Evaluating Patient-Based Outcome Measures - NIHR Health ...

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NHS R&D HTA Programme The overall aim of the NHS R&D Health Technology Assessment (HTA) programme is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and work in the NHS. Research is undertaken in those areas where the evidence will lead to the greatest benefits to patients, either through improved patient outcomes or the most efficient use of NHS resources. The Standing Group on Health Technology advises on national priorities for health technology assessment. Six advisory panels assist the Standing Group in identifying and prioritising projects. These priorities are then considered by the HTA Commissioning Board supported by the National Coordinating Centre for HTA (NCCHTA). This report is one of a series covering acute care, diagnostics and imaging, methodology, pharmaceuticals, population screening, and primary and community care. It was identified as a priority by the Methodology Panel and funded as project number 93/47/09. The views expressed in this publication are those of the authors and not necessarily those of the Standing Group, the Commissioning Board, the Panel members or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for the recommendations for policy contained herein. In particular, policy options in the area of screening will, in England, be considered by the National Screening Committee. This Committee, chaired by the Chief Medical Officer, will take into account the views expressed here, further available evidence and other relevant considerations. Reviews in Health Technology Assessment are termed ‘systematic’ when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. Series Editors: Andrew Stevens, Ruairidh Milne and Ken Stein Assistant Editors: Jane Robertson and Jane Royle The editors have tried to ensure the accuracy of this report but cannot accept responsibility for any errors or omissions. They would like to thank the referees for their constructive comments on the draft document. ISSN 1366-5278 © Crown copyright 1998 Enquiries relating to copyright should be addressed to the NCCHTA (see address given below). Published by Core Research, Alton, on behalf of the NCCHTA. Printed on acid-free paper in the UK by The Basingstoke Press, Basingstoke. Copies of this report can be obtained from: The National Coordinating Centre for Health Technology Assessment, Mailpoint 728, Boldrewood, University of Southampton, Southampton, SO16 7PX, UK. Fax: +44 (0) 1703 595 639 Email: hta@soton.ac.uk http://www.soton.ac.uk/~hta
List of abbreviations ..................................... i Executive summary ...................................... iii 1 Purpose and plan of this review ................. 1 2 What are patient-based outcome measures? ..................................... 3 The emergence of patient-based outcome measures ......................................... 3 Concepts and definitions ............................... 4 Content of instruments ................................. 7 Types of instruments ...................................... 8 Using instruments in combination ............... 16 Applications .................................................... 16 3 Criteria for selecting a patient-based outcome measure ........................................ 19 Appropriateness ............................................. 19 Reliability ......................................................... 22 Validity ............................................................. 24 Responsiveness ............................................... 28 Precision .......................................................... 32 Contents Health Technology Assessment 1998; Vol. 2: No. 14 Interpretability ............................................... 39 Acceptability ................................................... 39 Feasibility ........................................................ 43 4 Conclusions ................................................... 45 5 Recommendations ...................................... 47 For trialists selecting a patient-based outcome measure ........................................... 47 For developers of patient-based outcome measures ......................................... 47 Future research .............................................. 47 Acknowledgements ..................................... 49 References ..................................................... 51 Appendix 1 Method of the review ............... 65 Health Technology Assessment reports published to date ......................................... 71 Health Technology Assessment panel membership ....................................... 73
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Professor Senga Bond, University of
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