Patient Reported Outcomes

Patient Reported Outcomes

 19.12.17

Patient Reported Outcomes (PROs) refer to health data provided by patients through a direct reporting system that involves questions and responses on how they are feeling in the aftermath of a medical procedure or clinical trial. PRO constitutes the measurement of the feedback received directly from the patient that underwent treatment without the influence of medical supervisors.

PROs are usually administered with the help of questionnaires in clinical settings and they often cover three main areas; mental, physical and social health through which patients express the health changes they have observed. Questionnaires in PROs are known as PRO instruments which help patients to report directly without necessarily needing the assistance of a physician. These instruments can either be one-dimensional (involve reporting on a particular characteristic or construct) or multidimensional (involve a more diverse set of characteristics or constructs separately measured) with mathematical/numerical backing.

Examples of commonly used constructs in PRO include; symptoms or impairments, general health perceptions, physical functioning, quality of life or health related quality of life, healthcare reports and ratings etc.

The issues and constructs reported with values in PRO span physical ability levels, pain, fatigue, depression, satisfaction with social interactions, sexual function and others mostly important in the evaluation of management procedures for diseases without cure. The scores obtained from the various constructs and their analysis assist health care providers to improve and make their services better in medical treatments while providing very valuable data to researchers.

Technological advancement in the domain of PRO (ePRO-electronic) is making evaluations easier with soft copy questionnaires and other digital tools that facilitate the assessment of the collected information. ePRO instruments offer many added advantages such as error elimination, speed, data accessibility, reduced risk of data loss etc. An example of a leading ePRO is the PROMIS (Patient-Reported Outcomes Measurement Information System) having validated tools for measurement.

PRO and ePRO Benefits

Amongst the many benefits of PRO tools and instruments are the following;

  • PROs make it possible to collect useful and accurate information that can only be acquired from patients like thoughts, emotions, and opinions which cannot be obtained by the use of medical technology that targets physical and even biochemical issues.

  • Newly developed ePRO tools are characterized with speed and efficiency, with easily understandable systems that facilitate self-evaluation for patients providing a lot more reliable data.

  • PRO assessment in the direction of achieving treatment or drug approval for conditions without cure.

  • Treatment quality can be assessed and improved with effective PROs and ePROS.

  • PROs enhance communication between patients and medical personnel as the information obtained is always a base for action and not just for diagnosis ending in the easier finding of solutions.

There are numerous barriers in the setting up of PRO systems that are reliable, clinically relevant, easily interpreted and valid. These barriers must be tackled to obtain maximum proceeds from any setup. Among them are staff and patient burden, competing priorities, language, space and budget issues, and more. Some of them can be addressed by integrating collection with normal clinical work-flow, determining time periods for follow-up eligibility, deciding on ideal collection formats for PRO, practical considerations of security, outside access and hardware, etc.

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