Patient-reported outcome measures in the NHS: new methods for analysing and reporting EQ-5D data

In a landmark move, the UK Department of Health (DH) has introduced the routine collection of patient-reported outcome measures (PROMs) to measure the performance of health-care providers. From April 2009, generic (EQ-5D) and condition-specific PROMs are being collected from patients before and after four surgical procedures; eventually this will be extended to include a wide range of other NHS services. The aim of this article is to report analysis of the EQ-5D data generated from a pilot study commissioned by the DH and to consider the implications for the use of EQ-5D data in performance indicators and measures of patient benefit. We present two new methods that we have developed for analysing and displaying EQ-5D profile data: a Paretian Classification of Health Change and a health profile grid. We show that EQ-5D profile data can be readily analysed to generate insights into the nature of changes in patient-reported health that would be obscured by summarising these profiles by their index scores, or focusing just on the post operative outcomes. Our methods indicate differences between providers and between sub-groups of patients. Our results also show striking differences in changes in EQ-5D profiles between surgical procedures, which require further investigation.