Patient- Reported Outcomes

Question 1

What are the 3 used measures of health?

Answer 1

Mortality = easily defined, not always recorded accurately, not a good way of assessing outcomes and quality of care.

Morbidity = routinely collected, collection not always reliable/ accurate, tells us nothing about patients experience

Patient-based outcomes = Assesses well-being from the patients point of view. E.g. HRQoL, health status, functional abilities

Question 2

Why use patient-based outcomes?

Answer 2

Increase in conditions where aim is managing rather than curing

Biomedical tests just one part of the picture

Need to focus on patients concerns (patient centred care) (symptom burden and psychosocial impact is often unrecognised)

Need to pay attention to iatrogenic effects of care

Question 3

What needs to be monitored during clinical trials?

Answer 3

Study end point ( PROMs - patient-recorded outcome measures)

Monitor adverse events

Economic evaluation (QALY)

Question 4

What is meant of health related quality of life?

Answer 4

The impact of treatments and disease processes on these holistic aspects ( physical, mental, emotional, cognitive and social) of a persons life.

Question 5

How are PROMs recorded?

Answer 5

Quantitative approach relies on the use of questionnaires known as instruments or scales.

Question 6

What is the difference between generic PROMs and specific PROMs?

Answer 6

Generic = can be used in any patient population. Example is the EuroQoL EQ-5D

Specific = disease specific/site specific/ dimension specific
Example is the fatigue impact scale, oxford knee/hip score

Question 7

Give the advantages and disadvantages of specific instruments

Answer 7

ADVANTAGES : Very relevant content. Sensitive to change, acceptable to patients.

DISADVANTAGES = specific to those that have the disease, comparison is limited between disease carrying patients, may not detect unexpected effects.