9 - PROMs

Question 1

What are patient based outcomes?

Answer 1

Question 2

What are patient reported outcome measures?

Answer 2

Tools or instruments used to measure PRO’s. Turn subjective experiences into numerical scores.

Comparing scores before and after treatment

Question 3

When are patient based outcomes used?

Answer 3

When the aim is to manage not to cure

Question 4

What are three ways of measuring health?

Answer 4

• Mortality
• Morbidity
• PROMs

Question 5

Why should we measure health?

Answer 5

Question 6

What is quality of life?

Answer 6

Quality of life in clinical medicine represents the functional effect of an illness and its consequent therapy upon a patient, as perceived by the patient

Question 7

What is health related quality of life?

Answer 7

Imapct of treatment and disease on the holistic aspects of a persons life

Question 8

What the criteria when measuring HRQOL?

Answer 8

Question 9

What are the four types of PROMs?

Answer 9

- Generic (SF-36)

- Disease Specific (Oxford Hip Score)

- Multidimensional (EQ-5D)

- Unidimensional (BFI)

Question 10

How would you use a generic instrument and what are the advantages and disadvantages of using them?

Answer 10

Used with any population, usually assess perceptions of overall health

+ Use for broad range of health problems

+ Used if no disease-specific instrument

+ Allows comparisons amongst treatment groups

• Less detailed
• Loss of relevance
• Not clinically relevant

Question 11

How would you use a specific instrument and what are the advantages and disadvantages?

Answer 11

Evaluates a series of health dimensions specific to a disease

+ Very relevant content

+ Sensitive to change

+ Acceptable to patient

• Comparison is limited
• May not detect unexpected effects
• Cannot be used on any population

Question 12

Why are PROMs important?

Answer 12

• Imporves patient doctor communication
• Symptom burden and psychosocial impact is under recognised
• Quality of life may be more important than quantity

Question 13

What are PROMs used for in the NHS?

Answer 13

• Knee and Hip replacements
• Allows comparisons between hospitals
• Improves patient satisfaction
• Less frequent healthcare visits

Question 14

What are the barriers to PROMs?

Answer 14

• Costs
• Time
• Patients may become distressed
• Missing information
• Language and capacity barriers
• Doctors may not be able to interpret
• Lack of consistent records

Question 15

What is the selection criteria for a PROM?

Answer 15

• Appropriateness
• Acceptability
• Feasibility (easy to deliver and interpret)
• Precision
• Reliable
• Valid

Question 16

Identify three specific instruments and examples of these.

Answer 16

- Disease Specific (Asthma Quality of Life)

- Site Specific (Oxford Hip Score)

- Dimension specific (Beck Depression)