Using patient-reported outcomes in clinical practice: challenges and opportunities

2008 ◽  
Vol 18 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Kathleen N. Lohr ◽  
Bradley J. Zebrack
2016 ◽  
Vol 5 (5) ◽  
pp. 507-519 ◽  
Author(s):  
Ian Porter ◽  
Daniela Gonçalves-Bradley ◽  
Ignacio Ricci-Cabello ◽  
Chris Gibbons ◽  
Jaheeda Gangannagaripalli ◽  
...  

Author(s):  
Rikke Torenholt ◽  
Henriette Langstrup

In both popular and academic discussions of the use of algorithms in clinical practice, narratives often draw on the decisive potentialities of algorithms and come with the belief that algorithms will substantially transform healthcare. We suggest that this approach is associated with a logic of disruption. However, we argue that in clinical practice alongside this logic, another and less recognised logic exists, namely that of continuation: here the use of algorithms constitutes part of an established practice. Applying these logics as our analytical framing, we set out to explore how algorithms for clinical decision-making are enacted by political stakeholders, healthcare professionals, and patients, and in doing so, study how the legitimacy of delegating to an algorithm is negotiated and obtained. Empirically we draw on ethnographic fieldwork carried out in relation to attempts in Denmark to develop and implement Patient Reported Outcomes (PRO) tools – involving algorithmic sorting – in clinical practice. We follow the work within two disease areas: heart rehabilitation and breast cancer follow-up care. We show how at the political level, algorithms constitute tools for disrupting inefficient work and unsystematic patient involvement, whereas closer to the clinical practice, algorithms constitute a continuation of standardised and evidence-based diagnostic procedures and a continuation of the physicians’ expertise and authority. We argue that the co-existence of the two logics have implications as both provide a push towards the use of algorithms and how a logic of continuation may divert attention away from new issues introduced with automated digital decision-support systems.


2011 ◽  
Vol 21 (8) ◽  
pp. 1305-1314 ◽  
Author(s):  
Claire F. Snyder ◽  
Neil K. Aaronson ◽  
Ali K. Choucair ◽  
Thomas E. Elliott ◽  
Joanne Greenhalgh ◽  
...  

2021 ◽  
pp. bmjspcare-2020-002699
Author(s):  
Marthe Peeters ◽  
Germaine Ottenheijm ◽  
Paul Bienfait ◽  
Daniëlle Eekers ◽  
Anja Gijtenbeek ◽  
...  

IntroductionRoutine assessment of patient-reported outcomes (PROs) in oncology has shown to improve the quality of the delivered care and to prolong survival. However, for successful implementation of routine assessment of PROs, more knowledge on their usability in clinical practice is needed.ObjectiveThis study aimed to cross-sectionally assess the perspective of patients and clinicians on the practicality of routinely measuring PROs in clinical practice for glioma patients.MethodsSemistructured interviews were conducted evaluating the role of healthcare professionals (HCP) in discussing results of PRO measures (PROMs), and the preferred topics, methods and frequency of PRO assessment. Glioma patients, their proxies and HCPs involved in the treatment of glioma patients from eight centres in the Netherlands were included.ResultsTwenty-four patients, 16 proxies and 35 HCPs were interviewed. The majority of patients, proxies and HCPs (92%, 81% and 80%, respectively) were willing to discuss PRO results during consultations. Although HCPs prefer that results are discussed with the nurse specialist, only one-third of patients/proxies agreed. Functioning of daily life was considered important in all three groups. Most participants indicated that discussion of PROM results should take place during standard follow-up visits, and completed at home about 1 week in advance. On group level, there was no preference for administration of questionnaires on paper or digitally. Lastly, all centres had staff available to send questionnaires on paper.ConclusionThis study shows that routine assessment of PROs is desired by patients, proxies and HCP’s in neuro-oncological care in Dutch hospitals.


2020 ◽  
Vol 21 (3) ◽  
pp. 255-263.e4
Author(s):  
Laurie E. Steffen McLouth ◽  
Thomas W. Lycan ◽  
Beverly J. Levine ◽  
Jennifer Gabbard ◽  
Jimmy Ruiz ◽  
...  

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