Surgical Grand Rounds: Patient Reported Outcomes in Thoracic Surgery – What are our patients really telling us?

Presented by: Onkar Khullar MD, Assistant Professor of Surgery
Division of Cardiothoracic Surgery, Emory University School of Medicine

This is a collection of articles, resources, and commentary from Dr. Khullar’s presentation on February 13, 2020. 


Articles:

Jensen RE, Rothrock NE, DeWitt EM, et al. The role of technical advances in the adoption and integration of patient-reported outcomes in clinical care. Med Care. 2015 Feb;53(2): 153-9. doi: 10.1097/MLR.0000000000000289. Free full-text.

Colt HG, Murgu SD, Korst RJ, et al. Follow-up and surveillance of the patient with lung cancer after curative-intent therapy: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013 May;143(5 Suppl):e437S-e454S. doi: 10.1378/chest.12-2365. Full-text for Emory users.

Khullar OV, Rajaei MH, Force SD, Binongo JN, Lasanajak Y, Robertson S, Pickens
A, Sancheti MS, Lipscomb J, Gillespie TW, Fernandez FG. Pilot Study to Integrate
Patient Reported Outcomes After Lung Cancer Operations Into The Society of
Thoracic Surgeons Database. Ann Thorac Surg. 2017 Jul;104(1):245-253. doi:
10.1016/j.athoracsur.2017.01.110. Full-text for Emory users.


Resources:

Available PRO HRQoL instruments


NIH’s Patient-Reported Outcomes Measurement Information System (PROMIS)

  • Comprehensive set of person-centered measures that evaluate physical, social, and emotional health
  • PROMIS measures can be used with the general population and in patients with chronic conditions such as cancer
  • Specific to health domains rather than a specific disease
    • Created to be relevant across all conditions for the assessment of symptoms and functions

Assessment CenterSM 

…a online data collection tool that enables researchers to create study-specific websites for capturing participant data securely online.

Studies can include measures within the Assessment Center library as well as custom instruments entered by the researcher. The instrument library includes self- and proxy-report short forms, computerized adaptive tests (CATs), and batteries or profiles from:

  • Patient-Reported Outcomes Measurement Information System (PROMIS)
  • Quality of Life in Neurological Diseases (Neuro-QoL)
  • NIH Toolbox
  • Health LiTT

Society of Thoracic Surgeons (STS) Database

The STS National Database was established in 1989 as an initiative for quality improvement and patient safety among cardiothoracic surgeons. The Database has four components, each focusing on a different area of cardiothoracic surgery.

The absence of PROs represents a critical gap in the STS Database and our current approach to quality measurement:

  • Creation of the STS Patient Reported Outcomes Taskforce
  • Recent upgrade to the database platform will allow for future integration of PROMIS data on CABG, esophagectomy, and lung resection

PRO summary slide


Further reading: 

Subramanian M, Kozower BD, Brown LM, Khullar OV, Fernandez FG. Patient-Reported Outcomes in Cardiothoracic Surgery.Ann Thorac Surg. 2019 Jan;107(1):294-301. doi: 10.1016/j.athoracsur.2018.06.005. Full-text for Emory users.

Snyder CF, Jensen RE, Segal JB, Wu AW. Patient-reported outcomes (PROs): putting the patient perspective in patient-centered outcomes research.Med Care. 2013 Aug;51(8 Suppl 3):S73-9. doi: 10.1097/MLR.0b013e31829b1d84. Free full-text.

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