may not complete them
  • May be too broad, overlook things, be too general
  • They’re less details
  • less sensitive to changes that occur after an intervention
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16
Q

What are some examples of generic measures for PROMs?

A
  • Short form 36

- euroQOL EQ-5D.

17
Q

What is the SF 36? describe it’s properties.

A

A short questionaire of 36 questions, coverring 8 domains, which looks at health over the past 4 weeks.
Is widely used in research
proven to be reliable and valid.

18
Q

What are the 8 dimensions of the SF 36?

A
  • physical functioning
  • role functioning (physical)
  • social functioning
  • role functioning (emotional)
  • bodily pain
  • vitality
  • mental health
  • general health
19
Q

How does the scoring of the SF 36 work?

A

Scores relating to a single domain can be grouped together.
Scores across domains cannot. (takes more analysing)
No overall score.

20
Q

What are some advantages of the SF36?

A
  • acceptible to people
  • only takes 5-10 mins to fill out
  • high internal consistency
  • it’s responsive to change
  • widely used so theres population data available for comparison.
21
Q

Discuss features of the EuroQol 5d.

A

questions 5 dimensions of health, and generates a single index between 0 (death) and full health (1).

Commonly used as a stand alone measure.

22
Q

What are the dimensions of the EQ 5d?

A
  • mobility
  • self care
  • usual activities
  • pain
  • anxiety/depression.

(each has 3 levels, no problems, some problems, severe problems)

23
Q

What are the 3 types of specific instruments used for PROM’s?

A
  • disease specific (eg asthma QoL questionaire)
  • site specific (eg hip, shoulder)
  • dimension specific (eg pain, depression)
24
Q

What are the advantages of specific instrument use for proms?

A
  • very sensitive to change
  • more acceptible to people
  • very detailed (relevant)
25
Q

What are some disadvantages of using specific instruments for PROMS?

A
  • may miss unexpected effects (very specific)
  • can’t be used for people who don’t have the disease
  • limited comparison
26
Q

What things must you think about if you want to use a specific instrument to measure patient reported outcomes?

A
  • has someone used this instrument to measure this before?
  • does it have established validity and reliability?
  • is it suitable?
  • is it acceptable?
  • does it reflect patients concerns?
  • is it sensitive to change?
  • is it easy to administer and analyse?