Psychosocial Department, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam.
Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Med Care. 2019 May;57 Suppl 5 Suppl 1:S52-S58. doi: 10.1097/MLR.0000000000001061.
This paper describes the different ways in which information is being fed back to health care providers (HCPs) using the Dutch evidence-based KLIK Patient-Reported Outcome Measures (PROMs) portal (www.hetklikt.nu). KLIK was initially developed for children with a chronic illness and their parents, and recently expanded for use in adult health care. Patients complete online PROMs at home about their health-related quality of life (HRQOL), symptoms and/or psychosocial functioning before an outpatient consultation with their HCP. PROMs are subsequently converted into an individual KLIK electronic (e)PROfile and discussed during the consultation to facilitate systematic attention for HRQOL.
KLIK includes a variety of different PROMs. The KLIK ePROfile initially consisted of literal representations of the individual PROM items in the European traffic light colors (red, orange, green) and only one graph. Over the years, the KLIK ePROfile evolved into a broader spectrum of feedback options; (1) literal representation of individual items, (2) summary scores, and (3) graphic representations (4 options).
The primary goal of KLIK is to longitudinally monitor patient and parent self-reported or proxy-reported health outcomes, which means that the focus of KLIK is not mainly on recommending actions for PRO results. However, there are several aids that help interpretation of the KLIK ePROfile and recommendations are given for actions based on PROM scores. The main aid is the KLIK training, which includes a theoretical and a practical part. In the training, 2 tools-a decision tree and a summary of information about the KLIK ePROfile-are given to the HCPs to assist them in using KLIK.
Customization of a PROM portal is needed for each different patient group and clinical setting. Because the KLIK website is flexible, every PROM (with good psychometric qualities and permission of the publisher) can be built in. However, implementing and feeding back PROMs in pediatric health care encompasses different challenges, because different versions of the same PROM are needed for children of different ages, as well as proxy and self-report versions.
本文介绍了荷兰循证 KLIK 患者报告结局测量（PROMs）门户（www.hetklikt.nu）向医疗保健提供者（HCPs）反馈信息的不同方式。KLIK 最初是为患有慢性病的儿童及其父母开发的，最近扩展到成人保健领域。患者在与 HCP 进行门诊咨询前在家中在线完成有关其健康相关生活质量（HRQOL）、症状和/或心理社会功能的 PROMs。随后，PROMs 转换为个人 KLIK 电子（e）PROfile，并在咨询期间进行讨论，以促进对 HRQOL 的系统关注。
PRO 评分解释方法：KLIK 包括各种不同的 PROMs。KLIK ePROfile 最初由欧洲交通信号灯颜色（红色、橙色、绿色）的个体 PROM 项目的字面表示组成，只有一个图形。多年来，KLIK ePROfile 发展成了更广泛的反馈选项；（1）个体项目的字面表示，（2）总结分数，和（3）图形表示（4 种选择）。
制定针对 PRO 结果的行动建议：KLIK 的主要目标是纵向监测患者和家长自我报告或代理报告的健康结果，这意味着 KLIK 的重点主要不在于推荐针对 PRO 结果的行动。但是，有几种辅助工具可以帮助解释 KLIK ePROfile，并根据 PROM 分数给出行动建议。主要的辅助工具是 KLIK 培训，它包括理论和实践两部分。在培训中，向 HCPs 提供了一个决策树和一个关于 KLIK ePROfile 的信息摘要，以帮助他们使用 KLIK。
需要为每个不同的患者群体和临床环境定制 PROM 门户。由于 KLIK 网站具有灵活性，因此可以构建任何具有良好心理测量学质量并获得出版商许可的 PROM。然而，在儿科保健中实施和反馈 PROM 涉及到不同的挑战，因为需要为不同年龄的儿童以及代理和自我报告版本提供同一 PROM 的不同版本。
