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患者报告的结局指标:它们是患者生成的、以患者为中心的还是患者重视的?

Patient-reported outcome measures: are they patient-generated, patient-centred or patient-valued?

机构信息

Unitat de Conductes Addictives, Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau , Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau) , Barcelona , Spain.

出版信息

J Ment Health. 2013 Dec;22(6):555-62. doi: 10.3109/09638237.2012.734653. Epub 2013 Jan 16.

Abstract

BACKGROUND

In the past two decades, there has been a growing interest in the development of a more patient-centred approach to assessing treatment outcomes. This interest has resulted in the increasing use of patient-reported outcome measures (PROMs) in both clinical trials and usual clinical practice.

AIMS

To briefly discuss the paucity of efficacy and effectiveness studies in the field of mental health (exemplified by schizophrenia, depression and opioid dependence) that significantly incorporate the patient's perspective. The limited concordance between the perspectives of patients and clinicians in outcome assessment is also addressed. Finally, we propose a new PROM classification system based on the degree to which these instruments incorporate the patient's perspective.

CONCLUSIONS

PROMs may differ little from traditional instruments unless they truly incorporate the patient's perspective and not just the perspectives of clinicians and researchers. Efforts to develop new PROMs that provide a more patient-centred outcome assessment should use qualitative and participatory methods to capture and incorporate patient perspectives and values.

摘要

背景

在过去的二十年中,人们越来越关注开发一种更加以患者为中心的方法来评估治疗结果。这种兴趣导致患者报告的结果测量(PROM)在临床试验和常规临床实践中的使用越来越多。

目的

简要讨论在心理健康领域(以精神分裂症、抑郁症和阿片类药物依赖为例),很少有显著纳入患者视角的疗效和有效性研究。在结果评估中,患者和临床医生的观点之间也存在有限的一致性。最后,我们提出了一种新的 PROM 分类系统,该系统基于这些工具纳入患者视角的程度。

结论

除非 PROM 真正纳入患者视角,而不仅仅是临床医生和研究人员的视角,否则它们可能与传统工具没有太大区别。努力开发提供更以患者为中心的结果评估的新 PROM 应使用定性和参与性方法来获取和纳入患者的观点和价值观。

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