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Open Access Publications from the University of California

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

  • Author(s): Basch, E
  • Spertus, J
  • Adams Dudley, R
  • Wu, A
  • Chuahan, C
  • Cohen, P
  • Smith, ML
  • Black, N
  • Crawford, A
  • Christensen, K
  • Blake, K
  • Goertz, C
  • et al.

© 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). 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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