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Viewing assessments of patient-reported heath status as conversations: Implications for developing and evaluating patient-reported outcome measures

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Abstract

Patient-reported outcome measures (PROMs) are frequently used in research to reflect the patient’s perspective. In this commentary, I argue that further improvements can be made in how we develop and evaluate PROMs by viewing assessment as a type of conversation. Philosophically speaking, a PROM assessment can be conceptualized as a formal conversation that serves as a model of an informal, longer, and more nuanced conversation with a research participant about their health experience. Psychologically speaking, evidence from research in survey methodology and discursive psychology shows that respondents to self-report measures behave in ways consistent with the idea that they are doing their best to participate in a conversation, albeit an unusual one. Several suggestions are offered for creating a better conversational context through study materials and PROM instructions, and by improving the yield of cognitive interviews. It is hoped that this commentary can stimulate further discussions in our field regarding how to integrate insights about the conversational nature of assessment from survey research and discursive psychology to better reflect the patient’s voice in research.

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Acknowledgements

I am grateful to my colleagues who provided invaluable feedback on earlier drafts of this paper: Theresa Coles, PhD; Karon Cook, PhD; Kathryn Flynn, PhD; Bryce Reeve, PhD; Christy Zigler, PhD; and Nancy Zucker, PhD.

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  1. Department of Population Health Sciences, Center for Health Measurement, Duke University Medical Center, 215 Morris Street, Suite 210, Durham, NC, 27701, USA

    Kevin P. Weinfurt

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KW: Conceptualization and drafting of final manuscript.

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Correspondence to Kevin P. Weinfurt.

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Weinfurt, K.P. Viewing assessments of patient-reported heath status as conversations: Implications for developing and evaluating patient-reported outcome measures. Qual Life Res 28, 3395–3401 (2019). https://doi.org/10.1007/s11136-019-02285-8

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