PhD Defence Arvind Oemrawsingh

Patient-reported outcome measures (PROMs) can be defined as instruments that measure aspects of a patient’s health condition and/ or treatment that come directly from the patient, thus without external interpretation. PROMs have been implemented in clinical care with wide-ranging intentions: from screening of health problems, monitoring patients’ response to treatment, facilitating patient-provider communication, enhancing shared decision-making, to benchmarking healthcare institutions for quality-of-care improvement.  

The overall aim of this dissertation has been to study methodological aspects of the analysis of PROMs such as case-mix adjustment, and to explore the implementation and application of PROMs in clinical care including facilitators and barriers. Our findings suggest that PROMs are outcomes that are influenced by a wider variety of case-mix factors than traditional (clinical) outcomes. We also determined that the collection of PROMs can be challenging due to IT-infrastructure issues, care providers’ lack of experience, and the clinical workflow. The uptake of PROMs in clinical care is more likely to succeed with a multi-disciplinary approach, and by informing patients about the objectives of PROM collection.