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Using and Selecting a PRM

This information is for health professionals collecting PRMs. There are many PRMs available for use. When selecting a measure it is important to think about how you will use the information once you collect it. Most people are willing to complete PRMs if they know that the information they provide is going to be actually used to inform care.

When choosing an outcome or experience measure consider:

  • Are you going to use a PROM, PREM or both?
  • How will you collect the PRM (e.g., online survey, tablet device, paper)?
  • Where will the PRM be completed (e.g., in the waiting room, at home)?
  • What are the characteristics of my target population?
  • How will you ensure data is kept secure?

Selecting PROMs

When choosing which PROM to use, it can help to first think about how specific you want the measure to be. Some measures capture a broad assessment of symptoms and function while others are more tailored to a particular disease or condition.

The Australian Commission on Safety and Quality in Health Care (ACSQHC) Patient Reported Outcome Measures Literature Review1 outlined the importance of using valid, reliable and appropriate instruments when selecting PROMs. The ACSQHC recommends that the following dimensions should be considered when selecting PROMs2:

RELIABILITY: consistency of measurement, e.g. internal consistency and test/retest reliability.

VALIDITY: does the instrument measure what it claims to measure?

DISCRIMINATOR POWER / discriminant validity: is the instrument able to discriminate well between groups, for example, health public versus people with major diseases?

RESPONSIVENESS/SENSITIVITY to CHANGE: can the instrument detect change in health status over time?

AVAILABILITY OF COMPARATIVE DATA: are there norms and clinical reference datasets available for comparison purposes?

TYPE OF INSTRUMENT: generic health status measure, condition or disease-specific measure.

STYLE OF INSTUMENT: is it better to use a self-report instrument, or a rating scale or a combination of both?

PRACTICAL UTILITY: is the instrument too long/short, is it easy to administer and use, is it easy to score, will there be patient burden, etc?

FREEDOM FROM CONFOUNDING FACTORS: for example, social desirability of responses, literacy level etc.

RELEVANCE and SUITABILITY OF APPLICATION: for example, whether the generic and/or disease-specific measures adequately capture the relevant domains for the condition or disease concerned.

MODE OF ADMINISTRATION: self-reported or structured interview, telephone administration, tablet or online kiosk application etc.

CULTURE, GENDER and AGE APPROPRIATENESS: are there translations/adaptations for other cultural groups, are all the items suitable for both genders, and are there versions suitable for use with children/adolscents? Some instruments need linguistic validation for use in the Australian context.


For more information on selecting PRMs, please see our online education modules which are free to access.

Find out more about the Patient-Reported Outcomes Measurement Information System (PROMIS) (external website)

References:

1. Williams K, Sansoni K, Morris D, Grootemaat P and Thompson C, Patient-reported outcome measures: Literature review. Sydney: ACSQHC; 2016. https://www.safetyandquality.gov.au/wp-content/uploads/2017/01/PROMs-Literature-Review-December-2016.pdf

2. Sansoni J (2016) Health Outcomes: An Overview from an Australian Perspective. Australian Health Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong.