Washington University, St. Louis, Missouri.
Arthroscopy. 2023 Mar;39(3):853-855. doi: 10.1016/j.arthro.2022.08.032.
Measuring patient-reported outcomes (PROs) is a key tenet in the drive toward value-based care. A more detailed understanding of outcomes has traditionally been obtained with increasingly frequent and more in-depth patient questionnaires. Legacy PROs require patients to complete a predetermined set of questions. Administering lengthy surveys repeatedly can generate respondent fatigue that compromises quality of the survey responses and overall compliance. In addition, these legacy scales have notable ceiling and floor effects, which limit their capacity to describe the condition of patients who are functioning at relatively high or low levels. Modern computer adaptive instruments, such as PROMIS, strive to minimize responder burden and mitigate floor and ceiling effects associated with many legacy instruments. However, although these new newer instruments correlate (moderately) with legacy scores, PROMIS also shows floor and ceiling effects, and PROMIS responsiveness is currently understudied. Today, we collect both PROMIS and legacy scores for tracking patient outcomes and for research purposes. We predict that with further refinement, PROMIS will replace legacy patient-reported outcome measures.
衡量患者报告的结果 (PROs) 是迈向基于价值的护理的关键原则。传统上，通过越来越频繁和更深入的患者问卷调查来更详细地了解结果。传统的 PROs 要求患者完成一组预定的问题。反复进行冗长的调查会导致受访者疲劳，从而影响调查结果的质量和整体依从性。此外，这些传统量表存在明显的天花板和地板效应，限制了它们描述功能处于相对较高或较低水平的患者病情的能力。现代计算机自适应仪器，如 PROMIS，努力最小化应答者的负担，并减轻许多传统仪器相关的地板和天花板效应。然而，尽管这些新仪器与传统评分（中等程度）相关，但 PROMIS 也显示出地板和天花板效应，而且 PROMIS 的反应性目前研究不足。今天，我们收集 PROMIS 和传统评分来跟踪患者的结果和进行研究。我们预测，随着进一步的改进，PROMIS 将取代传统的患者报告结果测量。
