Journal CME, November 2022: PROMIS for the PM&R clinician using patient-reported outcomes in clinical care-Journal Nov 2022 PROMIS

Journal Nov 2022 PROMIS

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The article discusses the use of the Patient Reported Outcome Measurement Information System (PROMIS) in clinical care, particularly within the field of Physical Medicine and Rehabilitation (PM&R). PROMIS, an initiative by the National Institutes of Health, is a set of patient-reported outcome measures (PROMs) designed to assess health-related quality of life. It is extensively validated, free in English, and covers numerous clinical domains.<br /><br />PROMs, including PROMIS, are crucial because they shift the focus of healthcare quality assessment from clinician-reported to patient-reported outcomes, offering a more accurate reflection of the patient’s health status and perceived benefit from treatments. In light of increasing demands for transparency and better outcome metrics from payers, employers, and patients, integrating PROMs into clinical practice is becoming essential.<br /><br />PROMIS is advantageous due to its disease-agnostic nature, encompassing over 90 adult domains and more than 20 pediatric domains. It employs Item Response Theory (IRT) for scoring, similar to educational testing systems like the SAT, enhancing accuracy and reducing assessment burden. PROMIS can be administered via computer adaptive testing (CAT), making it time-efficient and precise.<br /><br />Clinicians can choose from standardized short forms or create custom forms, and PROMIS scores are easily comparable across various domains due to a uniform T-score metric derived from the U.S. general population.<br /><br />The article emphasizes the increasing adoption of PROMIS in clinical research, with significant usage in orthopedic and neurological studies. It highlights the practical benefits of PROMIS, such as ease of administration, reduced patient burden, and the ability of clinicians to track clinical progress and make informed decisions based on patient-reported data.<br /><br />To integrate PROMIS into a clinical setting, practices need to carefully select relevant measures, train staff, and potentially adjust workflows to routinely collect patient-reported data. Technical integration into electronic health records can streamline score interpretation and facilitate responsive care.<br /><br />The article concludes with the assertion that the benefits of implementing PROMIS outweigh the challenges, making it a valuable tool for PM&R physicians.

Keywords

PROMIS

Patient Reported Outcomes

Physical Medicine

Rehabilitation

Health-related Quality of Life

Item Response Theory

Clinical Care

Computer Adaptive Testing

Outcome Metrics

Electronic Health Records