Prioritizing Patient-Reported Outcome Measures for Routine Collection in Rheumatoid Arthritis: An Integrated Consensus-Building Process with Patients and Health Care Providers
Notice bibliographique
Résumé
Objectives Patient-reported outcome measures (PROMs) are essential tools for prioritizing patient-centered care. Effective use of PROMs collected in clinical care hinges on selecting appropriate measures. The aim of this study was to establish consensus on PROMs for routine collection in RA care based on Canadian patient and provider preferences. Methods Candidate PROMs were identified through an environmental scan. Candidate PROMs met the following criteria: 1) clinical and/or research evidence supporting their use, 2) valid psychometric properties, 3) available at no cost, and 4) feasible to complete in routine care. We adopted a dual-panel consensus-building approach with a patient-exclusive panel, and separate engagement with rheumatology healthcare providers (HCPs). Consensus among patients with RA was established via a modified Delphi, co-led with 2 patient partners. This began with a prioritization of health domains/outcomes for review (Round 0). PROMs were then rated using a Likert scale of 1-9 for content validity, importance, and feasibility (Round 1), followed by a virtual consensus-building discussion (Round 2), and final re-rating of PROMs (Round 3). HCPs were engaged in a two-part rating and discussion exercise with 2 groups of providers from Alberta academic centers. Consensus was achieved if PROMs received a median rating of 7 or higher in at least 2 criteria. We included a ranking exercise for highly rated PROMs (>7 in all 3 criteria) in the final patient panel round. An overall rank was assigned to PROMs based on the rank-weighted sum. Results Fifteen patients with RA took part in the Delphi rounds. From an initial set of 15 candidate PROMS, 10 were rated highly (≥ 7) across all 3 criteria in Round 3. These PROMs were subsequently ranked. A measure of physical function ranked highest. Among HCPs (n=23), 4 PROMs received a median rating of 7 or higher in at least 2 criteria. Though limited, there was agreement between patients and HCPs ratings for pain and fatigue PROMs. Of these, only pain interference was highly ranked by patients (Table 1). Feedback from providers suggests that PROMs should align with clinical documentation needs, including insurance forms for advanced therapies and disability claims. Table 1: Patients and Health Care Providers (HCPs) PROM consensus results Conclusion Given the limited agreement between patients and providers on PROM measurement priorities, further work is required to understand why and to select a meaningful set of PROMs for routine collection. To start, a measure of physical function will be initialized for routine collection as it is a high patient priority and supports HCPs clinical documentation.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,418 | 0,320 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,003 | 0,003 |
| Bibliométrie | 0,012 | 0,007 |
| Études des sciences et des technologies | 0,007 | 0,003 |
| Communication savante | 0,007 | 0,006 |
| Science ouverte | 0,006 | 0,015 |
| Intégrité de la recherche | 0,003 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».