Using patient-reported outcomes in clinical practice: challenges and opportunities.
OBJECTIVE
Introduce and explore issues at an international conference about the use of patient-reported outcomes (PROs) in clinical practice.


METHODS
Review of salient literature, clinical and personal experiences, conference presentations and discussions, and post-conference comments from outside experts.


RESULTS
PROs (information from patients about a health condition and its management) have been assessed through self-reports for at least four decades. Traditional applications are in clinical and health services research. Uses in clinical practice, although increasing, are less common and more challenging. PROs can enhance the understanding of patients' experiences and responses to therapy and inform clinical practice.


CONCLUSIONS
We pose and discuss four main questions: (1) Will clinicians accept PRO measures? (2) Will clinicians use PRO measures? (3) Will measuring PROs actually improve those outcomes? (4) Will PROs be perceived as having other, less salutary purposes? A patient-centered perspective on PRO measurement presents issues about the extent to which PROs can accurately capture patient experiences and assess psychosocial and environmental factors that influence communication with clinicians and eventual outcomes. We end with comments about the intersection of PROs and bioethics, noting contributions that PROs may make to beneficence, patient autonomy, and distributive justice.
Lohr
Kathleen N
KN
Social and Statistical Sciences, RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA. klohr@rti.org
Zebrack
Bradley J
BJ
D001675:Bioethics; D003695:Delivery of Health Care; D006304:Health Status; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life; D012196:Review Literature as Topic; D011795:Surveys and Questionnaires