Professor David Beard & Kristina Harris University of Oxford discusses Can PROMs be used to make decisions about individual patients?
Professor David Beard Professor of Musculoskeletal Sciences Co-Director of RCS Surgical Trials Unit (SITU) University of Oxford Director of Orthopaedic Surgical and Interventional Trials (OSIRIS) Fellow of Kellogg College & Member of Wolfson College & Kristina Harris Postdoctoral Research Associate University of Oxford discusses Can PROMs be used to make decisions about individual patients.
There has been a recent interest in the endorsement of PROMs, not just in research but also in audit and clinical practice setting. Whilst measuring health outcomes has potential to enhance patient care and outcomes and optimise provider performance, the evidence for this in certain settings is still wanting. Unfortunately, there has been recent evidence of use of some PROMs outside its original remit, in new and extended roles, with the generated data used for directly inform clinical decision-making, often for individual patients. Such use of PROMs, without essential understanding of their validated utilities and limitations, will not just yield incorrect information, but could also lead to incorrect decisions and negative impact. Optimisation of health systems by maximising outcomes and reducing unnecessary costs may indeed be informed by the use of PROMs, however more evidence in this field is needed. In this talk we will overview the current use of PROMs for individual use and outline the requirements and measurement characteristics necessary for this use. An ongoing HTA NIHR funded programme (ACHE), which looks at the potential use of a PROM in clinical practice and its potential use in improving patient outcomes and the quality of care in patients with hip and knee osteoarthritis, will be used as an example to highlight the salient issues. A summary will review the present position and progress made in using PROMs for individual patients.
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David Beard is Professor of Musculoskeletal Sciences at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS) in the University of Oxford. He is also Co-Director of the Royal College of Surgeons (RCS) Surgical Intervention Trials Unit (SITU-Oxford).
His academic qualifications include an MSc in Biomedical Science (Research Methodology) from Kings College (London) in 1992, an MA by Resolution (Kellogg College, Oxford) in 2012, and a Doctorate in Medicine (Oxford) in 1996 awarded for studies on knee joint proprioception and compensatory mechanisms after anterior cruciate injury.
Previous clinical work includes posts in Bath, Jersey, and Canada. He has previously held senior academic posts at Oxford and Australia, and held honorary academic positions in Cardiff and Bristol. Initially qualified a chartered physiotherapist (GDPhys) in Nottingham, he maintains an active clinical role as Specialist Practitioner (Complex Knee) for a West Wales NHS Trust (Abertawe Bro Morgannwg University Health Board). He is also a Professorial Fellow of Kellogg College and Member of Wolfson College.
Research interests include surgical clinical trials methodology, including placebo control designs, outcome measurement in health and a variety of musculoskeletal intervention studies.
Kristina’s current research interests mainly concern: health status measurements and their development, evaluation and applications with a view to improve patient care, evaluate health service delivery, and generate evidence based clinical practice guidelines (particularly in the areas within orthopaedics and musculoskeletal health). Her main areas of expertise are development and validation of PROs (Classical Test Theory and Item Response Theory), interpretation and clinical application of PROs, qualitative research, and systematic reviews of measurement properties of PROs. Her academic qualifications include an BSc in Physiotherapy, an MSc in Applied Biomechanics, and a DPhil in Musculoskeletal Sciences from Oxford University, awarded on the investigation of the extended use of the Oxford Knee Score in research and clinical practice. Kristina mainly works within the outcomes research group with Professor Andrew Price and Professor David Beard at the Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford. She supervises medical and postgraduate students at Oxford University and is involved in a number of projects and collaborations into health service research and musculoskeletal health.
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