Khullar Onkar V, Perez Aubriana, Dixon Meredith, Binongo Jose N, Sancheti Manu S, Pickens Allan, Gillespie Theresa, Force Seth D, Fernandez Felix G
Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Ann Thorac Surg. 2023 Feb;115(2):526-532. doi: 10.1016/j.athoracsur.2022.04.048. Epub 2022 May 11.
Patient-reported outcomes (PROs) assessment is a necessary component of surgical outcome assessment and patient care. This study examined the success of routine PROs assessment in an academic-based thoracic surgery practice.
PROs, measuring pain intensity, physical function, and dyspnea, were routinely obtained using the National Institutes of Health-sponsored Patient-Reported Outcomes Measurement Information System (PROMIS) on all thoracic surgery patients beginning in April 2018 through January 2021. Questionnaires were administered electronically through a web-based platform at home or during the office visit. Completion rates and barriers were measured.
A total of 9725 thoracic surgery office visits occurred during this time frame. PROs data were obtained in 6899 visits from a total of 3551 patients. The mean number of questions answered per survey was 22.4 ± 2.2. Overall questionnaire completion rate was 65.7%. A significant decline in survey completion was noted in April 2020, after which adjustments were made to allow for questionnaire completion through a mobile health platform. Overall monthly questionnaire completion rates ranged from 20% (April 2020) to 90% (October 2018). Mean T scores were dyspnea, 41.6 ± 12.3; physical function, 42.7 ± 10.5; and pain intensity, 52.8 ± 10.3.
PROs can be assessed effectively in a thoracic surgery clinic setting, with minimal disruption of clinical activities. Future efforts should focus on facilitating PROs collection from disadvantaged patient populations and scaling implementation across programs.
患者报告结局（PROs）评估是手术结局评估和患者护理的必要组成部分。本研究考察了在以学术为基础的胸外科实践中常规PROs评估的成效。
自2018年4月至2021年1月，对所有胸外科患者常规使用由美国国立卫生研究院资助的患者报告结局测量信息系统（PROMIS）来测量疼痛强度、身体功能和呼吸困难等PROs。问卷通过基于网络的平台以电子方式在家中或门诊时发放。测量完成率和障碍因素。
在此时间段内共进行了9725次胸外科门诊。从总共3551名患者的6899次就诊中获得了PROs数据。每次调查回答的问题平均数为22.4±2.2。总体问卷完成率为65.7%。2020年4月调查完成率显著下降，之后进行了调整，允许通过移动健康平台完成问卷。总体每月问卷完成率从20%（2020年4月）到90%（2018年10月）不等。平均T分数为：呼吸困难41.6±12.3；身体功能42.7±10.5；疼痛强度52.8±10.3。
在胸外科门诊环境中可以有效地评估PROs，对临床活动的干扰最小。未来的工作应侧重于促进从弱势患者群体中收集PROs，并在各项目中扩大实施范围。
