Patient Reported Outcomes: The New Future of Diagnosis By Eesha Balar Designed by Caroline Paik In a world where we are constantly seeking to improve, how can we optimize the efficiency of our healthcare system and make sure patients receive the care they need? Surprisingly, the solution may stem from a concept as simple as the patient-provider relationship. Traditionally, within this relationship, voices are heard unequally, with the physician holding the upper hand and making decisions based on what he or she sees clinically, often without much input on how patients truly feel. With shifting times and increasing awareness of the patient’s role in making health-related decisions, enter the patient-reported outcome (PRO) measurement system—patients are starting to have their voice heard as well, allowing for better communication regarding their needs, and a more reciprocal, transparent relationship. How are patient-reported outcome measurement systems formatted and integrated in routine practice? The idea behind recording patient-reported outcomes is relatively simple—physicians can use a system to send patients a comprehensive list of questions, ranging from quality of life to specific symptoms they feel in relation to their disease to adherence to their current treatment plan, and use their answers to gain a well-rounded depiction of the patient for a more targeted treatment plan. While thoroughly developed for clinical trials, this measurement is relatively new to the medical practice world. The questionnaires, typi-
cally around 9-12 questions, are formed using well-established professional “rubrics,” such as the Common Terminology Criteria for Adverse Events (CTCAE), and are conducted electronically through email, telephone systems, or in-clinic kiosks. Depending on the practice, patients are sent reminders through their system of choice to complete the survey before, during, and/or after the visit. The systems used to measure these PROs vary in their features; for example, the eRAPID, or the Electronic patient self-Reporting of Adverse events: Patient Information and aDvice, system used commonly in oncology requires patients to report their symptoms from home, and the resulting data is transferred directly to the patient’s electronic health record in advance of the consultation. Another system used at Memorial Sloan Kettering Cancer Center sent automatic alerts to clinicians if a patient reported an answer indicating a serious symptom, or severely worsening conditions compared to the last time the survey was completed.1 What are the benefits and downfalls in utilizing PRO measurements? The benefits to PROs are believed to outweigh its harms, for both the patient and physician. Generally, PROs can be taken across different disciplines, including oncology, primary care, surgical procedures, and beyond. Another important aspect is the system’s facilitation of critical care, as immediate action can be taken in response to completing a survey on PROs to prevent the patient’s health from deteriorating. Ad-
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