2010 review - Patient-Reported Outcomes Measurement - University ...

Appendix D
Membership, methods of working, and conclusions of the multidisciplinary panel
A search was conducted, using published literature and the websites of professional
organisations and health authorities, to identify a multidisciplinary panel with clinical or
research experience of elective coronary revascularisation procedures (ECRP) and a special
interest in patient-reported outcome measures (PROMs). Eight persons were invited to
participate, six of whom returned completed ratings scales. The group of six respondents
comprised two consultant cardiac surgeons, a consultant cardiologist, a professor of nursing
with particular expertise in cardiovascular disease, a research psychologist with an interest in
ECRP, and an expert in clinical governance based in a cardiothoracic centre.
The panel were sent the following documents:
‘A Structured Review of Patient-Reported Outcome Measures used in Elective
Procedures for Coronary Revascularisation’, February 2010;
copies of the PROMs short-listed for discussion (SF-36, EQ-5D, SAQ, CROQ).
The panel were sent by e-mail rating scales to judge the suitability of the questionnaires for
use in the NHS for the evaluation of services. The panel was asked whether they could
suggest other PROMs and whether they were in overall agreement with the conclusions of the
review; there was a section for additional comments.
The rating scale used the following responses:
‘not at all suitable’ (score 0);
‘to some extent unsuitable’ (score 1);
‘uncertain’ (score 2);
‘to some extent suitable’ (score 3);
‘very suitable’ (score 4).
Scores for each questionnaire were ranked in order of preference.
Five panel members provided scores for instruments; the sixth panel member feeling that no
measure was sufficiently appropriate to give a score.
Notes of electronic discussion: June-August 2010
Generic measures
SF-36
Members of the group had experience of using this well-established instrument, widely used
in ECRP. The availability of comparative and standardised normative data offered the
advantage of allowing for comparisons with other populations, including non-UK
populations. Given that recovery from revascularisation may be affected by multiple
morbidity, some panel members considered use of a generic measure to be appropriate.
However, others warned of the risk of false negatives, and pointed out that the success of
revascularisation ought not to be judged by the impact on symptoms which cannot be
ameliorated by the procedure.
Uncertainty was expressed as to whether subscale or summary scores (PCS and MCS) should
be reported; summary scores were felt to limit Type I errors. There was also a question
48