title: Impact of National Institutes of Health Gastrointestinal PROMIS Measures in Clinical Practice: Results of a Multicenter Controlled Trial.
abstract: OBJECTIVE
  The National Institutes of Health (NIH) created the Patient Reported Outcomes Measurement Information System (PROMIS) to allow efficient, online measurement of patient-reported outcomes (PROs), but it remains untested whether PROMIS improves outcomes. Here, we aimed to compare the impact of gastrointestinal (GI) PROMIS measures vs. usual care on patient outcomes.
  
  
  METHODS
  We performed a pragmatic clinical trial with an off-on study design alternating weekly between intervention (GI PROMIS) and control arms at one Veterans Affairs and three university-affiliated specialty clinics. Adults with GI symptoms were eligible. Intervention patients completed GI PROMIS symptom questionnaires on an e-portal 1 week before their visit; PROs were available for review by patients and their providers before and during the clinic visit. Usual care patients were managed according to customary practices. Our primary outcome was patient satisfaction as determined by the Consumer Assessment of Healthcare Providers and Systems questionnaire. Secondary outcomes included provider interpersonal skills (Doctors' Interpersonal Skills Questionnaire (DISQ)) and shared decision-making (9-item Shared Decision Making Questionnaire (SDM-Q-9)).
  
  
  RESULTS
  There were 217 and 154 patients in the GI PROMIS and control arms, respectively. Patient satisfaction was similar between groups (P>0.05). Intervention patients had similar assessments of their providers' interpersonal skills (DISQ 89.4±11.7 vs. 89.8±16.0, P=0.79) and shared decision-making (SDM-Q-9 79.3±12.4 vs. 79.0±22.0, P=0.85) vs.
  
  
  METHODS
  
  
  
  CONCLUSIONS
  This is the first controlled trial examining the impact of NIH PROMIS in clinical practice. One-time use of GI PROMIS did not improve patient satisfaction or assessment of provider interpersonal skills and shared decision-making. Future studies examining how to optimize PROs in clinical practice are encouraged before widespread adoption.
authors.affiliation: Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Christopher V
authors.initials: CV
authors.lastname: Almario
authors.affiliation: Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: Chey
authors.affiliation: Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Sasan
authors.initials: S
authors.lastname: Mosadeghi
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Shahzad
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Elham
authors.initials: E
authors.lastname: Afghani
authors.affiliation: Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Whitman
authors.affiliation: Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Garth
authors.initials: G
authors.lastname: Fuller
authors.affiliation: Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Reid
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Bolus
authors.affiliation: UCLA Computing Technology Research Laboratory (CTRL), Los Angeles, California, USA.
authors.forename: Buddy
authors.initials: B
authors.lastname: Dennis
authors.affiliation: UCLA Computing Technology Research Laboratory (CTRL), Los Angeles, California, USA.
authors.forename: Rey
authors.initials: R
authors.lastname: Encarnacion
authors.affiliation: Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Bibiana
authors.initials: B
authors.lastname: Martinez
authors.affiliation: Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Soares
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Rushaba
authors.initials: R
authors.lastname: Modi
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Lee
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Kubomoto
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Gobind
authors.initials: G
authors.lastname: Sharma
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Bolus
authors.affiliation: Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.|Division of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California, USA.
authors.forename: Brennan M R
authors.initials: BM
authors.lastname: Spiegel
mesh_terms: D000328:Adult; D000368:Aged; D003657:Decision Making; D005260:Female; D005762:Gastroenterology; D005767:Gastrointestinal Diseases; D006801:Humans; D007256:Information Systems; D020407:Internet; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D000072638:Patient Portals; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014495:Universities