Is There Room for Individual Patient-Specified Preferences in the Patient-Reported Outcome Measurement Revolution?

Area of Science:

• Orthopedic surgery
• Patient-reported outcomes
• Qualitative research methods

Background:

• Standardized patient-reported outcome measures (PROMs) are crucial for evaluating knee replacement surgery outcomes.
• Incorporating qualitative patient preferences can provide a more holistic view of surgical success.
• Existing PROMs often lack the granularity to capture individual patient goals.

Purpose of the Study:

• To assess the feasibility of collecting qualitative patient-preferred outcomes alongside quantitative PROMs.
• To determine the extent to which patients achieve their self-identified goals after knee replacement.
• To evaluate the impact of an open-ended question on capturing patient-preferred outcomes.

Main Methods:

• An open-ended question on preferred outcomes was added to a preoperative and postoperative PROM survey for knee replacement patients.
• Responses were collected for 6 months and quantitatively analyzed.
• Feasibility was assessed by completion rates, and qualitative data was analyzed for meaning preservation.

Main Results:

• High completion rates (98.8%) for the open-ended question were observed.
• A significant majority of patients (90.8%) identified preferred outcomes at baseline.
• Using multiple-choice categories would have diminished the meaning of 82.7% of patient responses.
• Many patients (86.1%) reported outcomes beyond pain relief, and 54.2% reported significant achievement of their goals at 3 months.

Conclusions:

• Patients undergoing knee replacement are willing to report their preferred outcomes via open-ended questions.
• Integrating qualitative data into PROMs enhances the understanding of patient-centered care.
• This approach can guide clinicians to address individual patient priorities more effectively.