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Gettel CJ, Galske J, Sather AR, Haidous AK, Hwang U, Brackett AL, Venkatesh AK, Rising KL, Goldberg EM, van Oppen JD, Conroy SP, Carpenter CR. Patient-reported outcome measure use among older adults after emergency department care: A systematic review. Acad Emerg Med 2024; 31:273-287. [PMID: 38366698 DOI: 10.1111/acem.14850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are gaining favor in clinical and research settings given their ability to capture a patient's symptom burden, functional status, and quality of life. Our objective in this systematic review was to summarize studies including PROMs assessed among older adults (age ≥ 65 years) after seeking emergency care. METHODS With the assistance of a medical librarian, we searched Ovid MEDLINE, PubMed, Embase, CINAHL, Web of Science-Core Collection, and Cochrane CENTRAL from inception through June 2023 for studies in which older adult ED patients had PROMs assessed in the post-emergency care time period. Independent reviewers performed title/abstract review, full-text screening, data extraction, study characteristic summarization, and risk-of-bias (RoB) assessments. RESULTS Our search strategy yielded 5153 studies of which 56 met study inclusion criteria. Within included studies, 304 unique PROM assessments were performed at varying time points after the ED visit, including 61 unique PROMs. The most commonly measured domain was physical function, assessed within the majority of studies (47/56; 84%), with measures including PROMs such as Katz activities of daily living (ADLs), instrumental ADLs, and the Barthel Index. PROMs were most frequently assessed at 1-3 months after an ED visit (113/304; 37%), greater than 6 months (91/304; 30%), and 4-6 months (88/304; 29%), with very few PROMs assessed within 1 month of the ED visit (12/304; 4%). Of the 16 interventional studies, two were determined to have a low RoB, four had moderate RoB, nine had high RoB, and one had insufficient information. Of the 40 observational studies, 10 were determined to be of good quality, 20 of moderate quality, and 10 of poor quality. CONCLUSIONS PROM assessments among older adults following an ED visit frequently measured physical function, with very few assessments occurring within the first 1 month after an ED visit.
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Affiliation(s)
- Cameron J Gettel
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
| | - James Galske
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Ali K Haidous
- University of Michigan-Dearborn, Dearborn, Michigan, USA
| | - Ula Hwang
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Geriatric Research, Education and Clinical Center, James J. Peters VAMC, Bronx, New York, USA
| | - Alexandria L Brackett
- Harvey Cushing/John Hay Whitney Medical Library, Yale School of Medicine, New Haven, Connecticut, USA
| | - Arjun K Venkatesh
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Kristin L Rising
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Center for Connected Care, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- College of Nursing, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Elizabeth M Goldberg
- Department of Emergency Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - James D van Oppen
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Simon P Conroy
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
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Huemer M, Bösch F. Measuring what matters: Why and how to include patient reported outcomes in clinical care and research on inborn errors of metabolism. J Inherit Metab Dis 2023; 46:796-805. [PMID: 37155299 DOI: 10.1002/jimd.12622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/10/2023]
Abstract
Patient reported outcomes (PROs) are generally defined as 'any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else'. A broader definition of PRO also includes 'any information on the outcomes of health care obtained directly from patients without modification by clinicians or other health care professionals'. Following this approach, PROs encompass subjective perceptions of patients on how they function or feel not only in relation to a health condition but also to its treatment as well as concepts such as health-related quality of life (HrQoL), information on the functional status of a patient, signs and symptoms and symptom burden. PRO measurement instruments (PROMs) are mostly questionnaires and inform about what patients can do and how they feel. PROs and PROMs have not yet found unconditional acceptance and wide use in the field of inborn errors of metabolism. This review summarises the importance and usefulness of PROs in research, drug legislation and clinical care and informs about quality standards, development, and potential methodological shortfalls of PROMs. Inclusion of PROs measured with high-quality, well-selected PROMs into clinical care, drug legislation, and research helps to identify unmet needs, improve quality of care, and define outcomes that are meaningful to patients. The field of IEM should open to new methodological approaches such as the definition of core sets of variables including PROs to be systematically assessed in specific metabolic conditions and new collaborations with PRO experts, such as psychologists to facilitate the systematic collection of meaningful data.
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Affiliation(s)
- Martina Huemer
- Division of Metabolism and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Paediatrics, LKH Bregenz, Bregenz, Austria
| | - Florin Bösch
- Department of Psychosomatics and Psychiatry, and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
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Naumann DN, Bhangu A, Brooks A, Martin M, Cotton BA, Khan M, Midwinter MJ, Pearce L, Bowley DM, Holcomb JB, Griffiths EA. A call for patient-centred textbook outcomes for emergency surgery and trauma. Br J Surg 2022; 109:1191-1193. [PMID: 35979582 PMCID: PMC10364760 DOI: 10.1093/bjs/znac271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/22/2022] [Accepted: 07/15/2022] [Indexed: 12/31/2022]
Affiliation(s)
- David N Naumann
- Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Aneel Bhangu
- Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,NIHR Global Health Unit on Global Surgery, Institute of Translational Medicine, University of Birmingham, Birmingham, UK
| | - Adam Brooks
- Department of Major Trauma, East Midlands Major Trauma Centre, Queen's Medical Centre, Nottingham, UK
| | - Matthew Martin
- Department of Surgery, Division of Trauma and Acute Care Surgery, Los Angeles County & USC Medical Center, Los Angeles, California, USA
| | - Bryan A Cotton
- The Center for Translational Injury Research, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Mansoor Khan
- Department of Surgery, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Mark J Midwinter
- School of Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Lyndsay Pearce
- Department of Surgery, Salford Royal NHS Foundation Trust, Salford, UK
| | - Douglas M Bowley
- Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - John B Holcomb
- Department of Surgery, Division of Acute Care Surgery, University of Alabama at Birmingham, Birmingham, USA
| | - Ewen A Griffiths
- Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Hughes JA, Jones L, Potter J, Wong A, Brown NJ, Chu K. An initial psychometric evaluation of the APS-POQ-R in acute pain presenting to the emergency department. Australas Emerg Care 2021; 24:287-295. [PMID: 33451967 DOI: 10.1016/j.auec.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/18/2020] [Accepted: 12/06/2020] [Indexed: 12/29/2022]
Abstract
AIM The purpose of this study was to examine the psychometric properties of a modified version of the American Pain Societies - Patient Outcome Questionnaire - Revised edition in adult patients presenting with acute pain to the emergency department. BACKGROUND There is a lack of validation and use of patient-reported outcome measures of pain care in the adult emergency setting. DESIGN Prospective psychometric evaluation. METHODS Adult patients who had presented with acute pain were invited to participate in the study after their emergency department care. The Questionnaire was administered by one of the investigators. Exploratory factor analysis (principal axis factoring) was used to explore items mapping to constructs. The number of constructs with an Eigenvalue closest to 1 was considered the correct fit for the data. Assessment of the analysis was conducted using the Kaiser-Meier-Olkin test of sampling adequacy, and the fit was assessed using Bartlett's test of sphericity. RESULTS The Questionnaire demonstrated construct validity in these patients. Exploratory factor analysis demonstrated five constructs. The tool demonstrated discriminatory ability based on patient urgency, and subscale measurement was associated with patient satisfaction with care CONCLUSIONS: The Questionnaire has demonstrable construct validity in adult patients presenting with acute pain to the ED.
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Affiliation(s)
- James A Hughes
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia; School of Nursing, Queensland University of Technology, Brisbane, Australia.
| | - Lee Jones
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | | | - Alixandra Wong
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Nathan J Brown
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Kevin Chu
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia
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Young VN, Jordan KM, Schneider SL, Lazar A, Dwyer CD, Rosen CA. Laryngology Quality of Life Questionnaire Associations: Towards Reducing Survey Burden. Laryngoscope 2020; 131:1561-1565. [PMID: 32901941 DOI: 10.1002/lary.29019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/06/2020] [Accepted: 07/24/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Outcomes in laryngology focus primarily on patient reported outcome measures (PROMs). The increasing number of questionnaires may lead to survey fatigue. We sought to determine the relationship between the newest questionnaire, Laryngopharyngeal Universal Measure of Perceived Sensation (LUMP), and other laryngology PROMs. STUDY DESIGN Cross-sectional study. METHODS Patients undergoing laryngology multidisciplinary evaluation prospectively completed laryngology questionnaires. Average summed scores between standard laryngology PROMs (ie, VHI-10, RSI, DI, CSI, EAT-10) and LUMP were compared. Expert consensus panel identified the most clinically relevant statements which were then compared to LUMP summed scores, in increasingly additive fashion. RESULTS Four hundred eighty patients (259 female) were assessed. Average age was 57.1 ± 17.7 years. Intraclass correlation coefficient (ICC) for each PROM in comparison to LUMP ranged from moderate to poor correlation: 0.64 (RSI), 0.55 (EAT-10), 0.50 (DI), 0.48 (CSI), and 0.34 (VHI-10). ICC for combinations of the five most clinically relevant individual items ranged from 0.29-0.53. CONCLUSIONS Patients with self-reported globus had statistically significantly higher scores across all PROMs. RSI had moderate correlation with LUMP, and the five selected expert consensus items demonstrated weaker correlation. While RSI may serve as a moderately selective clinical proxy for the LUMP questionnaire, LUMP remains a validated tool with increased specificity for quantification of globus which may be especially important in the research setting. There is continued question about the need for multiple laryngologic PROMs to evaluate patient complaints, and survey reduction remains an area of interest to decrease respondent fatigue, optimize patient care, and quantify interventional success. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1561-1565, 2021.
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Affiliation(s)
- VyVy N Young
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Kristiana M Jordan
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Sarah L Schneider
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Ann Lazar
- Division of Biostatistics, Clinical and Translational Science Institute, University of California - San Francisco, San Francisco, California, U.S.A
| | - Christopher D Dwyer
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Clark A Rosen
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
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