School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
Department of Dermatology, University of Rochester Medical Center, 601 Elmwood Ave, Box 697, Rochester, NY, 14642, USA.
Arch Dermatol Res. 2021 Jan;313(1):17-24. doi: 10.1007/s00403-020-02074-1. Epub 2020 Apr 8.
Patient-reported outcome (PRO) measures play an important role in clinical care. Currently, a broad-spectrum, validated PRO measure suitable for all dermatology patients, as part of clinical care, does not exist. Patient-reported Outcome Measures Information System (PROMIS) measures track specific domain outcomes across all diseases. To assess the relevance and utility of a computer-adaptive health assessment consisting of three PROMIS domains in routine dermatologic care. This retrospective study evaluated a PROMIS health assessment, consisting of three computer-adaptive test domains (pain interference, anxiety, and depression), administered as part of routine clinical care in three dermatology clinics at an academic medical center. The primary objective was to identify clinically significant associations between high PROMIS domain scores (i.e., t score > 55) and dermatologic disease, as well as change in PROMIS domain scores in response to treatment. The majority of patients who initiated the assessment completed all domains (88.7%). In patients with atopic dermatitis, acne, hidradenitis suppurativa, and psoriasis, high PROMIS scores correlated with clinically relevant outcomes, such as severe disease, unsuccessful treatment, uncontrolled disease, and the presence of a mental health condition. PROMIS Pain Interference, anxiety and depression identified patients with severe disease, unsuccessful treatment regimens, poorly-controlled disease, and/or mental health comorbidities for multiple skin conditions. Further utilization of PROMIS domains in routine clinical care will promote patient-centered care and improve quality of care.
患者报告的结局（PRO）测量在临床护理中起着重要作用。目前，作为临床护理的一部分，还没有一种广谱的、经过验证的、适合所有皮肤科患者的 PRO 测量方法。患者报告结局测量信息系统（PROMIS）测量方法可以跟踪所有疾病的特定领域的结果。评估由三个 PROMIS 领域组成的计算机自适应健康评估在常规皮肤科护理中的相关性和实用性。这项回顾性研究评估了一项 PROMIS 健康评估，该评估由三个计算机自适应测试领域（疼痛干扰、焦虑和抑郁）组成，作为学术医疗中心的三个皮肤科诊所常规临床护理的一部分。主要目的是确定高 PROMIS 领域得分（即 t 得分>55）与皮肤科疾病之间的临床显著关联，以及治疗后 PROMIS 领域得分的变化。大多数开始评估的患者完成了所有领域（88.7%）。在特应性皮炎、痤疮、化脓性汗腺炎和银屑病患者中，高 PROMIS 评分与临床相关结局相关，如严重疾病、治疗失败、疾病控制不佳以及心理健康状况的存在。PROMIS 疼痛干扰、焦虑和抑郁可以识别出多种皮肤疾病的严重疾病、治疗方案失败、疾病控制不佳和/或精神健康合并症患者。进一步在常规临床护理中使用 PROMIS 领域将促进以患者为中心的护理，并提高护理质量。
