Skip to main content
Erschienen in: Quality of Life Research 3/2016

01.03.2016 | Special Section: PROs in Non-Standard Settings (by invitation only)

Evaluation of point-of-care PRO assessment in clinic settings: integration, parallel-forms reliability, and patient acceptability of electronic QOL measures during clinic visits

verfasst von: Pranav Sharma, Rodney L. Dunn, John T. Wei, James E. Montie, Scott M. Gilbert

Erschienen in: Quality of Life Research | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Assessment of patient-reported outcomes (PROs), such as health-related quality of life, has become an important component of healthcare that measures the impact of disease and medical treatment on patient health. Collecting PROs during point-of-care assessments and integrating them into the clinical setting, however, remains challenging. The objective of this pilot study was to evaluate the reliability, usability, and acceptability of point-of-care electronic PRO assessments implemented in a prostate cancer clinic.

Methods

Fifty subjects completed paper–pencil and computerized formats of the Expanded Prostate Cancer Index Composite (EPIC), a validated, condition-specific QOL instrument, at separate times before treatment. Parallel-forms reliability was evaluated by comparing mean scores, variations in response distribution, and correlations between administration formats. Correlation coefficients of at least 0.70 were used for reliability testing. Differences between administration forms, indicating potential bias, were compared using the signed-rank test. A 6-item acceptability scale was also used to evaluate patient acceptability and satisfaction with the electronic format.

Results

Mean scores and standard deviations were similar between the paper–pencil and electronic forms across all EPIC instrument domains, and no assessment bias was found. Each EPIC domain demonstrated a high reliability between administration formats (correlation coefficients: 0.70–0.98). The majority (>90 %) of respondents found that the computerized QOL format was user friendly and simple to use.

Conclusions

Point-of-care computerized QOL assessments were reliable and acceptable to patients in this study, supporting the feasibility of PRO integration at the point-of-care in clinical settings.
Literatur
1.
Zurück zum Zitat Santana, M. J., Haverman, L., Absolom, K., Takeuchi, E., Feeny, D., Grootenhuis, M., & Velikova, G. (2015). Training clinicians in how to use patient-reported outcome measures in routine clinical practice. Quality of Life Research, 24(7), 1707–1718. CrossRefPubMed Santana, M. J., Haverman, L., Absolom, K., Takeuchi, E., Feeny, D., Grootenhuis, M., & Velikova, G. (2015). Training clinicians in how to use patient-reported outcome measures in routine clinical practice. Quality of Life Research, 24(7), 1707–1718. CrossRefPubMed
2.
Zurück zum Zitat Detmar, S. B., & Aaronson, N. K. (1998). Quality of life assessment in daily clinical oncology practice: A feasibility study. European Journal of Cancer, 34(8), 1181–1186.CrossRefPubMed Detmar, S. B., & Aaronson, N. K. (1998). Quality of life assessment in daily clinical oncology practice: A feasibility study. European Journal of Cancer, 34(8), 1181–1186.CrossRefPubMed
3.
Zurück zum Zitat Velikova, G., Booth, L., Smith, A. B., Brown, P. M., Lynch, P., Brown, J. M., & Selby, P. J. (2004). Measuring quality of life in routine oncology practice improves communication and patient well-being: A randomized controlled trial. Journal of Clinical Oncology, 22(4), 714–724.CrossRefPubMed Velikova, G., Booth, L., Smith, A. B., Brown, P. M., Lynch, P., Brown, J. M., & Selby, P. J. (2004). Measuring quality of life in routine oncology practice improves communication and patient well-being: A randomized controlled trial. Journal of Clinical Oncology, 22(4), 714–724.CrossRefPubMed
4.
Zurück zum Zitat Jensen, R. E., Snyder, C. F., Abernethy, A. P., Basch, E., Potosky, A. L., Roberts, A. C., et al. (2014). Review of electronic patient-reported outcomes systems used in cancer clinical care. Journal of Oncology Practice, 10(4), e215–e222.PubMedCentralCrossRefPubMed Jensen, R. E., Snyder, C. F., Abernethy, A. P., Basch, E., Potosky, A. L., Roberts, A. C., et al. (2014). Review of electronic patient-reported outcomes systems used in cancer clinical care. Journal of Oncology Practice, 10(4), e215–e222.PubMedCentralCrossRefPubMed
5.
Zurück zum Zitat Wu, A. W., Kharrazi, H., Boulware, L. E., & Snyder, C. F. (2013). Measure once, cut twice—Adding patient-reported outcome measures to the electronic health record for comparative effectiveness research. Journal of Clinical Epidemiology, 66(8 Suppl), S12–S20.PubMedCentralCrossRefPubMed Wu, A. W., Kharrazi, H., Boulware, L. E., & Snyder, C. F. (2013). Measure once, cut twice—Adding patient-reported outcome measures to the electronic health record for comparative effectiveness research. Journal of Clinical Epidemiology, 66(8 Suppl), S12–S20.PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat Deyo, R. A., & Patrick, D. L. (1989). Barriers to the use of health status measures in clinical investigation, patient care, and policy research. Medical Care, 27(3 Suppl), S254–S268.CrossRefPubMed Deyo, R. A., & Patrick, D. L. (1989). Barriers to the use of health status measures in clinical investigation, patient care, and policy research. Medical Care, 27(3 Suppl), S254–S268.CrossRefPubMed
8.
Zurück zum Zitat Hjollund, N. H., Larsen, L. P., Biering, K., Johnsen, S. P., Riiskjaer, E., & Schougaard, L. M. (2014). Use of patient-reported outcome (PRO) measures at group and patient levels: Experiences from the generic integrated PRO system, WestChronic. Interactive Journal of Medical Research, 3(1), e5.PubMedCentralCrossRefPubMed Hjollund, N. H., Larsen, L. P., Biering, K., Johnsen, S. P., Riiskjaer, E., & Schougaard, L. M. (2014). Use of patient-reported outcome (PRO) measures at group and patient levels: Experiences from the generic integrated PRO system, WestChronic. Interactive Journal of Medical Research, 3(1), e5.PubMedCentralCrossRefPubMed
9.
Zurück zum Zitat Gwaltney, C. J., Shields, A. L., & Shiffman, S. (2008). Equivalence of electronic and paper-and-pencil administration of patient-reported outcome measures: A meta-analytic review. Value in Health, 11(2), 322–333.CrossRefPubMed Gwaltney, C. J., Shields, A. L., & Shiffman, S. (2008). Equivalence of electronic and paper-and-pencil administration of patient-reported outcome measures: A meta-analytic review. Value in Health, 11(2), 322–333.CrossRefPubMed
10.
Zurück zum Zitat Velikova, G. (2004). Use of electronic quality of life applications in cancer research and clinical practice. Expert Review of Pharmacoeconomics & Outcomes Research, 4(4), 403–411.CrossRefPubMed Velikova, G. (2004). Use of electronic quality of life applications in cancer research and clinical practice. Expert Review of Pharmacoeconomics & Outcomes Research, 4(4), 403–411.CrossRefPubMed
11.
Zurück zum Zitat Velikova, G., Brown, J. M., Smith, A. B., & Selby, P. J. (2002). Computer-based quality of life questionnaires may contribute to doctor-patient interactions in oncology. British Journal of Cancer, 86(1), 51–59.PubMedCentralCrossRefPubMed Velikova, G., Brown, J. M., Smith, A. B., & Selby, P. J. (2002). Computer-based quality of life questionnaires may contribute to doctor-patient interactions in oncology. British Journal of Cancer, 86(1), 51–59.PubMedCentralCrossRefPubMed
12.
Zurück zum Zitat Davis, K. M., Kelly, S. P., Luta, G., Tomko, C., Miller, A. B., & Taylor, K. L. (2014). The association of long-term treatment-related side effects with cancer-specific and general quality of life among prostate cancer survivors. Urology, 84(2), 300–306.CrossRefPubMed Davis, K. M., Kelly, S. P., Luta, G., Tomko, C., Miller, A. B., & Taylor, K. L. (2014). The association of long-term treatment-related side effects with cancer-specific and general quality of life among prostate cancer survivors. Urology, 84(2), 300–306.CrossRefPubMed
13.
Zurück zum Zitat Hamoen, E. H., De Rooij, M., Witjes, J. A., Barentsz, J. O., & Rovers, M. M. (2015). Measuring health-related quality of life in men with prostate cancer: A systematic review of the most used questionnaires and their validity. Urologic Oncology, 33(2), 69-e19–69-e28.CrossRef Hamoen, E. H., De Rooij, M., Witjes, J. A., Barentsz, J. O., & Rovers, M. M. (2015). Measuring health-related quality of life in men with prostate cancer: A systematic review of the most used questionnaires and their validity. Urologic Oncology, 33(2), 69-e19–69-e28.CrossRef
14.
Zurück zum Zitat Montague, D. K., Barada, J. H., Belker, A. M., Levine, L. A., Nadig, P. W., Roehrborn, C. G., et al. (1996). Clinical guidelines panel on erectile dysfunction: Summary report on the treatment of organic erectile dysfunction. The American Urological Association. The Journal of Urology, 156(6), 2007–2011.CrossRefPubMed Montague, D. K., Barada, J. H., Belker, A. M., Levine, L. A., Nadig, P. W., Roehrborn, C. G., et al. (1996). Clinical guidelines panel on erectile dysfunction: Summary report on the treatment of organic erectile dysfunction. The American Urological Association. The Journal of Urology, 156(6), 2007–2011.CrossRefPubMed
15.
Zurück zum Zitat Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49(6), 822–830.CrossRefPubMed Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49(6), 822–830.CrossRefPubMed
16.
Zurück zum Zitat Litwin, M. S., Hays, R. D., Fink, A., Ganz, P. A., Leake, B., & Brook, R. H. (1998). The UCLA Prostate Cancer Index: Development, reliability, and validity of a health-related quality of life measure. Medical Care, 36(7), 1002–1012.CrossRefPubMed Litwin, M. S., Hays, R. D., Fink, A., Ganz, P. A., Leake, B., & Brook, R. H. (1998). The UCLA Prostate Cancer Index: Development, reliability, and validity of a health-related quality of life measure. Medical Care, 36(7), 1002–1012.CrossRefPubMed
17.
Zurück zum Zitat Wei, J. T., Dunn, R. L., Litwin, M. S., Sandler, H. M., & Sanda, M. G. (2000). Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology, 56(6), 899–905.CrossRefPubMed Wei, J. T., Dunn, R. L., Litwin, M. S., Sandler, H. M., & Sanda, M. G. (2000). Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology, 56(6), 899–905.CrossRefPubMed
18.
Zurück zum Zitat Gilbert, S. M., Dunn, R. L., Wittmann, D., Montgomery, J. S., Hollingsworth, J. M., Miller, D. C., et al. (2015). Quality of life and satisfaction among prostate cancer patients followed in a dedicated survivorship clinic. Cancer, 121(9), 1484–1491.CrossRefPubMed Gilbert, S. M., Dunn, R. L., Wittmann, D., Montgomery, J. S., Hollingsworth, J. M., Miller, D. C., et al. (2015). Quality of life and satisfaction among prostate cancer patients followed in a dedicated survivorship clinic. Cancer, 121(9), 1484–1491.CrossRefPubMed
19.
Zurück zum Zitat Chang, P., Szymanski, K. M., Dunn, R. L., Chipman, J. J., Litwin, M. S., Nguyen, P. L., et al. (2011). Expanded prostate cancer index composite for clinical practice: Development and validation of a practical health related quality of life instrument for use in the routine clinical care of patients with prostate cancer. Journal of Urology, 186(3), 865–872.CrossRefPubMed Chang, P., Szymanski, K. M., Dunn, R. L., Chipman, J. J., Litwin, M. S., Nguyen, P. L., et al. (2011). Expanded prostate cancer index composite for clinical practice: Development and validation of a practical health related quality of life instrument for use in the routine clinical care of patients with prostate cancer. Journal of Urology, 186(3), 865–872.CrossRefPubMed
20.
Zurück zum Zitat Lewis, J. R. (1995). IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use. International Journal of Human–Computer Interaction, 7(1), 57–78.CrossRef Lewis, J. R. (1995). IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use. International Journal of Human–Computer Interaction, 7(1), 57–78.CrossRef
21.
Zurück zum Zitat Blum, D., Raj, S. X., Oberholzer, R., Riphagen, II, Strasser, F., Kaasa, S., & Euro Impact, E. I. M. P. C. R. T. (2014). Computer-based clinical decision support systems and patient-reported outcomes: A systematic review. The Patient-Patient-Centered Outcomes Research. doi:10.1007/s40271-014-0100-1. Blum, D., Raj, S. X., Oberholzer, R., Riphagen, II, Strasser, F., Kaasa, S., & Euro Impact, E. I. M. P. C. R. T. (2014). Computer-based clinical decision support systems and patient-reported outcomes: A systematic review. The Patient-Patient-Centered Outcomes Research. doi:10.​1007/​s40271-014-0100-1.
22.
Zurück zum Zitat Tariman, J. D., Berry, D. L., Halpenny, B., Wolpin, S., & Schepp, K. (2011). Validation and testing of the acceptability E-scale for web-based patient-reported outcomes in cancer care. Applied Nursing Research, 24(1), 53–58.PubMedCentralCrossRefPubMed Tariman, J. D., Berry, D. L., Halpenny, B., Wolpin, S., & Schepp, K. (2011). Validation and testing of the acceptability E-scale for web-based patient-reported outcomes in cancer care. Applied Nursing Research, 24(1), 53–58.PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Mohler, J., Bahnson, R. R., Boston, B., Busby, J. E., D’Amico, A., Eastham, J. A., et al. (2010). NCCN clinical practice guidelines in oncology: Prostate cancer. Journal of the National Comprehensive Cancer Network, 8(2), 162–200.PubMed Mohler, J., Bahnson, R. R., Boston, B., Busby, J. E., D’Amico, A., Eastham, J. A., et al. (2010). NCCN clinical practice guidelines in oncology: Prostate cancer. Journal of the National Comprehensive Cancer Network, 8(2), 162–200.PubMed
24.
Zurück zum Zitat Basch, E., & Abernethy, A. P. (2011). Supporting clinical practice decisions with real-time patient-reported outcomes. Journal of Clinical Oncology, 29(8), 954–956.CrossRefPubMed Basch, E., & Abernethy, A. P. (2011). Supporting clinical practice decisions with real-time patient-reported outcomes. Journal of Clinical Oncology, 29(8), 954–956.CrossRefPubMed
25.
Zurück zum Zitat Efficace, F., Jacobs, M., Pusic, A., Greimel, E., Piciocchi, A., Kieffer, J. M., et al. (2014). Patient-reported outcomes in randomised controlled trials of gynaecological cancers: Investigating methodological quality and impact on clinical decision-making. European Journal of Cancer, 50(11), 1925–1941.CrossRefPubMed Efficace, F., Jacobs, M., Pusic, A., Greimel, E., Piciocchi, A., Kieffer, J. M., et al. (2014). Patient-reported outcomes in randomised controlled trials of gynaecological cancers: Investigating methodological quality and impact on clinical decision-making. European Journal of Cancer, 50(11), 1925–1941.CrossRefPubMed
26.
Zurück zum Zitat Basch, E., Artz, D., Dulko, D., Scher, K., Sabbatini, P., Hensley, M., et al. (2005). Patient online self-reporting of toxicity symptoms during chemotherapy. Journal of Clinical Oncology, 23(15), 3552–3561.CrossRefPubMed Basch, E., Artz, D., Dulko, D., Scher, K., Sabbatini, P., Hensley, M., et al. (2005). Patient online self-reporting of toxicity symptoms during chemotherapy. Journal of Clinical Oncology, 23(15), 3552–3561.CrossRefPubMed
27.
Zurück zum Zitat Velikova, G., Wright, E. P., Smith, A. B., Cull, A., Gould, A., Forman, D., et al. (1999). Automated collection of quality-of-life data: A comparison of paper and computer touch-screen questionnaires. Journal of Clinical Oncology, 17(3), 998–1007.PubMed Velikova, G., Wright, E. P., Smith, A. B., Cull, A., Gould, A., Forman, D., et al. (1999). Automated collection of quality-of-life data: A comparison of paper and computer touch-screen questionnaires. Journal of Clinical Oncology, 17(3), 998–1007.PubMed
28.
Zurück zum Zitat Rutherford, C., Mercieca-Bebber, R., Rice, H., Costa, D., & King, M. (2014). Mode of administration of patient-reported outcomes (pro) measures: A systematic review. In Paper presented at the Asia–Pacific Journal of Clinical Oncology. Rutherford, C., Mercieca-Bebber, R., Rice, H., Costa, D., & King, M. (2014). Mode of administration of patient-reported outcomes (pro) measures: A systematic review. In Paper presented at the AsiaPacific Journal of Clinical Oncology.
29.
Zurück zum Zitat Vickers, A. J., Savage, C. J., Shouery, M., Eastham, J. A., Scardino, P. T., & Basch, E. M. (2010). Validation study of a web-based assessment of functional recovery after radical prostatectomy. Health Quality Life Outcomes, 8, 82. Vickers, A. J., Savage, C. J., Shouery, M., Eastham, J. A., Scardino, P. T., & Basch, E. M. (2010). Validation study of a web-based assessment of functional recovery after radical prostatectomy. Health Quality Life Outcomes, 8, 82.
30.
Zurück zum Zitat Abernethy, A. P., Herndon, J. E, 2nd, Wheeler, J. L., Day, J. M., Hood, L., Patwardhan, M., et al. (2009). Feasibility and acceptability to patients of a longitudinal system for evaluating cancer-related symptoms and quality of life: Pilot study of an e/Tablet data-collection system in academic oncology. Journal of Pain and Symptom Management, 37(6), 1027–1038.CrossRefPubMed Abernethy, A. P., Herndon, J. E, 2nd, Wheeler, J. L., Day, J. M., Hood, L., Patwardhan, M., et al. (2009). Feasibility and acceptability to patients of a longitudinal system for evaluating cancer-related symptoms and quality of life: Pilot study of an e/Tablet data-collection system in academic oncology. Journal of Pain and Symptom Management, 37(6), 1027–1038.CrossRefPubMed
31.
Zurück zum Zitat McCann, L., Maguire, R., Miller, M., & Kearney, N. (2009). Patients’ perceptions and experiences of using a mobile phone-based advanced symptom management system (ASyMS) to monitor and manage chemotherapy related toxicity. European Journal of Cancer Care, 18(2), 156–164.CrossRefPubMed McCann, L., Maguire, R., Miller, M., & Kearney, N. (2009). Patients’ perceptions and experiences of using a mobile phone-based advanced symptom management system (ASyMS) to monitor and manage chemotherapy related toxicity. European Journal of Cancer Care, 18(2), 156–164.CrossRefPubMed
32.
Zurück zum Zitat Litwin, M. S., & McGuigan, K. A. (1999). Accuracy of recall in health-related quality-of-life assessment among men treated for prostate cancer. Journal of Clinical Oncology, 17(9), 2882–2888.PubMed Litwin, M. S., & McGuigan, K. A. (1999). Accuracy of recall in health-related quality-of-life assessment among men treated for prostate cancer. Journal of Clinical Oncology, 17(9), 2882–2888.PubMed
33.
Zurück zum Zitat Judson, T. J., Bennett, A. V., Rogak, L. J., Sit, L., Barz, A., Kris, M. G., et al. (2013). Feasibility of long-term patient self-reporting of toxicities from home via the Internet during routine chemotherapy. Journal of Clinical Oncology, 31(20), 2580–2585.PubMedCentralCrossRefPubMed Judson, T. J., Bennett, A. V., Rogak, L. J., Sit, L., Barz, A., Kris, M. G., et al. (2013). Feasibility of long-term patient self-reporting of toxicities from home via the Internet during routine chemotherapy. Journal of Clinical Oncology, 31(20), 2580–2585.PubMedCentralCrossRefPubMed
34.
Zurück zum Zitat Nama, V., Nordin, A., & Bryant, A. (2013). Patient-reported outcome measures for follow-up after gynaecological cancer treatment. Cochrane Database System Review, 11, CD010299. Nama, V., Nordin, A., & Bryant, A. (2013). Patient-reported outcome measures for follow-up after gynaecological cancer treatment. Cochrane Database System Review, 11, CD010299.
35.
Zurück zum Zitat Gregorich, S. E. (2006). Do self-report instruments allow meaningful comparisons across diverse population groups? Testing measurement invariance using the confirmatory factor analysis framework. Medical Care, 44(11 Suppl 3), S78–S94.PubMedCentralCrossRefPubMed Gregorich, S. E. (2006). Do self-report instruments allow meaningful comparisons across diverse population groups? Testing measurement invariance using the confirmatory factor analysis framework. Medical Care, 44(11 Suppl 3), S78–S94.PubMedCentralCrossRefPubMed
Metadaten
Titel
Evaluation of point-of-care PRO assessment in clinic settings: integration, parallel-forms reliability, and patient acceptability of electronic QOL measures during clinic visits
verfasst von
Pranav Sharma
Rodney L. Dunn
John T. Wei
James E. Montie
Scott M. Gilbert
Publikationsdatum
01.03.2016
Verlag
Springer International Publishing
Erschienen in
Quality of Life Research / Ausgabe 3/2016
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-015-1113-5

Weitere Artikel der Ausgabe 3/2016

Quality of Life Research 3/2016 Zur Ausgabe