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Guide to Statistics and Methods
January 29, 2020

Practical Guide to Assessment of Patient-Reported Outcomes

Author Affiliations
  • 1Department of Surgery, University of Washington, Seattle
  • 2Department of Health Services, University of Washington, Seattle
  • 3Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado
  • 4School of Medicine, Department of Emergency Medicine, University of Colorado, Aurora
  • 5Department of Epidemiology, Colorado School of Public Health, Aurora
  • 6Department of Surgery, McGill University, Montreal, Quebec, Canada
JAMA Surg. Published online January 29, 2020. doi:10.1001/jamasurg.2019.4526

As surgeons, we strive to provide high-value quality care that meets the needs of patients. A pillar of quality improvement is measuring outcomes to optimize health system processes and surgical techniques. Traditionally, surgical outcomes have been evaluated using clinical measures that are readily extractable and quantifiable from the health record or from large administrative databases. In contrast, a patient-reported outcome (PRO) is an assessment of health status that comes directly from the patient without interpretation by health care professionals. While clinical outcomes certainly include metrics that matter to patients (eg, complications or mortality rates), this limited focus misses critical information that can only be captured with information that only a patient can provide. Evaluating outcomes that include the patient’s perspective is necessary for a high-value and patient-centered health care system in which value is defined as “health care outcomes achieved that matter to patients relative to the cost of achieving those outcomes.”1 Collecting PROs in routine health services research and clinical care rounds out the important outcome domains we should consider as we evaluate disease burden and treatment effectiveness. Patient-reported outcomes provide unique insight into patients' experience with their symptoms, health care–related quality of life (HRQOL), function, and their values and preferences (Box).

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