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用于新冠后状况和其他长期状况的数字化患者报告结局测量平台:以用户为中心的开发和技术描述。

Digital Patient Reported Outcome Measures Platform for Post-COVID-19 Condition and Other Long-Term Conditions: User-Centered Development and Technical Description.

机构信息

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.

ELAROS 24/7 Ltd, Sheffield, United Kingdom.

出版信息

JMIR Hum Factors. 2023 Oct 20;10:e48632. doi: 10.2196/48632.

Abstract

BACKGROUND

Post-COVID-19 condition (PCC), colloquially known as long COVID, is a multisystem condition characterized by persistent symptoms beyond 4 weeks after the SARS-CoV-2 infection. More than 60 million people with PCC worldwide need prompt assessment, diagnosis, and monitoring, with many requiring specialist help from a multidisciplinary team of health care professionals (HCPs). Consequently, a scalable digital system is required for both people with PCC and HCPs to capture the breadth of symptoms and their impact on health, using patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs).

OBJECTIVE

We aim to develop and implement a novel PCC digital PROM (DPROM) platform for (1) securely collecting PROM and PREM data from people with PCC, (2) enabling users to monitor symptoms longitudinally and assess response to treatment, (3) generating reports for the electronic health records (EHRs), (4) providing summary reports on PCC services based on national requirements, and (5) facilitating the sharing of relevant data with authorized research teams to accelerate our understanding of this new condition and evaluate new strategies to manage PCC.

METHODS

We (1) undertook requirement analysis with people with PCC, HCPs, and researchers to identify the needs of the DPROM platform and determine its required functionalities; (2) designed and developed a clinically useful web portal for staff and a mobile app for patients, with a web-based alternative app to improve patient and staff choice, limit the risk of digital exclusion, and account for variability across services; (3) determined the PROMs and PREMs that PCC services would prefer to use on the platform; and (4) designed the summary report function that can be generated for each user for the EHR and for reporting to national health authorities.

RESULTS

A DPROM platform to record PCC symptom profile, condition severity, functional disability, and quality of life, based on the C19-YRS (Yorkshire Rehabilitation Scale) and other PROMs and PREMs, was developed. Individual-level medical information and details on the COVID-19 illness can be captured systematically. The platform generates easy-to-understand scores, radar plots and line graphs for people with PCC to self-monitor their condition and for HCPs to assess the natural course of the condition and the response to interventions. Clinics can configure a suite of PROMs and PREMs based on their local and national service and commissioning requirements and support research studies which require large-scale data collection on PROMs. The DPROM platform enables automatic aggregate data analysis for services to undertake service evaluation and cost-effectiveness analysis. The DPROM platform generated summary report can be uploaded to the EHRs of people with PCC.

CONCLUSIONS

A multifunctional DPROM platform to assess, grade, and monitor PCC has been developed. Future research will analyze the system's usability in specialist PCC clinical services and other long-term conditions.

摘要

背景

新冠后状况(PCC),俗称长新冠,是一种多系统疾病,其特征是在 SARS-CoV-2 感染后 4 周以上持续出现症状。全球有超过 6000 万人患有 PCC,他们需要及时进行评估、诊断和监测,其中许多人需要多学科医疗保健专业人员团队的专家帮助。因此,需要一个可扩展的数字系统,以便 PCC 患者和 HCP 都可以使用患者报告的结果测量(PROMs)和患者报告的体验测量(PREMs)来捕捉症状的广度及其对健康的影响。

目的

我们旨在开发和实施一种新颖的 PCC 数字 PROM(DPROM)平台,用于(1)从 PCC 患者那里安全地收集 PROM 和 PREM 数据,(2)使用户能够纵向监测症状并评估治疗反应,(3)为电子健康记录(EHRs)生成报告,(4)根据国家要求提供 PCC 服务的总结报告,以及(5)促进与授权研究团队共享相关数据,以加速我们对这种新疾病的理解并评估管理 PCC 的新策略。

方法

我们(1)与 PCC 患者、HCP 和研究人员一起进行需求分析,以确定 DPROM 平台的需求并确定其所需的功能;(2)为员工设计和开发了一个临床有用的网络门户,为患者设计了一个移动应用程序,为改善患者和员工的选择、降低数字排斥的风险以及考虑到服务的差异,还设计了基于网络的替代应用程序;(3)确定了 PCC 服务在平台上首选使用的 PROM 和 PREM;以及(4)设计了可以为每个用户生成的 EHR 中的摘要报告功能和向国家卫生当局报告的摘要报告功能。

结果

开发了一种基于 C19-YRS(约克郡康复量表)和其他 PROM 和 PREM 的 DPROM 平台,用于记录 PCC 症状谱、疾病严重程度、功能障碍和生活质量。可以系统地捕获个人的医疗信息和 COVID-19 疾病的详细信息。该平台为 PCC 患者生成易于理解的分数、雷达图和线图,以便他们自我监测病情,为 HCP 评估病情的自然进程和干预措施的反应。诊所可以根据其当地和国家的服务和委托要求配置一套 PROM 和 PREM,并支持需要大规模收集 PROM 的研究。DPROM 平台能够自动进行数据分析,为服务提供服务评估和成本效益分析。DPROM 平台生成的摘要报告可以上传到 PCC 患者的 EHRs。

结论

已经开发出一种用于评估、分级和监测 PCC 的多功能 DPROM 平台。未来的研究将分析该系统在专业 PCC 临床服务和其他长期疾病中的可用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70a/10592725/577b104d2be1/humanfactors_v10i1e48632_fig1.jpg

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