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将患者报告的结局置于心血管临床实践的中心:对护理质量和管理的影响。

Placing patient-reported outcomes at the centre of cardiovascular clinical practice: implications for quality of care and management.

机构信息

KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35 PB7001, 3000 Leuven, Belgium.

Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden.

出版信息

Eur Heart J. 2023 Sep 21;44(36):3405-3422. doi: 10.1093/eurheartj/ehad514.

Abstract

Patient-reported outcomes (PROs) provide important insights into patients' own perspectives about their health and medical condition, and there is evidence that their use can lead to improvements in the quality of care and to better-informed clinical decisions. Their application in cardiovascular populations has grown over the past decades. This statement describes what PROs are, and it provides an inventory of disease-specific and domain-specific PROs that have been developed for cardiovascular populations. International standards and quality indices have been published, which can guide the selection of PROs for clinical practice and in clinical trials and research; patients as well as experts in psychometrics should be involved in choosing which are most appropriate. Collaborations are needed to define criteria for using PROs to guide regulatory decisions, and the utility of PROs for comparing and monitoring the quality of care and for allocating resources should be evaluated. New sources for recording PROs include wearable digital health devices, medical registries, and electronic health record. Advice is given for the optimal use of PROs in shared clinical decision-making in cardiovascular medicine, and concerning future directions for their wider application.

摘要

患者报告结局(PROs)提供了患者对自身健康和医疗状况的重要见解,有证据表明,使用它们可以改善医疗质量并做出更明智的临床决策。在过去几十年中,心血管人群中对 PROs 的应用不断增加。本陈述描述了 PROs 是什么,并列出了为心血管人群开发的特定疾病和特定领域的 PROs。已经发布了国际标准和质量指标,可以指导 PROs 在临床实践以及临床试验和研究中的选择;应让患者和心理测量学专家参与选择最合适的 PROs。需要合作来定义使用 PROs 来指导监管决策的标准,并且应该评估 PROs 在比较和监测医疗质量以及分配资源方面的效用。记录 PROs 的新来源包括可穿戴数字健康设备、医疗登记处和电子健康记录。就 PROs 在心血管医学中共同临床决策中的最佳使用以及更广泛应用的未来方向提供了建议。

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