Patient-reported outcomes in performance measurement
Patient-reported outcomes (PROs) are measures of how patients feel or what they are able to do in the context of their health status; PROs are reports, usually on questionnaires, about a patient's health conditions, health behaviors, or experiences with health care that individuals report directly, without modification of responses by clinicians or others; thus, they directly reflect the voice of the patient. PROs cover domains such as physical health, mental and emotional health, functioning, symptoms and symptom burden, and health behaviors. They are relevant for many activities: helping patients and their clinicians make informed decisions about health care, monitoring the progress of care, setting policies for coverage and reimbursement of health services, improving the quality of health care services, and tracking or reporting on the performance of health care delivery organizations. We address the major methodological issues related to choosing, administering, and using PROs for these purposes, particularly in clinical practice settings. We include a framework for best practices in selecting PROs, focusing on choosing appropriate methods and modes for administering PRO measures to accommodate patients with diverse linguistic, cultural, educational, and functional skills, understanding measures developed through both classic and modern test theory, and addressing complex issues relating to scoring and analyzing PRO data.
Cella, D., Hahn, E. A., Jensen, S. E., Butt, Z., Nowinski, C. J., Rothrock, N., & Lohr, K. (2015). Patient-reported outcomes in performance measurement. (RTI Press Publication No. BK-0014-1509). Research Triangle Park, NC: RTI Press. https://doi.org/10.3768/rtipress.2015.bk.0014.1509
© 2019 RTI International. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
"Here it is, all in one place. A compact book on patient-reported outcomes beginning with the idea and ending with implementation for performance measurement and integration in electronic health records. A great resource from a team of experts."
—Eugene C. Nelson, DSc, MPH, Professor, The Dartmouth Institute for Health Policy and Clinical Practice
"NQF supported this seminal work to help amplify the essential patient voice in quality measurement. This work provides the right balance of science and practical advice needed to move patient-reported outcomes into the mainstream of performance measurement."
—Helen Burstin, MD, MPH, Chief Scientific Officer, National Quality Forum
"Measurement of patient-reported outcomes is the next frontier in health care delivery quality assessment. Although interest is rapidly growing to integrate the patient’s voice into performance evaluation, guidance is limited on how actually to go about doing this. This monograph provides invaluable practical and methodological insights for those aiming to integrate patient-reported outcomes into a quality program, ranging from selection of outcomes, to measures, analysis, and reporting."
—Ethan Basch, MD, MSc, Director, Cancer Outcomes Research Program, University of North Carolina at Chapel Hill