Al Sayah Fatima, Jin Xuejing, Johnson Jeffrey A
Alberta PROMs & EQ-5D Research & Support Unit (APERSU), School of Public Health, University of Alberta, 2-040 Li Ka Shing Centre for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada.
Centre for Evidence-Based Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
J Patient Rep Outcomes. 2021 Oct 12;5(Suppl 2):99. doi: 10.1186/s41687-021-00374-2.
Many healthcare systems around the world have been increasingly using patient-reported outcome measures (PROMs) in routine outcome measurement to enhance patient-centered care and incorporate the patient's perspective in health system performance evaluation. One of the key steps in using PROMs in health systems is selecting the appropriate measure(s) to serve the purpose and context of measurement. However, the availability of many PROMs makes this choice rather challenging. Our aim was to provide an integrated approach for PROM(s) selection for use by end-users in health systems.The proposed approach was based on relevant literature and existing guidebooks that addressed PROMs selection in various areas and for various purposes, as well as on our experience working with many health system users of PROMs in Canada. The proposed approach includes the following steps: (1) Establish PROMs selection committee; (2) Identify the focus, scope, and type of PROM measurement; (3) Identify potential PROM(s); (4) Review practical considerations for each of the identified PROMs; (5) Review measurement properties of shortlisted PROMs; (6) Review patient acceptance of shortlisted PROMs; (7) Recommend a PROM(s); and (8) Pilot the selected PROM(s). The selection of appropriate PROMs is one step in the successful implementation of PROMs within health systems, albeit, an essential step. We provide guidance for the selection of PROMs to satisfy all potential usages at the micro (patient-clinician), meso (organization), and macro (system) levels within the health system. Selecting PROMs that satisfy all these purposes is essential to ensure continuity and standardization of measurement over time. This is an iterative process and users should consider all the available information from all presented steps in selecting PROMs. Each of these considerations has a different weight in diverse clinical contexts and settings with various types of patients and resources.
全球许多医疗保健系统越来越多地在常规结果测量中使用患者报告的结局指标（PROMs），以加强以患者为中心的护理，并将患者的观点纳入卫生系统绩效评估。在卫生系统中使用PROMs的关键步骤之一是选择合适的指标以满足测量目的和背景。然而，众多PROMs的存在使得这一选择颇具挑战性。我们的目标是为卫生系统的最终用户提供一种综合的PROMs选择方法。所提出的方法基于相关文献和现有指南，这些文献和指南涉及不同领域、不同目的的PROMs选择，以及我们在加拿大与众多使用PROMs的卫生系统用户合作的经验。所提出的方法包括以下步骤：（1）成立PROMs选择委员会；（2）确定PROM测量的重点、范围和类型；（3）确定潜在的PROMs；（4）审查每个已确定PROMs的实际考虑因素；（5）审查入围PROMs的测量属性；（6）审查患者对入围PROMs的接受度；（7）推荐一个或多个PROMs；（8）对选定的PROMs进行试点。选择合适的PROMs是在卫生系统中成功实施PROMs的一步，尽管是至关重要的一步。我们为选择PROMs提供指导，以满足卫生系统内微观（患者-临床医生）、中观（组织）和宏观（系统）层面的所有潜在用途。选择满足所有这些目的的PROMs对于确保测量随时间的连续性和标准化至关重要。这是一个迭代过程，用户在选择PROMs时应考虑所有步骤中提供的所有可用信息。在不同的临床背景和环境中，针对不同类型的患者和资源，这些考虑因素中的每一个都具有不同的权重。
