Flashcards in HaDSoc 5.2 patient reported outcomes Deck (26):
1
Why should we measure health?
-Have an idea of the health needs
-helps with resource allocation
-can look at effectiveness of interventions
-monitor progress
-look at quality of health services (Are people happy with the service?)
2
What are some commonly used measures of health?
-mortality
-morbidity
-patient reported outcomes
3
What are some pros and cons of using mortality as a measure of health?
-it is easily defined
-its not always recorded properly (wont know the cause of death)
-not a good measure of outcome (death shouldn't really be an outcome)
4
What are some pros and cons of using morbidity as a measure of health?
-its already widely collected (general health checks etc)
-collection isnt always accurate
-not easy to evaluate
-no insight into the patients experiences.
5
why use a patient-based outcome?
To attempt to assess well being from the patients perspective.
- good for conditions where there is no cure, just management.
-good for looking at iatrogenic effects of care (are certain parts of the treatment affecting the patient negatively?)
6
What does PROMs stand for?
Patient reported outcomes measure.
7
What are some uses of patient reported outcomes?
-used in audit
-used to evaluate quality of care
-used to look at effectiveness and benefits associated with cost
-used to measure health status of populations
8
What happens to the data collected by proms?
-it's published
-comparisons can be made between trusts
-patients can use it to help them make decisions
-of interest to commissioners
9
What are some drawbacks of PROMs?
-take a lot of time to collect, analyse and publish
-difficult to get everyone to participate (introduces bias)
-need to make sure they arent being misused
10
Define health related quality of life.
'the functional effects of an illness and its consequent therapy upon a patient, as percieved by that patient.'
11
How do we measure HRQoL?
-qualitative methods
-quantitative methods
-specific or generic instruments
12
What 2 properties must a quatitative instrument be, in order to be a good PROM?
-validity (does it measure what it should measure?)
-reliability (is it accurate over time and internally consistant, are any changes recorded due to a change in the condition, instead of the way the questions are asked etc)
13
What are some advantages of using published instruments instead of unpublished, for PROMs?
-they've been proven to be reliable and valid
-you can compare across different groups becuase they are widely used.
-
14
What are some advantages of generic instrument use for PROMs?
-you can use them on any population, including healthy people
-good for a broad range of problems
-can detect unexpected effects of interventions
-can assess the health of populations
15
What are some disadvantages of generic instrument use for PROMs?
-Patients may not feel they're relevant so may not complete them
-May be too broad, overlook things, be too general
-They're less details
-less sensitive to changes that occur after an intervention
16
What are some examples of generic measures for PROMs?
-Short form 36
-euroQOL EQ-5D.
17
What is the SF 36? describe it's properties.
A short questionaire of 36 questions, coverring 8 domains, which looks at health over the past 4 weeks.
Is widely used in research
proven to be reliable and valid.
18
What are the 8 dimensions of the SF 36?
-physical functioning
-role functioning (physical)
-social functioning
-role functioning (emotional)
-bodily pain
-vitality
-mental health
-general health
19
How does the scoring of the SF 36 work?
Scores relating to a single domain can be grouped together.
Scores across domains cannot. (takes more analysing)
No overall score.
20
What are some advantages of the SF36?
-acceptible to people
-only takes 5-10 mins to fill out
-high internal consistency
-it's responsive to change
-widely used so theres population data available for comparison.
21
Discuss features of the EuroQol 5d.
questions 5 dimensions of health, and generates a single index between 0 (death) and full health (1).
Commonly used as a stand alone measure.
22
What are the dimensions of the EQ 5d?
-mobility
-self care
-usual activities
-pain
-anxiety/depression.
(each has 3 levels, no problems, some problems, severe problems)
23
What are the 3 types of specific instruments used for PROM's?
-disease specific (eg asthma QoL questionaire)
-site specific (eg hip, shoulder)
-dimension specific (eg pain, depression)
24
What are the advantages of specific instrument use for proms?
-very sensitive to change
-more acceptible to people
-very detailed (relevant)
25
What are some disadvantages of using specific instruments for PROMS?
-may miss unexpected effects (very specific)
-can't be used for people who don't have the disease
-limited comparison
26