PRO instrument and its types – Pubrica

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Patient-Reported Outcomes (PROs) is " a unique health status indicator that reveals the current and past scenarios of a ones health condition by the patient them self, without any other interpretation (clinician or care giver). "Patient-Reported Outcome" (PRO) is considered a broad phenomenon, encompassing various factors of perceiving and quantifying a person’s health status, which includes health conditions (physical and mental), health related quality of life (HRQOL), social well being, clinical trials, functional status linked with the treatment taken by the patient etc.

Literature has identified several crucial factors for development of a PRO instrument namely

1. Study parameters should hold strong literature support
2. Should possess a conceptual structure
3. Should be drafted based on a end-point model
4. Study must possess ideal number of study items
5. The model should conceal identity of the patients
6. Reproducible at any given point of time
7. The questionnaire should be simplified and understandable to the patients

The universal availability of the content is expected to bring upon striking changes in the policies by the regulatory authorities, drug developers, researchers, technologists and be used for advanced clinical trials over the time.

The commonly known types of PRO instruments are

• Generic
• Disease specific
• Population specific
• Dimension specific
• Individualized
• Summary items
• Utility measures

Generic PRO instrument:

Generic PRO instruments are used to measure broad health aspects, illness outcomes and are applicable for a wide spectrum of patient groups and population across the countries. The key benefits of generic PRO instrument is that they are ideally suitable to evaluate large number of health disorders and can be used for comparative studies among different patient groups, treatment methods to determine the competency of the models.

Disease specific:

This instrument aims to estimate the patient's view of a specific disease or disorder Specific instruments are made developed targeting specific health ailments. For example: Rheumatoid Arthritis Quality of Life questionnaire (RAQoL) developed to evaluate the patient purview of health care and quality of life with Rheumatoid Arthritis,

Population specific:

Population-specific instrument are developed targeting a specific demographic group (children or elderly people) and geographic groups. The term "Population specific" can be classified based on disease condition, treatment methods, population and geography.

Dimension specific:

Dimension-specific instrument evaluates a particular aspect of a person’s health. The classic examples are physical function, psychological wellness, personal strengths, global health perspectives, specific role based perceptions (house hold works, job, finance), personal put up (appearance, spiritual viewpoint, gratification).

Individualized PRO instrument:

Individualized instruments enable patients to frame their own choice of items and can evaluate the significance of individual items such as the health issue, other concerns or factors that are not predetermined by the evaluator.

Summary Items:

Summary item is a versatile PRO instrument where respondents are asked to consolidate the varied aspect of health condition via a single item or a very small number of items. It is less time consuming and is used to get inputs from large sample groups of a general population leading to ample correlative evidences. However, summary item restricts the specific inferences that can be made on a specific health disorder, which is due to its conciseness.

Utility measures:

Utility measures, involves choice or values pertaining to an individual health condition and represents it as a single index/score. This PRO instrument evaluates the overall strength of health status in a society and is used for cost-utility analysis.

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