Thank you for listening: Assessing the Feasibility and Accessibility of Collecting Patient Reported Outcomes on Anxiety and Hospital Experience among Inpatients on an Internal Medicine Floor
Bibliographic record
Abstract
RationalPatient Reported Outcomes Measures (PROMs) are increasingly collected in healthcare settings to capture patient experiences and outcomes. However, few studies have assessed the feasibility of PROM collection among hospitalized Canadians. AimTo evaluate the feasibility and acceptability of collecting PROMs in an urban Canadian inpatient setting. MethodsThe project was conducted in 3 phases. The first phase involved an analysis of a survey of Canadian PROM researchers and an environmental scan of PROMs in use within Canada. In the second phase, input was gathered from a relevant stakeholder including floor nurses to prioritize PROMs and discuss opportunities and barriers for PROM implementation. Participants were a convenience sample of adults hospitalized between October 2023 and March 2024 on the Internal Medicine floors of the Royal Victoria Hospital, McGill University Health Centre. Participants completed a sociodemographic questionnaire, PROMIS Anxiety 8a and a modified version of the Canadian Patient Experience Survey-Inpatient Care (CPES-IC). Hospitalization information was abstracted from patient charts. Anxiety was classified as normal, moderate or severe. CPES-IC scored were recoded into “Middle/Bottom Box” vs. “Top Box” scores. Feasibility and acceptability were assessed by number of eligible patients; recruitment time, rate, refusal, and retention; and questionnaire completion rate and time. Acceptability among nurses was assessed by their willingness and availability to identify suitable patients; among patients it was assessed by informal comments about completing the surveys. Sociodemographic and questionnaire results were summarized, and groups were compared by anxiety status on using Mann-Whitney U test. Spearman correlations were calculated to evaluate the association between anxiety and CPES-IC domain scores. Logistic regression was used to evaluate the relationship between anxiety and selected patient experience domains, controlling for patient sex and age. ResultsThe researcher survey indicated that PROMs were mainly collected for research, with the most common domains being those assessing mental health (56%), physical health (28%) and disease-specific measures (16%). Stakeholders identified the Internal Medicine floor as optimal for the study; nursing staff identified anxiety as an important but unmeasured symptom. Of 360 inpatients assessed for eligibility, 245 were excluded and 15 refused with 100 completing the surveys. The mean age of patients was 59 years, the majority of patients were male (60%), white (67%), college educated (64%), had at least five comorbidities (42%), and were on the floor for 5 days. Two-thirds (68%) of inpatients had at least mild anxiety. Anxiety was associated with significantly lower satisfaction with Communication with Nurses and Doctors; Pain Control; Involvement in Decision-Making and Treatment Options; and Emotional Support.ConclusionA dedicated research assistant could reliably collect information PROMs and PREMs in a subset of hospitalized adults on the Internal Medicine Service of a major academic hospital. Anxiety was common and was associated with reduced satisfaction with a range of patient experience outcomes
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.027 | 0.053 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".