Antoinette Crawford

© 2015 International Society for Pharmacoeconomics and Outcomes Research. Objective: To recommend methods for assessing quality of care via patient-reported outcome-based performance measures of symptoms, functional status, and quality of life. Methods: A Technical Expert Panel was assembled by the American Medical Association-convened Physician Consortium for Performance Improvement. An environmental scan and structured literature review were conducted to identify quality programs that integrate PRO-PMs. Key methodological considerations in the design, implementation, and analysis of these PRO-PM data were systematically identified. Recommended methods for addressing each identified consideration were developed on the basis of published patient-reported outcome standards and refined through public comment. Literature review focused on programs using PROs to assess performance and on PRO guidance documents. Results: Thirteen PRO programs and 10 guidance documents were identified. Nine best practices were developed, including the following: provide a rationale for measuring the outcome and for using a PRO-PM; describe the context of use; select a measure that is meaningful to patients with adequate psychometric properties; provide evidence of the measure's sensitivity to differences in care; address missing data and risk adjustment; and provide a framework for implementation, interpretation, dissemination, and continuous refinement. Conclusion: Methods for integrating PROs into performance measurement are available.

45 Background: There is growing interest to use performance measures that integrate patient-reported outcomes, but there are no existing methodological standards for developing, implementing, or analyzing such measures in this context.To develop standards for evaluating PRO-based performance measures submitted to or developed by the American Medical Association-convened Physician Consortium for Performance Improvement, a multi-disciplinary expert technical panel was assembled. A systematic literature review and landscape overview were conducted to identify use cases and existing PRO standards in related contexts. Lessons learned from use cases and existing standards guided development of discrete methodological standards.The systematic review identified only one use case, whereas the landscape overview identified eight. Five purposes were identified for which PROs might be measured to assess performance, including one categorized as process and four as outcome. Eight discrete methodological standards were developed which will be detailed at the meeting.The patient perspective is an essential but missing component of performance evaluation. When appropriately elicited, data from patients can be informative. Lack of adherence to good practices and inadequate patient input when developing measurement strategies are potential pitfalls to be avoided.