title: Pragmatic characteristics of patient-reported outcome measures are important for use in clinical practice.
abstract: OBJECTIVE
  Measures for assessing patient-reported outcomes (PROs) that may have initially been developed for research are increasingly being recommended for use in clinical practice as well. Although psychometric rigor is essential, this article focuses on pragmatic characteristics of PROs that may enhance uptake into clinical practice.
  
  
  METHODS
  Three sources were drawn on in identifying pragmatic criteria for PROs: (1) selected literature review including recommendations by other expert groups; (2) key features of several model public domain PROs; and (3) the authors' experience in developing practical PROs.
  
  
  RESULTS
  Eight characteristics of a practical PRO include: (1) actionability (i.e., scores guide diagnostic or therapeutic actions/decision making); (2) appropriateness for the relevant clinical setting; (3) universality (i.e., for screening, severity assessment, and monitoring across multiple conditions); (4) self-administration; (5) item features (number of items and bundling issues); (6) response options (option number and dimensions, uniform vs. varying options, time frame, intervals between options); (7) scoring (simplicity and interpretability); and (8) accessibility (nonproprietary, downloadable, available in different languages and for vulnerable groups, and incorporated into electronic health records).
  
  
  CONCLUSIONS
  Balancing psychometric and pragmatic factors in the development of PROs is important for accelerating the incorporation of PROs into clinical practice.
authors.affiliation: VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, 1481 W. 10th St., Indianapolis, IN 46202, USA; Department of Medicine, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., 1050 Wishard Blvd, Indianapolis, IN 46202, USA. Electronic address: kkroenke@regenstrief.org.
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine and School of Public Health, 410 W. 10th St., Indianapolis, IN 46202, USA.
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Monahan
authors.affiliation: VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, 1481 W. 10th St., Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., 1050 Wishard Blvd, Indianapolis, IN 46202, USA; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Goodman Hall, 355 W. 16th St., Indianapolis, IN 46202, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Kean
mesh_terms: D006801:Humans; D063868:Patient Outcome Assessment; D011594:Psychometrics; D011788:Quality of Life; D012107:Research Design; D011795:Surveys and Questionnaires
keywords: Measures; Patient-reported outcomes; Psychometrics; Quality of life; Scales; Utility