Katzan Irene L, Fan Youran, Griffith Sandra D, Crane Paul K, Thompson Nicolas R, Cella David
Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Value Health. 2017 Sep;20(8):1143-1149. doi: 10.1016/j.jval.2017.05.012. Epub 2017 Jun 20.
Patient-reported outcome performance measures (PRO-PMs) incorporate outcomes from the patient's perspective into performance measures and may have great potential to impact health care. The various patient-reported outcome measures (PROMs) used to assess the same outcome challenge widespread use of PRO-PMs. A potential solution is to statistically link PROMs to provide equivalent PRO-PM conclusions to be drawn regardless of which PROM was used.
To determine the level of agreement in the performance of two depression-related PRO-PMs assessed using the nine-item Patient Health Questionnaire (PHQ-9) depression scale and the eight-item Patient-Reported Outcomes Measurement Information System (PROMIS) Depression short form and the PHQ-9 cocalibrated on the PROMIS metric.
We conducted a retrospective cohort study of patients who visited one of eight ambulatory neurological and psychiatric clinics at the Cleveland Clinic between January 23 and June 15, 2012, and who completed both the PHQ-9 and PROMIS Depression scales at the same visit. The level of agreement was measured between PRO-PM performance assessed with standard scoring of the PHQ-9, the PROMIS cocalibrated scoring of the PHQ-9, and the PROMIS score for two depression-related PRO-PMs.
Of the 5736 enrolled patients, 701 had PROMs from two or more visits. Differences in performance of the depression remission PRO-PM ranged from 0.4% to 2.1%, and differences in the progress toward remission PRO-PM ranged from 0.9% to 5.1%, depending on which depression score was used.
There was a high level of agreement in the PRO-PM for depression when incorporating different PROMs. These findings support the ability to use linkage of scale scores to assess performance of PRO-PMs with different PROMs.
患者报告的结局绩效指标（PRO-PM）将患者视角的结局纳入绩效指标，可能对医疗保健产生重大影响。用于评估同一结局的各种患者报告结局指标（PROM）给PRO-PM的广泛应用带来了挑战。一个潜在的解决方案是通过统计方法将PROM联系起来，以便无论使用哪种PROM，都能得出等效的PRO-PM结论。
确定使用九项患者健康问卷（PHQ-9）抑郁量表、八项患者报告结局测量信息系统（PROMIS）抑郁简表以及在PROMIS指标上共同校准的PHQ-9评估的两种与抑郁相关的PRO-PM的表现一致性水平。
我们对2012年1月23日至6月15日期间在克利夫兰诊所的八个门诊神经科和精神科诊所之一就诊，并在同一次就诊时完成PHQ-9和PROMIS抑郁量表的患者进行了一项回顾性队列研究。评估了用PHQ-9标准评分、PROMIS共同校准评分的PHQ-9以及两种与抑郁相关的PRO-PM的PROMIS评分所评估的PRO-PM表现之间的一致性水平。
在5736名登记患者中，701名患者有两次或更多次就诊的PROM。根据所使用的抑郁评分，抑郁缓解PRO-PM的表现差异在0.4%至2.1%之间，缓解进展PRO-PM的表现差异在0.9%至5.1%之间。
纳入不同的PROM时，抑郁的PRO-PM表现具有高度一致性。这些发现支持通过量表分数的联系来评估不同PROM的PRO-PM表现的能力。
