Technological developments enable measuring and using patient-reported outcomes data in orthopaedic clinical practice

Abstract

Patient-reported outcomes measures form the backbone of outcomes evaluation in orthopaedics, with most of the literature now relying on these scoring tools to measure change in patient health status. This patient-reported information is increasingly collected routinely by orthopaedic providers but use of the data is typically restricted to academic research. Developments in electronic data capture and the outcome tools themselves now allow use of this data as part of the clinical consultation. This review evaluates the role of patient reported outcomes data as a tool to enhance daily orthopaedic clinical practice, and documents how develop-ments in electronic outcome measures, computer-adaptive questionnaire design and instant graphical display of questionnaire can facilitate enhanced patient-clinician shared decision making.

Keywords: Computer adaptive design; Electronic patient-reported outcome; Outcomes evaluation; Patient reported outcome measures.

Figure 1

Current usage of patient information data flows.

Figure 2

Potential usage of patient information data flows.

Figure 3

OKS T-scores feedback model stratified to patient demographics. Figure showing the longitudinal course of expected patient outcomes. The exemplary course (green line) of an individual patient undergoing total knee arthroplasty at 3 different points prior to and following surgery is presented in terms of t-scores against a background of an age and gender matched population. The dark grey area is the range for +/- 1 standard deviation of the appropriate matched population and the light grey area the range for +/- 2 standard deviation.