PROM-ED: Development and Testing of a Patient-Reported Outcome Measure for Emergency Department Patients Who Are...

Area of Science:

• Emergency Medicine
• Health Services Research
• Patient-Reported Outcomes

Background:

• Characterizing patient-valued outcomes for emergency department (ED) patients not requiring hospitalization is crucial.
• No validated measurement instrument currently exists for these specific outcomes.
• Previous research identified four key domains: symptom relief, understanding, reassurance, and having a plan.

Purpose of the Study:

• To develop and validate a patient-reported outcome measure (PROM) for adult ED patients discharged home.
• To create a reliable and valid instrument to assess patient-centered outcomes in the ED setting.

Main Methods:

• Developed a question bank and refined it through cognitive debriefing with patients.
• Quantitatively tested revised questions with a large cohort of recent ED patients.
• Utilized a modified Delphi process with expert consensus for item reduction.
• Evaluated the final instrument (PROM-ED 1.0) for structural validity, hypothesis testing, and reliability.

Main Results:

• The initial 67-item bank was reduced to a 22-item instrument (PROM-ED 1.0) across four domains.
• Cognitive debriefing and quantitative testing led to item modification and exclusion based on suitability and statistical performance.
• The final PROM-ED 1.0 demonstrated good evidence of validity and test-retest reliability in a validation sample.

Conclusions:

• The PROM-ED is a validated instrument for measuring patient-centered outcomes for non-hospitalized ED patients.
• This measure can be applied to research and quality improvement initiatives in emergency care.
• It provides a standardized method to capture the patient experience and valued outcomes post-ED visit.