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Choosing and Using Patient-Reported Outcome Measures in Clinical Practice.
Kurt Kroenke1, Timothy A Miksch2, Aaron C Spaulding3
1Indiana University School of Medicine and Regenstrief Institute, Indianapolis, IN.
Archives of Physical Medicine and Rehabilitation
|March 13, 2021
Summary
Choosing patient-reported outcome (PRO) measures requires evaluating psychometric properties and practical factors. This overview guides clinicians and health systems in selecting and implementing PROs effectively into clinical workflows and decision support.
Area of Science:
- Health Informatics
- Clinical Practice Research
- Patient-Centered Care
Background:
- Growing adoption of patient-reported outcome (PRO) measures presents challenges for selection and integration.
- Clinicians and healthcare systems need guidance on choosing and implementing PROs into electronic health records and workflows.
Purpose of the Study:
- To review key factors in selecting PROs for clinical practice.
- To highlight clinical decision support issues related to PRO implementation.
- To discuss pragmatic decisions for PRO use in healthcare settings.
Main Methods:
- Literature review of psychometric and practical factors for PRO selection.
- Analysis of clinical decision support issues, including data gathering and EHR integration.
- Review of crosscutting domains and pragmatic decision-making for PRO administration.
Main Results:
- Key factors for PRO selection include reliability, responsiveness, computer adaptive testing, and interpretability.
- Clinical decision support challenges involve PRO data gathering, EHR impact, and integration.
- Crosscutting domains (e.g., SPADE symptom pentad) and 9 pragmatic decisions guide PRO implementation.
Conclusions:
- Effective selection and integration of PROs require careful consideration of psychometric, practical, and pragmatic factors.
- Addressing clinical decision support issues is crucial for successful PRO implementation.
- Standardized approaches to crosscutting domains and pragmatic decisions can optimize PRO utility.
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