Entete 3

60-second lecture at AHRQ Grantees conference (9/2011)

By Elizabeth A. Bayliss

In delivering patient-centered care to complex patients, success is measured by achieving health outcomes that matter to patients. 

Historically health outcomes have been disease-specific. These reflect appropriate treatment intensification by clinicians and appropriate adherence to recommendations by patients in order to achieve the best outcomes for a single condition. Goal attainment is facilitated by incentives and protocols that make it relatively easy for both groups to adhere to guidelines. For example, our current investigation suggests that attainment of cholesterol goals in cancer survivors—a protocol-driven outcome—is not associated with cancer stage, but is associated with overall morbidity.  

But which outcomes matter to patients? These often fall into the category of patient-reported outcomes and are increasingly recognized as equally important. Many clinicians are in favor of systematic collection of these outcomes as well. Thanks to extensive validation, we know which measures of patient-reported outcomes are valid, but do we know which outcomes matter? And to whom?

It may be worth pausing before we systematize the collection of patient-reported outcomes in order to check in with patients. We should ask them which health outcomes they consider meaningful, how they would like their clinicians to use this information, and how they would like to have it collected. At that point we will be better prepared to collect –and jointly use– health outcomes relevant to complex patients. 

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