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

The aim of the literature review is to give a
comprehensive report of the range of issues
and views regarding methods of evaluating patientbased
outcome measures. The review is based on
a structured and extensive search of the literature.
It was not, however, the purpose of the review to
calculate or survey the total number of papers
published on the methodology of evaluating
patient-based outcome measures, nor to report
the frequency with which particular views
were expressed.
Intellectual mapping of the topic
The first step in the structured review of the literature
was to focus the broad remit of the project by
intellectual mapping of the topic, the aim being to
establish central and surrounding issues and specify
inclusion and exclusion criteria for the subsequent
literature search. This was done by project members
reviewing an in-house collection of journal
articles. Overall, 94 publications were identified,
of which 41 articles were used as a base set because
of their emphasis on methodology of evaluating
patient-based outcome measures. This joint exercise
enabled the group to initiate inclusion and
exclusion criteria for obtaining relevant articles,
with adjustments made during collaborative project
meetings. Box 5 shows the inclusion and exclusion
criteria for the literature search.
Main literature review
The chosen strategy for the main literature review
comprised the following steps:
1. Retrospective searching
2. Handsearching of relevant journals
3. Searching of in-house database (Pro-cite) at
Brunel University
4. Qualitative analysis of articles retrieved in steps
one to three
5. Electronic search of databases.
It was decided to conduct the electronic search after
the retrospective and hand searching for a number
of reasons. Firstly, the initial in-house collection of
articles provided a reference point of publications
Appendix 1
Method of the review
Health Technology Assessment 1998; Vol. 2: No. 14
BOX 5 Inclusion and exclusion criteria for
selecting articles
• Include articles that focus on:
Reviews of methods of evaluating patient-based
outcome measures
Psychometric evaluation of patient-based outcome
measures, i.e. responsiveness, reliability, validity,
acceptability
Practical feasibility: response rates, time
to complete
Principles of selection of patient-based
outcome measures
Patient-based outcome measures used in
clinical trials
Utility methodology
Comparative studies of patient-based
outcome measures
Validation publications of prominent patient-based
outcome measures, with specific evaluation and
methodological sections
• Exclude articles comprising only these issues:
Routine use of patient-based outcome measures
in particular conditions/diseases
Translation or cross-culture studies
Clinician-based outcome measures
Economic theory
Validation studies of questionnaires and
interviews in general
NB: If an article contained information that covered both
inclusion and exclusion criteria it was included.
that referred to relevant articles. Secondly, the
heterogeneity of the terminology used in this field
required an extensive list of search terms to make
the electronic search as sensitive as possible. The
first stage of the literature review provided a full
and comprehensive range of search terms that were
then used to establish the electronic search strategy.
However, a sensitive electronic search ran the risk of
lacking specificity. Thus through having established
a base of reviewed literature, the researcher had an
up-to-date knowledge of the issues and was in a
favourable position to be selective of crucial and,
importantly, new publications.
Almost all relevant articles were identified by the
process shown in the flow chart in Figure 1. The
exception was those identified during handsearching
of relevant journals and the Pro-cite
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