Session 5.1 - Patient reported outcomes

Question 1

What are patient reported outcomes and why is it important to use patient-based outcomes as a measure of health?

Answer 1

• PB outcomes are a measure of health and assess wellbeing from a patients point of view by assigning a score before and after treatment
• Mortality not always accurately recorded and cannot access quality of care
• Morbidity cannot get information about patient experience
• Get more information then a biomedical test and provides the ability to look for iatrogenic factors of care

Question 2

What is a HRQoL?

Answer 2

-Health related quality of life. A measure used in patient reported outcomes which takes the quality of life in clinical medicine and represents it as a functional effect on the life of a patient

Question 3

In what situations can PROMs be used?

Answer 3

-Clinically, economically, audits, RCTs, service quality

Question 4

Give 3 examples of treatments where PROMs are currently used

Answer 4

• Hip/knee replacement
• Hernias
• Varicose veins

Question 5

What factors do HRQoL take into account?

Answer 5

-Physical function and symptoms, global judgements of healthm psychological well-being, cognitive function, personal constructs and satisfaction with care

Question 6

What mathods are used to measure HRQoL? State the advantages and disadvantages of each method

Answer 6

• Qualitative and quantitative methods
• Qual -> interviews are good for initial assessment and develeopment of quantitative methods, Resource hungry and not easy to evaluate
• Quan -> questionnaires are easy to evaluate but force people into specific groups

Question 7

Why are PROMs a valuable measure of health?

Answer 7

• Reliable -> accurate over time and internally consistent
• Valid -> assesses one aspect at a time
• Allows comparisons between different groups of patients using standardised measures

Question 8

What are the differences between generic and specific instruments used to measure HRQoL?

Answer 8

• Generic provide tools used to assess any population and gain an overall perception of health as well as social, emotional and physical functioning
• Specific instruments evaluate a series of diseases, sites or health dimensions

Question 9

What are the advantages and disadvantages of generic instruments to measure HRQoL?

Answer 9

• Covers a broad range of health problems
• Enables comparisons
• Detect unexpected positive/megative effects
• Less detailed
• loss of relevance
• less sensitive to change

Question 10

What are the advantages and disadvantages of specific instruments to measure HRQoL?

Answer 10

• Relevant to particular areas
• Sensitive to sudden changes
• Detailed
• Comparison limited as restricted to specific topic
• limited use
• not good at detecting unexpected outcomes

Question 11

Give an example of a generic instrument used to measure HRQoL

Answer 11

-SF36 -> questionnaire with a 4 week recall period which is widely used in research and population surveys covering physical, mental, social, role, pain and generic health

Question 12

Give an example of a specific HRQoL tool

Answer 12

• AIMS -> Arthritis Impact Measurement Scale
• Oxford Hip Score
• McGill Pain questionnaire