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December 06, 2016; 87 (23) Article

Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic

Lidia M.V.R. Moura, Eli Schwamm, Valdery Moura Junior, Michael P. Seitz, John Hsu, Andrew J. Cole, Lee H. Schwamm
First published November 4, 2016, DOI: https://doi.org/10.1212/WNL.0000000000003409
Lidia M.V.R. Moura
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
MD, MPH
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Eli Schwamm
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
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Valdery Moura Junior
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
MBA, MSc
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Michael P. Seitz
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
BA
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John Hsu
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
MD, MBA
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Andrew J. Cole
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
MD
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Lee H. Schwamm
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
MD
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Citation
Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic
Lidia M.V.R. Moura, Eli Schwamm, Valdery Moura Junior, Michael P. Seitz, John Hsu, Andrew J. Cole, Lee H. Schwamm
Neurology Dec 2016, 87 (23) 2435-2442; DOI: 10.1212/WNL.0000000000003409

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Abstract

Objective: To determine whether patients could self-report physical and mental health assessments in the waiting room and whether these assessments would be associated with modified Rankin Scale (mRS) and Quality of Life in Epilepsy (QOLIE-10) scores.

Methods: We offered iPad-based surveys to consecutive adult neurology patients at check-in to collect patient-reported outcome measures (PROMs). We collected demographic and clinical data on 6,075 patients through survey or administrative claims and PROMs from participating patients. We compared demographic characteristics of participants and nonparticipants and tested associations between physical and mental health scores and mRS and QOLIE-10.

Results: Of 6,075 patients seen by neurologists during the study period, 2,992 (49.3%) participated in the survey. Compared to nonparticipating patients, participating patients more often were privately insured (53.5% vs 42.7%, p < 0.01), married (51.5% vs 47.9%, p < 0.01), and seen in general neurology (nonsubspecialty) clinics (53.1% vs 46.6%, p < 0.01) and more likely to report English as their preferred language (50.1% vs 38.4%, p < 0.01). Participating patients had a mean physical health T score of 28.7 (SD 15) and mental health T score of 33 (SD 15), which were 3 and 2 SD worse than the average for the US general population, respectively. Mean T scores in every category of the mRS were different from every other category (n = 232, p < 0.01). Patient Reported Outcomes Measurement Information System-10 T scores were linearly associated with QOLIE-10 scores (n = 202, p < 0.01)

Conclusions: Systematic digital collection of PROMs is feasible. Differences among survey participants and nonparticipants highlight the need to develop multilingual measurement tools that may improve collection from vulnerable populations.

GLOSSARY

mRS=
modified Rankin Scale;
PROM=
patient-reported outcome measure;
PROMIS=
Patient Reported Outcomes Measurement Information System;
QOLIE-10=
Quality of Life in Epilepsy;
RPDR=
Research Patient Data Registry;
WHO=
World Health Organization

Footnotes

  • ↵* These authors contributed equally to this work.

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received May 17, 2016.
  • Accepted in final form September 8, 2016.
  • © 2016 American Academy of Neurology
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