Background
Patient-reported outcome and experience measures (PROMs and PREMs) fall into three broad categories: condition-specific measures, which are applicable to patients with specific conditions only; generic measures, which apply to all types of patient; and individualised or person-specific measures (iPROMs), which let people identify issues that are most important to them.1 2 Thousands of condition-specific measures have been developed mainly for use in clinical trials; standardised generic measures are widely used in evaluation, for quality improvement and for allocating resources between different groups. However, fewer individualised measures have been developed, although there is increasing awareness of their value in tailoring personalised care in domains such as social prescribing. Individualised measures need to be used alongside generic or condition-specific measures because every patient has their own set of priorities and some are much easier to resolve than others.
Several individualised measures were developed during the 1990s, such as SEIQOL (Schedule for Evaluation of Individual Quality Of Life),3 PGI (Patient Generated Index)4 and MYMOP (Measure Yourself Medical Outcome Profile).5 MYMOP evolved into MYCaW (Measure Yourself Concerns and Wellbeing), which is a little simpler, with two concerns plus well-being.6 7
At the request of customers working in social prescribing projects, at R-Outcomes we used MYMOP and then MYCaW alongside our other measures. This identified a number of issues, which led to the development of a new iPROM, the person-specific outcome (PSO) measure, which is described here.
Development of the measure
We designed PSO to work in a way similar to other measures in the R-Outcomes family of short generic PROMs and PREMs.8 Common core characteristics of all these measures include:
Brevity and low reading age.
Quick and easy to use and understand.
Four response options.
Optional use of emojis (smiley faces) and colour (green, yellow, orange red) to help understanding.
Mean scores for a population are reported on a 0–100 scale.
A high score is always good, low is always bad.
For individuals, the PSO uses the same response options as the howRu health status measure.9 Extreme scores 0, Quite a lot scores 1, A little scores 2 and None scores 3. In reports on individuals, the original patient-specific text and score is used for each issue.
The questions are typically asked at first meeting with the patient and on follow-up. The final version, showing both first meeting and follow-up questions, is shown in figure 1.
On follow-up, the original issue(s) are digitally prepopulated with the issue texts recorded at first meeting. Patients are asked to record their current level of concern. The questions can be asked face-to-face or by telephone. We do not recommend asking these questions at first meeting without any staff involvement, because patients often seek advice about what issues to record.
When reporting the results for a cohort, the mean scores for issue #1 and issue #2 are presented on a 0–100 scale (by multiplying by 100 and dividing by 3). Mean scores are usually shown without decimal points. A summary score is not calculated.
For example:
First meeting (issue #1) mean score=30.
Follow-up (issue #1) mean score=70.
Mean change (issue #1)=40.