The Use of Patient-reported Outcomes (PRO) Within Comparative Effectiveness Research Implications for Clinical Practice and Health Care Policy
The Use of Patient-reported Outcomes (PRO) Within Comparative Effectiveness Research Implications for Clinical Practice and Health Care Policy
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DOI：
10.1097/mlr.0b013e318268aaff
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发表时间：
2012-12-01
期刊：
影响因子：
3
通讯作者：
Wu, Albert W.
中科院分区：
文献类型：
--
作者：
Ahmed, Sara;Berzon, Richard A.;Wu, Albert W.
背景资料：比较有效性研究（CER）的目的是解释预防、诊断、治疗和监测临床状况或改善护理服务的替代方法的不同益处和危害。为了告知决策，需要从患者的角度反映患者关心的结局的信息，并且可以使用适当的患者报告结局（PRO）严格收集这些信息。鉴于过去20年中此类问卷的激增，选择最合适的PRO测量可能具有挑战性。Objective：在本文中，我们讨论了CER中PRO的价值，可能在CER背景下有用的测量类型，PRO工具选择以及与CER中使用PRO相关的关键挑战。我们描述了定义CER背景、选择适当的测量方法以及分析和解释PRO数据的重要考虑因素。还审查了可能促进CER使用PRO作为结局的新变化，包括实施电子和个人健康记录、医院和基于人群的登记以及在国家监测计划中使用PRO。链接来自PRO端点CER中的信息，以决策的潜在好处也review.Conclusions：提出的建议，将PRO在CER中的目的是提供一个指南，研究人员，临床医生和政策制定者，以确保来自PRO的信息是适用的，并解释为一个给定的CER上下文。反过来，CER将为临床医生、患者和家属提供必要的信息，以做出明智的护理决策。
Background: The goal of comparative effectiveness research (CER) is to explain the differential benefits and harms of alternate methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. To inform decision making, information from the patient's perspective that reflects outcomes that patients care about are needed and can be collected rigorously using appropriate patient-reported outcomes (PRO). It can be challenging to select the most appropriate PRO measure given the proliferation of such questionnaires over the past 20 years.Objective: In this paper, we discuss the value of PROs within CER, types of measures that are likely to be useful in the CER context, PRO instrument selection, and key challenges associated with using PROs in CER.Methods: We delineate important considerations for defining the CER context, selecting the appropriate measures, and for the analysis and interpretation of PRO data. Emerging changes that may facilitate CER using PROs as an outcome are also reviewed including implementation of electronic and personal health records, hospital and population-based registries, and the use of PROs in national monitoring initiatives. The potential benefits of linking the information derived from PRO endpoints in CER to decision making is also reviewed.Conclusions: The recommendations presented for incorporating PROs in CER are intended to provide a guide to researchers, clinicians, and policy makers to ensure that information derived from PROs is applicable and interpretable for a given CER context. In turn, CER will provide information that is necessary for clinicians, patients, and families to make informed care decisions.