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      Patient involvement in the development of patient‐reported outcome measures: a scoping review

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          Abstract

          Background

          Patient‐reported outcome measures ( PROMs) measure patients’ perspectives on health outcomes and are increasingly used in health care. To capture the patient's perspective, it is essential that patients are involved in PROM development

          Objective

          This article reviews in what ways and to what extent patients are involved in PROM development and whether patient involvement has increased over time.

          Search strategy

          Literature was searched in Pub Med, EMBASE, MEDLINE and the Cochrane Methodology Register.

          Inclusion criteria

          Studies were included if they described a new PROM development.

          Data extraction

          Basic information and information regarding patient involvement in development phases was recorded.

          Main results

          A total of 189 studies, describing the development of 193 PROMs, were included. Most PROMs were meant for chronic disease patients ( n = 59) and measured quality of life ( n = 28). In 25.9% of the PROM development studies, no patients were involved. Patients were mostly involved during item development (58.5%), closely followed by testing for comprehensibility (50.8%), while patient involvement in determining which outcome to measure was minimal (10.9%). Some patient involvement took place in the development of most PROMs, but in only 6.7% patients were involved in all aspects of the development. Patient involvement did not increase with time.

          Conclusions

          Although patient involvement in PROM development is essential to develop valid patient‐centred PROMs, patients are not always involved. When patients are involved, their level of involvement varies considerably. These variations suggest that further attention to building and/or disseminating consensus on requirements for patient involvement in PROM development is necessary.

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          Most cited references29

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          The GRIPP checklist: strengthening the quality of patient and public involvement reporting in research.

          The aim of this study was to develop the GRIPP (Guidance for Reporting Involvement of Patients and Public) checklist to enhance the quality of PPI reporting. Thematic analysis was used to synthesize key issues relating to patient and public involvement (PPI) identified in the PIRICOM and PAPIRIS systematic reviews. These issues informed the development of the GRIPP checklist. The key issues identified included limited conceptualization of PPI, poor quality of methods reporting, unclear content validity of studies, poor reporting of context and process, enormous variability in the way impact is reported, little formal evaluation of the quality of involvement, limited focus on negative impacts, and little robust measurement of impact. The GRIPP checklist addresses these key issues. The reporting of patient and public involvement in health research needs significant enhancement. The GRIPP checklist represents the first international attempt to enhance the quality of PPI reporting. Better reporting will strengthen the PPI evidence-base and so enable more effective evaluation of what PPI works, for whom, in what circumstances and why.
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            Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Palliative Care Core Audit Project Advisory Group.

            To develop an outcome measure for patients with advanced cancer and their families which would cover more than either physical symptoms or quality of life related questions. To validate the measure in various specialist and non-specialist palliative care settings throughout the UK. A systematic literature review of measures appropriate for use in palliative care settings was conducted. In conjunction with a multidisciplinary project advisory group, questions were chosen for inclusion into the scale based on whether they measured aspects of physical, psychological, or spiritual domains pertinent to palliative care, and whether similar items had shown to be valid as part of another measure. A staff completed version was developed to facilitate data collection on all patients throughout their care, and a patient completed version was designed to enable the patient to contribute to the assessment of their outcomes when possible. A full validation study was conducted to evaluate construct validity, internal consistency, responsiveness to change over time, and test-retest reliability. Assessments were timed. Eight centres in England and Scotland providing palliative care, including inpatient care, outpatient care, day care, home care, and primary care. A total of 450 patients entered care during the study period. Staff collected data routinely on patients in care long enough to be assessed (n = 337). Of these, 262 were eligible for patient participation; 148 (33%) went on to complete a questionnaire. The Palliative Care Outcome Scale (POS), the European Organisation for Research on Cancer Treatment, and the Support Team Assessment Schedule. The POS consists of two almost identical measures, one of which is completed by staff, the other by patients. Agreement between staff and patient ratings was found to be acceptable for eight out of 10 items at the first assessment. The measure demonstrated construct validity (Spearman rho = 0.43 to 0.80). Test/re-test reliability was acceptable for seven items. Internal consistency was good (Cronbach's alpha = 0.65 (patients), 0.70 (staff)). Change over time was shown, but did not reach statistical significance. The questionnaire did not take more than 10 minutes to complete by staff or patients. The POS has acceptable validity and reliability. It can be used to assess prospectively palliative care for patients with advanced cancer.
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              Measuring patient-reported outcomes: moving beyond misplaced common sense to hard science

              Interest in the patient's views of his or her illness and treatment has increased dramatically. However, our ability to appropriately measure such issues lags far behind the level of interest and need. Too often such measurement is considered to be a simple and trivial activity that merely requires the application of common sense. However, good quality measurement of patient-reported outcomes is a complex activity requiring considerable expertise and experience. This review considers the most important issues related to such measurement in the context of chronic disease and details how instruments should be developed, validated and adapted for use in additional languages. While there is often consensus on how best to undertake these activities, there is generally little evidence to support such accord. The present article questions these orthodox views and suggests alternative approaches that have been shown to be effective.
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                Author and article information

                Contributors
                Role: ResearcherB.M.Wiering@uvt.nl
                Role: Senior Researcher
                Role: Professor of Transparency in Care from the Patients' Perspective
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                18 February 2016
                February 2017
                : 20
                : 1 ( doiID: 10.1111/hex.2017.20.issue-1 )
                : 11-23
                Affiliations
                [ 1 ] Tranzo (Scientific Centre for Transformation in Care and Welfare)Tilburg University TilburgThe Netherlands
                [ 2 ]NIVEL (Netherlands Institute for Health Services Research) UtrechtThe Netherlands
                Author notes
                [*] [* ] Correspondence

                Bianca Wiering, MSc

                Tilburg University

                PO Box 90153

                5000 LE Tilburg

                The Netherlands

                E‐mail: B.M.Wiering@ 123456uvt.nl

                Article
                HEX12442
                10.1111/hex.12442
                5217930
                26889874
                2f253429-67d9-4b45-82ab-ff694a43c1f6
                © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 December 2015
                Page count
                Figures: 1, Tables: 2, Pages: 13, Words: 6943
                Funding
                Funded by: The National Health Care Institute
                Categories
                Review Article
                Review Article
                Custom metadata
                2.0
                hex12442
                February 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.0 mode:remove_FC converted:04.01.2017

                Health & Social care
                patient participation,patient‐reported outcome measures,questionnaire development procedures,scoping review

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