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A View of the Development of Patient-Reported Outcomes Measures, Their Clinical Integration, Electronification, and Potential Impact on Rehabilitation Service Delivery

Published:December 09, 2021DOI:https://doi.org/10.1016/j.apmr.2021.10.031

      Abstract

      Recognition of the importance of a patient's perception of their status and experience has become central to medical care and its evaluation. This recognition has led to a growing reliance on the use of patient-reported outcome measures (PROMs). Nevertheless, although awareness of PROMs and acceptance of their utility has increased markedly, few of us have a good insight into their development; their utility relative to clinician-rated and performance measures such as the FIM and 6-minute walk test or how their “electronification” and incorporation into electronic health records (EHRs) may improve the individualization, value, and quality of medical care. In all, the goal of this commentary is to provide some insight into historical factors and technology developments that we believe have shaped modern clinical PROMs as they relate to medicine in general and to rehabilitation in particular. In addition, we speculate that while the growth of PROM use may have been triggered by an increased emphasis on the centrality of the patient in their care, future uptake will be shaped by their embedding in EHRs and used to improve clinical decision support though their integration with other sources of clinical and sociodemographic data.

      Keyword

      List of abbreviations:

      CAT (computerized adaptive test), CRO (clinician-rated outcome), EHR (electronic health record), ePROM (electronic patient-reported outcome), IRT (item response theory), MCID (minimal clinically important difference), MOS (Medical Outcomes Study), PHQ-9 (Patient Health Questionnaire-9), PROM (patient-reported outcome measure), SIP (Sickness Impact Profile), TBI (traumatic brain injury)
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