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Methods for Developing Patient-Reported Outcome-Based Performance Measures (PRO-PMs).

  • Author(s): Basch, Ethan
  • Spertus, John
  • Dudley, R Adams
  • Wu, Albert
  • Chuahan, Cynthia
  • Cohen, Perry
  • Smith, Mary Lou
  • Black, Nick
  • Crawford, Amaris
  • Christensen, Keri
  • Blake, Kathleen
  • Goertz, Christine
  • et al.
Abstract

OBJECTIVE: To recommend methods for assessing quality of care via patient-reported outcome-based performance measures (PRO-PMs) of symptoms, functional status, and quality of life. METHODS: A Technical Expert Panel was assembled by the American Medical Association-convened Physician Consortium for Performance Improvement. An environmental scan and structured literature review were conducted to identify quality programs that integrate PRO-PMs. Key methodological considerations in the design, implementation, and analysis of these PRO-PM data were systematically identified. Recommended methods for addressing each identified consideration were developed on the basis of published patient-reported outcome (PRO) standards and refined through public comment. Literature review focused on programs using PROs to assess performance and on PRO guidance documents. RESULTS: Thirteen PRO programs and 10 guidance documents were identified. Nine best practices were developed, including the following: provide a rationale for measuring the outcome and for using a PRO-PM; describe the context of use; select a measure that is meaningful to patients with adequate psychometric properties; provide evidence of the measure's sensitivity to differences in care; address missing data and risk adjustment; and provide a framework for implementation, interpretation, dissemination, and continuous refinement. CONCLUSION: Methods for integrating PROs into performance measurement are available.

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