Truth and dare: patients dare to tell the truth when using PROMs in clinical practice.

IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Quality of Life Research Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI:10.1007/s11136-024-03772-3
Lotte Haverman, Michiel A J Luijten, Amanda L Blackford, Kate Absolom, Ethan M Basch, Marion A J van Rossum, Vivian Engelen, Martha A Grootenhuis, Galina Velikova, Claire Snyder
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引用次数: 0

Abstract

Purpose: As patient-reported outcome measures (PROMs) are increasingly used in clinical practice for screening, monitoring, and management, the potential for response bias has been raised (e.g., over-reporting problems for attention, under-reporting to avoid treatment changes/discontinuation). We investigated whether patients systematically bias their responses when they know clinicians will review their PROM results.

Methods: We conducted secondary analyses of three experimental studies evaluating PROMs in adult and pediatric care. Prior to PROM completion, intervention group patients were informed that the results would be shown to their clinicians ("feedback" arm), whereas control group patients were told that their clinicians would not see their responses ("no feedback" arm). Independent sample t-tests compared the "feedback" and "no feedback" arms' PROM scores at baseline. Effect sizes and 95% confidence intervals were estimated using Cohen's d statistics with Hedges' g correction, and effect sizes > 0.50 were considered clinically relevant.

Results: Across the 29 domains assessed in the three studies, no between-arm differences reached an effect size of ± 0.50. Only 3/29 effect sizes exceeded ± 0.30. The confidence intervals for 14 domains included ± 0.50, with 4 favoring the "no feedback" arm and 10 favoring the "feedback" arm. Two domains reached statistical significance, one favoring the "no feedback" arm and one favoring the "feedback" arm.

Conclusion: This study does not support the hypothesis that patients systematically bias their PROM responses if they know that clinicians will see their results. These findings support using PROMs in clinical practice as a valid mechanism to promote patient-centered care.

真心与胆量:在临床实践中使用 PROMs 时,患者敢于说真话。
目的:随着患者报告的结果测量(PROMs)越来越多地被用于临床实践中的筛查、监测和管理,出现反应偏差的可能性也随之提高(例如,为了引起注意而过多报告问题,为了避免治疗改变/中止而过少报告)。我们研究了当患者知道临床医生会审查他们的 PROM 结果时,他们的回答是否会出现系统性偏差:我们对评估成人和儿科护理中 PROMs 的三项实验研究进行了二次分析。在完成 PROM 之前,干预组患者被告知其结果将向临床医生展示("反馈 "组),而对照组患者被告知其临床医生不会看到他们的回答("无反馈 "组)。独立样本 t 检验比较了 "反馈 "组和 "无反馈 "组的 PROM 基线得分。效应大小和 95% 置信区间使用 Cohen's d 统计量和 Hedges'g 校正进行估计,效应大小 > 0.50 被视为具有临床意义:结果:在三项研究评估的 29 个领域中,臂间差异的效应大小均未达到 ± 0.50。只有 3/29 例的效应大小超过 ± 0.30。14 个领域的置信区间为 ± 0.50,其中 4 个领域有利于 "无反馈 "治疗组,10 个领域有利于 "有反馈 "治疗组。有两个领域达到了统计显著性,一个有利于 "无反馈 "组,一个有利于 "有反馈 "组:本研究并不支持患者在知道临床医生会看到其结果的情况下系统性地偏向其 PROM 回答的假设。这些研究结果支持在临床实践中使用 PROM 作为促进以患者为中心的护理的有效机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Quality of Life Research
Quality of Life Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
8.60%
发文量
224
审稿时长
3-8 weeks
期刊介绍: Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences. Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership. This is an official journal of the International Society of Quality of Life Research.
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