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患者报告结局测量的发展、其临床整合、电子化及其对康复服务提供的潜在影响的观点。

A View of the Development of Patient-Reported Outcomes Measures, Their Clinical Integration, Electronification, and Potential Impact on Rehabilitation Service Delivery.

机构信息

Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota.

Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota.

出版信息

Arch Phys Med Rehabil. 2022 May;103(5S):S24-S33. doi: 10.1016/j.apmr.2021.10.031. Epub 2021 Dec 10.

DOI:10.1016/j.apmr.2021.10.031
PMID:34896403
Abstract

Recognition of the importance of a patient's perception of their status and experience has become central to medical care and its evaluation. This recognition has led to a growing reliance on the use of patient-reported outcome measures (PROMs). Nevertheless, although awareness of PROMs and acceptance of their utility has increased markedly, few of us have a good insight into their development; their utility relative to clinician-rated and performance measures such as the FIM and 6-minute walk test or how their "electronification" and incorporation into electronic health records (EHRs) may improve the individualization, value, and quality of medical care. In all, the goal of this commentary is to provide some insight into historical factors and technology developments that we believe have shaped modern clinical PROMs as they relate to medicine in general and to rehabilitation in particular. In addition, we speculate that while the growth of PROM use may have been triggered by an increased emphasis on the centrality of the patient in their care, future uptake will be shaped by their embedding in EHRs and used to improve clinical decision support though their integration with other sources of clinical and sociodemographic data.

摘要

认识到患者对自身状况和体验的感知的重要性已成为医疗保健及其评估的核心。这种认识导致越来越依赖使用患者报告的结果测量(PROMs)。尽管对 PROMs 的认识和对其效用的接受程度显著提高,但我们很少有人对其发展有很好的了解;它们与临床医生评估和表现测量(如 FIM 和 6 分钟步行测试)相比的效用,或者它们的“电子化”及其纳入电子健康记录(EHRs)如何提高医疗保健的个性化、价值和质量。总的来说,本评论的目的是提供一些对历史因素和技术发展的洞察,我们认为这些因素塑造了现代临床 PROMs,这些 PROMs与一般医学,特别是康复医学有关。此外,我们推测,尽管 PROM 使用的增长可能是由于更加重视患者在其护理中的中心地位所引发的,但未来的采用将受到它们在 EHR 中的嵌入以及通过与其他临床和社会人口数据来源的整合来改善临床决策支持的影响。

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Improving the Delivery of Function-Directed Care During Acute Hospitalizations: Methods to Develop and Validate the Functional Assessment in Acute Care Multidimensional Computerized Adaptive Test (FAMCAT).改善急性住院期间功能导向护理的提供:开发和验证急性护理多维计算机自适应测试功能评估(FAMCAT)的方法。
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Examination of the Measurement Equivalence of the Functional Assessment in Acute Care MCAT (FAMCAT) Mobility Item Bank Using Differential Item Functioning Analyses.使用差异项目功能分析检验急性护理 MCAT(FAMCAT)移动项目库中功能评估的测量等效性。
Arch Phys Med Rehabil. 2022 May;103(5S):S84-S107.e38. doi: 10.1016/j.apmr.2021.03.044. Epub 2021 Jun 16.
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