Patient defined outcomes: lessons from systematic review

S Mathers*+, G McKenzie*, E Robertson*, J Proctor*+, R Chesson+

*NHS Grampian +The Health Services Research GroupAberdeen, Scotland, UK.

What aspects of health care can be evaluated?

Outcome

Change due to intervention

Process

Intervention e.g.surgery, procedure

Structure

Resources, facilitiesorganisational settings

Donabedian, 1980

‘ ...a successful outcome, as defined from the professionals perspective, may not necessarily be regarded as a successful outcome by the patient.’

Wright, 1999

Patient centred outcome• determined solely by health

professionals and researchers

Patient defined outcome• identified by patients as being

important

Dixon, 1995

Aim

To carry out a systematic review of literature to identify:

• the prevalence, • use of patient focused outcome measures

in radiology.

Search Strategy

▼

Databases searched

▼

Abstracts read according to defined criteria

▼

Criteria redefined, abstracts to be re-read in light of this

▼

Articles to be retrieved

▼

Initial paper review

▼

Data synthesis1. Data extraction form

2. Quality checklist

▼

Data analysis1.SPSS

2. Summary tables3. Meta-analysis

▼

Write up and dissemination.

Modified from NHS Centre for Reviews and Dissemination, (UK)

• 47 key words used

radiology, diagnostic imaging, x-ray/

outcomes patient satisfaction

efficacy outcome measures

utility adverse reaction

waiting times quality of care

• Databases searched e.g. MEDLINE

Results

• Citations 5516

• Citations reviewed111

• Patient focused outcome 23

• NO paper was found in which patient defined outcome had been used in radiology

Patient focused outcome papers

Primary focus of research

4 papers

- ALL concerned with lumbar spine imaging

Patient focused outcome papers

Secondary focus of research

5 papers

- 4 interventional studies

- 1 chest imaging

Conclusions

• Dearth of research into patient centred outcomes in radiology

• Lack of coherent body of work

• Demonstrates little patient involvement in radiology research in radiology departments

• Highlights need for considering patient needs

• Continuing need for CPD reflecting PFPI agenda

Recommendations

• Patient engagement should take place in developing patient defined outcome especially in the area of interventional radiology

• Value of patient defined outcomes incorporated into education, and planning of health care

Acknowledgements

The Royal College of Radiologists (UK)

(Pump Priming Research Award)