This information is for health professionals collecting patient-reported measures (PRMs). There are many patient surveys 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 patient surveys if they know that the information they provide is going to be used to inform their care.
When choosing an outcome or experience measure, it’s important to consider the following:
- Are you going to use a patient-reported outcome measure (
PROM ), patient-reported experience measure (PREM ), or both? - How will you collect the
PRMs (e.g. online survey, tablet device, paper)? - Where will the PRMs be completed (e.g. in the waiting room, at home)?
- What are the characteristics of your target population?
- How will you ensure data is kept secure?
Patient surveys used in the statewide PRMs program
The NSW PRMs Program has used a co-design approach to develop the PROM and PREM surveys to be used across NSW Health services. This is to ensure the measures are standardised across the health system and help reduce burden and fatigue.
A list of PROM and PREM surveys included in the NSW PRMs program can be found in the Resources section.
Selecting a patient survey
When choosing which PRM 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 functions 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 considering the following dimensions 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 (e.g. 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 instrument: 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 and literacy level.
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?
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/adolescents? Some instruments need linguistic validation for use in the Australian context.
Useful resources when selecting a PRM
- Refer to our free online education modules
- Refer to our resources section for a list of PRMs surveys included in the NSW PRMs program
- Analytic principles for patient-reported outcome measures
- Patient-Reported outcome measures: Methods for analysis and reporting
- Patient-Reported Outcomes Measurement Information System (PROMIS)
- International consortium for health outcome measurements
Electronic collection of PRMs
A common concern from healthcare workers is that some of their patients may not be willing (or able) to complete the survey on an electronic tablet device. Experience has shown that most surveys take a short time to complete (approximately 2-5 minutes), and that people find using a tablet device acceptable and easy.
The use of a tablet device allows for:
- adjustable font size
- voice function available on new tablet devices, i.e. ‘Read-out-loud’ mode (converting text to speech)
- tools provided in different languages
- immediate feedback to the care team to use in care and decision making.
Assisting people to complete patient-reported measures
A healthcare worker, carer or family member can assist the patient to complete the survey (for example, a person who is vision-impaired may have their carer read out the questions and record their answers for them).
If the patient has assistance completing their surveys, it is important that the questions are answered from the perspective of the patient, rather than the person filling it out.
PRM surveys can also be completed by a healthcare provider during a consultation via virtual care (or telehealth). The healthcare provider will be required to read any consent information and answer the survey from the perspective of the patient.
A clinician can access a patient survey using the Secure (Restricted) Access Portal and a secure access ID, with the permission of the patient.
References
- Williams K, Sansoni K, Morris D, Grootemaat P and Thompson C. Patient-reported outcome measures: Literature review. Sydney: ACSQHC; 2016 (cited Nov 2020).
- Sansoni J. Health Outcomes: An Overview from an Australian Perspective. Australian Health Outcomes Collaboration, Australian Health Services Research Institute. Wollongong: University of Wollongong; 2016.
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