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Patient reported outcome measures: a model-based classification system for research and clinical practice

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Abstract

Purpose

The umbrella term Patient Reported Outcomes (PRO) has been successfully proposed for instruments measuring perceived health outcomes, but its relationship to current conceptual models remains to be established. Our aim was to develop a classification system for PRO measures based on a valid conceptual model.

Methods

We reviewed models and classification schemes of health outcomes and integrated them in a common conceptual framework, based on the models by Wilson and Cleary and the International Classification of Functioning (ICF). We developed a cross-classification system based on the minimum common set of consistent concepts identified in previous classifications, and specified categories based on the WHO International Classifications (ICD-10, and ICF). We exemplified the use of the classification system with selected PRO instruments.

Results

We identified three guiding concepts: (1) construct (the measurement object); (2) population (based on age, gender, condition, and culture); and (3) measurement model (dimensionality, metric, and adaptability). The application of the system to selected PRO measures demonstrated the feasibility of its use, and showed that most of them actually assess more than one construct.

Conclusion

This classification system of PRO measures, based on a valid integrated conceptual model, should allow the classification of most currently used instruments and may facilitate a more adequate selection and application of these instruments.

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Acknowledgement

The authors would like to thank Dr Montse Ferrer, MD PhD MPH (Health Services Research Unit, IMIM-Hospital del Mar, Spain) and Dr Martin Roland, DM (Director of the National Primary Care Research and Development Centre, Manchester University, UK) for their thoughtful comments on a previous draft of the manuscript. We would also wish to acknowledge the contribution of two anonymous reviewers to the completeness and clarity we may have achieved in this article.

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Authors and Affiliations

  1. National School for Primary Care Research, University of Manchester, Oxford Road, Williamson Building, Manchester, M13 9PL, UK

    Jose M. Valderas

  2. Health Services Research Unit. Institut Municipal d’Investigació Mèdica (IMIM-hospital del Mar), Barcelona, Spain

    Jose M. Valderas & Jordi Alonso

  3. CIBERESP Spanish Network of Epidemiology and Public Health http://www.ciberesp.es/

    Jose M. Valderas & Jordi Alonso

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  1. Jose M. Valderas
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Correspondence to Jose M. Valderas.

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Valderas, J.M., Alonso, J. Patient reported outcome measures: a model-based classification system for research and clinical practice. Qual Life Res 17, 1125–1135 (2008). https://doi.org/10.1007/s11136-008-9396-4

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