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The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.
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This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
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Related Experiment Video

Updated: Apr 29, 2026

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
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Mixed-Methods Development and Validation of PRO/PREM Items for Patients Undergoing Colon Polyp Surveillance.

Sidney May1,2, Erin M Knight1,2, Nancy Boyer1,2

  • 1The Dartmouth Institute for Health Policy and Clinical Practice.

Journal of Clinical Gastroenterology
|April 27, 2026
PubMed
Summary

This study developed and validated patient-reported outcome and experience measures for colon polyp surveillance. The findings support the use of these new tools for assessing patient experiences in clinical settings.

Keywords:
PREMPROcolon polyp surveillancemixed methodspatient-centered care

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Area of Science:

  • Health Services Research
  • Patient-Reported Outcomes
  • Medical Informatics

Background:

  • Patient-reported outcomes (PROs) and experience measures (PREMs) are crucial for evaluating patient care.
  • Existing PROs/PREMs are insufficient for colon polyp surveillance.
  • There is a need for validated instruments to capture patient perspectives in colon polyp surveillance.

Purpose of the Study:

  • To develop and validate novel PRO/PREM items specifically for adults undergoing colon polyp surveillance.
  • To establish the psychometric properties of these new patient-centered measures.
  • To provide tools for assessing patient experiences in colon polyp surveillance research and practice.

Main Methods:

  • Mixed-methods instrument development involving semistructured interviews with patients and physicians.
  • Exploratory and confirmatory factor analyses (N=449, N=466) to assess construct validity.
  • Test-retest reliability assessments (N=155) to evaluate measurement stability.

Main Results:

  • Interviews identified six key PRO/PREM domains: satisfaction, convenience, complications, assistance, confidence, and cancer worry.
  • Confirmatory factor analysis supported a 4-item model of Test Experience/Satisfaction.
  • Good test-retest reliability was found for the composite score; moderate to poor for individual items.

Conclusions:

  • This study presents the first validated PRO/PREM items for colon polyp surveillance.
  • The developed items demonstrate promising psychometric properties for research and clinical use.
  • Further research is needed to confirm predictive validity, but these findings are a crucial first step.