Patient-reported outcomes and the mandate of measurement.
Purpose: Coherent clinical care depends on answering a basic question: is a patient getting worse, getting better, or staying about the same? This can prove surprisingly difficult to answer confidently. Patient-reported outcomes (PROs) could potentially help by providing quantifiable evidence. But q...
| Publicado en: | Quality of Life Research Vol. 17; no. 10; pp. 1303 - 1314 |
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| Autores principales: | , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Dec2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105583712&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105583712 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09629343 GPQ jtl: Quality of Life Research issn: 09629343 maglogo: N pubinfo: dt: Dec2008 vid: 17 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 105583712 NLM18953670 2010114589 10.1007/s11136-008-9408-4 NLM18953670 105583712 ppf: 1303 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Patient-reported outcomes and the mandate of measurement. aug: au: Donaldson G Donaldson, Gary affil: Department of Anesthesiology, Pain Research Center, University of Utah, Salt Lake City, UT, USA sug: subj: Outcome Assessment Methods Patient Satisfaction Confidence Intervals Health Status Reproducibility of Results Human ab: Purpose: Coherent clinical care depends on answering a basic question: is a patient getting worse, getting better, or staying about the same? This can prove surprisingly difficult to answer confidently. Patient-reported outcomes (PROs) could potentially help by providing quantifiable evidence. But quantifiable evidence is not necessarily good evidence, as this article details.Method: The fundamental mandate of measurement requires that errors in making an assessment be smaller than the distinctions to be measured. This mandate implies that numerical observations of patients may be poor measurements.Results: Individual assessments require high measurement precision and reliability. Group-averaged comparisons cancel out measurement error, but individual PROs do not. Individual PROs generate numbers, to be sure, but the numbers may fall short of what we should demand of measurements. When typical errors of measurement are large, it is not possible to answer confidently even the modest question of whether a patient is getting worse or getting better.Conclusion: This article explains some theory behind the mandate of measurement, provides several examples based on clinical research, and suggests strategies to measure and monitor individual patient outcomes more precisely. These include more frequent low-burden assessments, more realistic confidence levels, and strengthened measurement that integrates population data. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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