Methods for Developing Patient-Reported Outcome-Based Performance Measures

Kirsty Blake
Lincoln University
Nathaniel Black
Sarah Lawrence College
Kari Christensen
Bethel College and Seminary, St. Paul Minnesota
2 more
© 2015 International Society for Pharmacoeconomics and Outcomes Research. Objective: To recommend methods for assessing quality of care via patient-reported outcome-based performance measures 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 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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