Evaluating the outcome of treatment. Shouldn't We be asking patients if they are better?

Abstract

Increasingly clinicians and investigators are recognizing the need to include patients in the assessment of therapy. Patient-based assessments, such as measures of health status or health-related quality-of-life, require patients to rate themselves on a fixed number of questions. Because patients come to their doctors with unique, different, and individual concerns, the concern is that commonly used scales with a fixed number of questions might be excluding important individual concerns or including issues irrelevant to individual patients. Clinicians usually do not rely on health status questionnaires in routine practice to judge the success of therapy, but ask patients directly if they are better. Despite this fundamental interchange between patients and clinicians, relatively little attention has been directed towards the specification, measurement, and quantification of patients' individual concerns. Patient-specific measures are a particular type of measure which allow patients to state their individual concerns, and weight their relative importance. Because we are often trying to address with treatment the concerns of individual patients, patient-specific outcomes would provide us a standardized method useful in research and clinical practice of asking patients whether they are better.