Topic

Challenges and Opportunities for Using Common PRO Measures in Comparative Effectiveness Research

Presenters

Greg Simon, MD, MPH, Senior Scientific Investigator, Group Health Research Institute
David Cella, PhD, Professor and Chair, Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
Reesa Laws, BS, Research & Data Analytics Center Manager, Technical Research Program Manager, Kaiser Permanente Center for Health Research

Keywords

Patient-reported outcomes; PROs; Comparative effectiveness research; CER; Patient Health Questionnare-9; PHQ-9; Depression; Measurement-based care

Key Points

• Broad opportunities exist for enabling comparative effectiveness research using patient-reported outcome data routinely collected in healthcare settings. This presentation describes depression care in large health systems as a use case.
• The Patient Health Questionnaire-9 (PHQ-9)—a multipurpose instrument for screening, diagnosing, monitoring, and measuring depression severity—maps to DSM criteria for major depression and has become the default standard measure in most large healthcare systems. Yet, several large and small providers resist using PHQ-9 for various reasons related to the type/relevance of certain questions and length of time to administer the tool.
• Migrating to a common metric via PROsetta Stone® can assist in the collection of measures across healthcare systems. The tool links Patient-Reported Outcomes Measurement Information System (PROMIS®) measures with other related instruments. Depression is 1 of 83 calibrated PROMIS scales. In the depression use case, PROsetta Stone allows PHQ-9 scores to be expressed as a standardized T-score linked to the PROMIS metric.

Discussion Themes

What’s the role of EHR vendors in promoting and standardizing the use of patient-reported outcome measures?

To what extent could we expect to see greater integration of National Quality Forum-endorsed measures with PROMIS measures?

With a computer adaptive testing (CAT) approach, PRO assessment can cover a wide range of question/response items with increased precision.

For More Information

Read more about measuring outcomes from the patient perspective at the PROMIS website: http://bit.ly/1poLRN8.

Get information on linking PRO measures with PROsetta Stone at: http://bit.ly/1FuahWS.

See a demonstration of PROMIS computer adaptive testing at: http://bit.ly/1YQ8Vk3.

Tags
#PROMIS; #PatientReportedOutcomes; #ComputerAdaptiveTesting; #LearningHealthcareSystem; #pctGR
@promisNIH; @PCTGrandRounds, @Collaboratory1, @PCORnetwork