PMID- 33183858
OWN - NLM
STAT- MEDLINE
DCOM- 20210806
LR  - 20210806
IS  - 1531-6564 (Electronic)
IS  - 0363-5023 (Print)
IS  - 0363-5023 (Linking)
VI  - 46
IP  - 2
DP  - 2021 Feb
TI  - The Patient Perspective on Patient-Reported Outcome Measures Following Elective 
      Hand Surgery: A Convergent Mixed-Methods Analysis.
PG  - 153.e1-153.e11
LID - S0363-5023(20)30538-4 [pii]
LID - 10.1016/j.jhsa.2020.09.008 [doi]
AB  - PURPOSE: Patient-reported outcome measures (PROMs) have traditionally been used 
      for research purposes, but are now being used to evaluate outcomes from the 
      patient's perspective and inform ongoing management and quality of care. We used 
      quantitative and qualitative approaches to evaluate the short-version 
      Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and the Patient-Specific 
      Functional Scale (PSFS) with regard to patient preference and measurement of 
      patient goals and their responsiveness after treatment. METHODS: Patients 18 
      years or older undergoing elective hand surgery received the QuickDASH and PSFS 
      questionnaires before and at 6 weeks after surgery. Two additional questions 
      intended to elicit patients' preferences regarding the QuickDASH and PSFS were 
      included. Responsiveness was measured by change in pre- to postoperative score. 
      We analyzed patients' responses to the 2 additional questions to identify themes 
      in PROM preferences. Results from the quantitative and qualitative analyses were 
      combined into a convergent mixed-methods (eg, quantitative and qualitative) 
      analysis. RESULTS: Thirty-eight patients completed preoperative questionnaires; 
      25 (66%) completed postoperative questionnaires. Seventeen patients (77%) 
      preferred the PSFS, 3 (14%) had no preference, 2 (9%) preferred the QuickDASH. 
      The average change from pre- to postoperative QuickDASH was -10 (SD, 20), and 
      that of the PSFS was -27 (SD, 26). Ten patients (40%) reported QuickDASH score 
      changes above the minimal clinically importance difference (MCID), 17 patients 
      (68%) reported PSFS score changes above the MCID. Content analysis revealed 4 
      themes in preference for a PROM: instrument simplicity (ease of instrument 
      understanding and completion), personalized assessment (individualization and 
      relevance), goal directed (having measurable aims or objectives), distinct items 
      (concrete or specific instrument items or functions). CONCLUSIONS: Most patients 
      felt the PSFS better measured their goals because it is a simple, personalized 
      instrument with distinct domains. CLINICAL RELEVANCE: Whereas standardized PROMs 
      may better compare across populations, physicians, or conditions, employing PROMs 
      that address patient-specific goals may better assess aspects of care most 
      important to patients. A combination of these 2 types of PROMs can be used to 
      assess outcomes and inform quality of care.
CI  - Copyright (c) 2021 American Society for Surgery of the Hand. Published by Elsevier 
      Inc. All rights reserved.
FAU - Shapiro, Lauren M
AU  - Shapiro LM
AD  - Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
FAU - Eppler, Sara L
AU  - Eppler SL
AD  - Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
FAU - Roe, Allison K
AU  - Roe AK
AD  - Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
FAU - Morris, Arden
AU  - Morris A
AD  - Department of Surgery, Stanford University, Stanford, CA.
FAU - Kamal, Robin N
AU  - Kamal RN
AD  - Department of Orthopaedic Surgery, Stanford University, Redwood City, CA; VOICES 
      Health Policy Research Center, Department of Orthopaedic Surgery, Stanford 
      University, Redwood City, CA. Electronic address: rnkamal@stanford.edu.
LA  - eng
GR  - K23 AR073307/AR/NIAMS NIH HHS/United States
PT  - Journal Article
DEP - 20201109
PL  - United States
TA  - J Hand Surg Am
JT  - The Journal of hand surgery
JID - 7609631
SB  - IM
MH  - *Disability Evaluation
MH  - *Hand/surgery
MH  - Humans
MH  - Minimal Clinically Important Difference
MH  - Patient Reported Outcome Measures
MH  - Surveys and Questionnaires
PMC - PMC8080672
MID - NIHMS1693620
OTO - NOTNLM
OT  - Hand surgery
OT  - patient-centered care
OT  - patient-reported outcome measures
OT  - shared decision making
EDAT- 2020/11/14 06:00
MHDA- 2021/08/07 06:00
PMCR- 2021/04/28
CRDT- 2020/11/13 05:37
PHST- 2019/07/15 00:00 [received]
PHST- 2020/07/15 00:00 [revised]
PHST- 2020/09/22 00:00 [accepted]
PHST- 2020/11/14 06:00 [pubmed]
PHST- 2021/08/07 06:00 [medline]
PHST- 2020/11/13 05:37 [entrez]
PHST- 2021/04/28 00:00 [pmc-release]
AID - S0363-5023(20)30538-4 [pii]
AID - 10.1016/j.jhsa.2020.09.008 [doi]
PST - ppublish
SO  - J Hand Surg Am. 2021 Feb;46(2):153.e1-153.e11. doi: 10.1016/j.jhsa.2020.09.008. 
      Epub 2020 Nov 9.