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促进患者报告结局在临床实践中的有效应用:“方法工具包”系列论文的主题。

Promoting effective use of patient-reported outcomes in clinical practice: themes from a "Methods Tool kit" paper series.

机构信息

Cancer Care and Epidemiology, Queen's Cancer Research Institute, Cancer Center of Southeastern Ontario at Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.

Johns Hopkins Bloomberg School of Public Health and School of Medicine, Baltimore, MD, USA.

出版信息

J Clin Epidemiol. 2020 Jun;122:153-159. doi: 10.1016/j.jclinepi.2020.01.022. Epub 2020 Feb 13.

Abstract

OBJECTIVES

"PRO-cision Medicine," using patients' reports of their symptoms, functioning, and well-being to personalize their care, is becoming more prevalent. Patient-reported outcomes (PROs) are assessed using standardized, validated measures. Research shows that clinicians' and patients' understanding of what the PRO scores mean and how to act on them is often suboptimal. Methods to improve interpretation of PRO scores and action based on PRO results can promote more effective use of PROs in practice.

STUDY DESIGN AND SETTING

A recent supplement to Medical Care describes various approaches to address challenges in interpreting and acting on PROs in practice and therefore serves as a "PRO-cision Medicine Methods Tool kit." This commentary provides an overview of the supplement and identifies cross-cutting themes guided by a theoretical framework.

RESULTS

Six papers describe methods for interpreting PROs, and eight papers describe how different PRO systems address interpreting PRO scores and/or acting on PRO results. Based on the theoretical framework, cross-cutting themes are described in terms of (1) providing PRO information, (2) using PRO data, (3) screening for problems and monitoring for changes, and (4) changing management and behavior.

CONCLUSIONS

The PRO-cision Medicine Methods Tool kit provides a useful resource for interpreting and acting on PRO scores to personalize patient care.

摘要

目的

利用患者对其症状、功能和幸福感的报告来个性化他们的治疗,即所谓的“精准医疗”正变得越来越普遍。患者报告的结果(PROs)使用标准化、经过验证的测量方法进行评估。研究表明,临床医生和患者对 PRO 评分的含义以及如何根据这些评分采取行动的理解往往并不理想。改善 PRO 评分解释和基于 PRO 结果采取行动的方法可以促进 PRO 在实践中的更有效使用。

研究设计和设置

最近一期《医疗保健》杂志增刊描述了在实践中解释和根据 PRO 采取行动的挑战的各种方法,因此可作为“精准医疗方法工具包”。本评论概述了该增刊,并根据理论框架确定了跨领域主题。

结果

六篇论文描述了解释 PRO 的方法,八篇论文描述了不同的 PRO 系统如何解释 PRO 评分和/或根据 PRO 结果采取行动。基于理论框架,跨领域主题可从以下方面进行描述:(1)提供 PRO 信息,(2)使用 PRO 数据,(3)筛查问题和监测变化,以及(4)改变管理和行为。

结论

精准医疗方法工具包为解释和根据 PRO 评分采取行动以实现患者护理的个性化提供了有用的资源。

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