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用于认知和语言障碍的个体成年患者的 PROMIS、Neuro-QoL、TBI-QoL 和其他患者报告结局测量的临床应用。

Clinical Use of PROMIS, Neuro-QoL, TBI-QoL, and Other Patient-Reported Outcome Measures for Individual Adult Clients with Cognitive and Language Disorders.

机构信息

Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware.

Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware.

出版信息

Semin Speech Lang. 2021 Jun;42(3):192-210. doi: 10.1055/s-0041-1731365. Epub 2021 Jul 14.

Abstract

Patient-reported outcome measures (PROMs) assess health outcomes from the patient's perspective. The National Institutes of Health has invested in the creation of numerous PROMs that comprise the PROMIS, Neuro-QoL, and TBI-QoL measurement systems. Some of these PROMs are potentially useful as primary or secondary outcome measures, or as contextual variables for the treatment of adults with cognitive/language disorders. These PROMs were primarily created for clinical research and interpretation of group means. They also have potential for use with individual clients; however, at present there is only sparse evidence and direction for this application of PROMs. Previous research by Cohen and Hula (2020) described how PROMs could support evidence-based practices in speech-language pathology. This companion article extends upon that work to present clinicians with implementation information about obtaining, administering, scoring, and interpreting PROMs for individual clients with cognitive/language disorders. This includes considerations of the type and extent of communication support that is appropriate, implications of the relatively large measurement error that accompanies individual scores and pairs of scores, and recommendations for applying minimal detectable change values depending on the clinician's desired level of measurement precision. However, more research is needed to guide the interpretation of PROM scores for an individual client.

摘要

患者报告的结局测量指标(PROMs)从患者的角度评估健康结果。美国国立卫生研究院投资创建了许多 PROMs,这些 PROMs 构成了 PROMIS、Neuro-QoL 和 TBI-QoL 测量系统。其中一些 PROMs 可能作为主要或次要结局测量指标,或作为治疗成人认知/语言障碍的情境变量有用。这些 PROMs 主要是为临床研究和群体均值的解释而创建的。它们也有可能用于个体客户;然而,目前对于 PROMs 的这种应用只有稀疏的证据和方向。Cohen 和 Hula(2020)之前的研究描述了 PROMs 如何支持言语病理学中的循证实践。这篇伴随的文章扩展了这项工作,为临床医生提供了有关为认知/语言障碍的个体客户获取、管理、评分和解释 PROMs 的实施信息。这包括考虑适当的沟通支持的类型和程度、伴随个体分数和分数对的相对较大测量误差的影响,以及根据临床医生期望的测量精度水平应用最小可检测变化值的建议。然而,需要更多的研究来指导对个体客户的 PROM 分数的解释。

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