title: An Electronic Patient-Reported Outcome Measures System in UK Chiropractic Practices: A Feasibility Study of Routine Collection of Outcomes and Costs.
abstract: OBJECTIVE
  The purpose of this study was to test the feasibility of collecting valid and widely used health outcomes, including information concerning cost of care, using a Web-based patient-driven patient-reported outcome measure (PROM) collection process within a cohort of UK chiropractic practices.
  
  
  METHODS
  A Web-based PROM system (Care Response) was used. Patients with low back and neck pain were recruited from a group of chiropractic practices located in the United Kingdom. Information collected included demographic data, generic and condition-specific PROMs at the initial consultation and 90 days later, patient-reported experience measures, and additional health seeking to estimate costs of care.
  
  
  RESULTS
  A group of 33 clinics provided information from a total of 1895 patients who completed baseline questionnaires with 844 (45%) completing the measures at 90-day follow-up. Subsequent outcomes suggest that more than 70% of patients improved over the course of treatment regardless of the outcome used. Using the baseline as a virtual counterfactual with respect to follow-up, we calculated quality-adjusted life years and the cost thereof resulting in a mean quality-adjusted life years gained of 0.8 with an average cost of £895 per quality-adjusted life year.
  
  
  CONCLUSIONS
  Routine collection of PROMs, including information about cost, is feasible and can be achieved using an online system within a clinical practice environment. We describe a Web-based collection system and discuss the choice of measures leading to a comprehensive understanding of outcomes and costs in routine practice.
authors.affiliation: Director of Research, Anglo-European College of Chiropractic, Bournemouth, UK. Electronic address: dnewell@aecc.ac.uk.
authors.forename: Dave
authors.initials: D
authors.lastname: Newell
authors.affiliation: Research Fellow, Anglo-European College of Chiropractic, Bournemouth, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Diment
authors.affiliation: Professor and Vice Principal, Anglo-European College of Chiropractic, Bournemouth, UK.
authors.forename: Jenni E
authors.initials: JE
authors.lastname: Bolton
mesh_terms: D000328:Adult; D002684:Chiropractic; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000191:economics / Q000628:therapy*; D008297:Male; D026882:Manipulation, Chiropractic / Q000191:economics; D019547:Neck Pain / Q000191:economics / Q000628:therapy*; D000071066:Patient Reported Outcome Measures; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D006113:United Kingdom
keywords: Chiropractic; Electronic Health Records; Patient Outcome Assessment; Quality-Adjusted Life Years