Article

Quality of Life Research

, Volume 17, Issue 2, pp 179-193

The impact of measuring patient-reported outcomes in clinical practice: a systematic review of the literature

  • J. M. ValderasAffiliated withNational Primary Care Research and Development Center, The University of ManchesterHealth Services Research Unit, Institut Municipal d’Investigació Mèdica (IMIM-Hospital del Mar)
  • , A. KotzevaAffiliated withCatalan Agency for Health Technology Assessment and Research (CAHTA)
  • , M. EspallarguesAffiliated withCatalan Agency for Health Technology Assessment and Research (CAHTA)
  • , G. GuyattAffiliated withMcMaster University
  • , C. E. FerransAffiliated withCollege of Nursing (MC 802), University of Illinois at Chicago
  • , M. Y. HalyardAffiliated withMayo Clinic
  • , D. A. RevickiAffiliated withCenter for Health Outcomes Research, United Biosource Corporation
  • , T. SymondsAffiliated withWorldwide Outcomes Research (IPC160), Pfizer Global Research and Development
  • , A. ParadaAffiliated withCatalan Agency for Health Technology Assessment and Research (CAHTA)
    • , J. AlonsoAffiliated withHealth Services Research Unit, Institut Municipal d’Investigació Mèdica (IMIM-Hospital del Mar)Department of Experimental and Life Sciences, Universitat Pompeu Fabra Email author 

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Abstract

Objective

The purpose of this paper is to summarize the best evidence regarding the impact of providing patient-reported outcomes (PRO) information to health care professionals in daily clinical practice.

Methods

Systematic review of randomized clinical trials (Medline, Cochrane Library; reference lists of previous systematic reviews; and requests to authors and experts in the field).

Results

Out of 1,861 identified references published between 1978 and 2007, 34 articles corresponding to 28 original studies proved eligible. Most trials (19) were conducted in primary care settings performed in the USA (21) and assessed adult patients (25). Information provided to professionals included generic health status (10), mental health (14), and other (6). Most studies suffered from methodologic limitations, including analysis that did not correspond with the unit of allocation. In most trials, the impact of PRO was limited. Fifteen of 23 studies (65%) measuring process of care observed at least one significant result favoring the intervention, as did eight of 17 (47%) that measured outcomes of care.

Conclusions

Methodological concerns limit the strength of inference regarding the impact of providing PRO information to clinicians. Results suggest great heterogeneity of impact; contexts and interventions that will yield important benefits remain to be clearly defined.

Keywords

Patient-reported outcomes Quality of life Health status indicators Outcome assessment Clinical practice