Balancing fidelity and practicality in short version musculoskeletal patient reported outcome measures

Abstract

Background: Musculoskeletal patient reported outcome (PRO) measures are essential to clinical practice as they determine the status of a patient's health. While such measures are meant to improve the delivery of evidence based medicine, the design process often overlooks their clinical relevance and utility.

Discussion: The demand for greater efficiency through shorter, user friendly PRO measures is discussed. The aim is to reduce respondent, clinician and researcher burden while retaining precision instruments with validated psychometric properties. The reductive statistical methodology and techniques used to achieve these goals are highlighted. The general lack of important qualitative input from the clinician and patient in these processes is noted. This lack of input can be detrimental to the clinical practicality and cost efficiency of the final product. It may also raise problems of potential conflicts of interest. Four additional areas of practical concern with particular significance are outlined: questionnaire format, item number, time benefits and scoring methods.

Summary: It is important that developers of new and modified musculoskeletal PRO measures ensure that their instruments, whilst maximising the psychometric properties and methodological characteristics, satisfy the requirements of patient and clinician practicality while emphasising the essential principles of evidence based medicine.

Keywords:

• PATIENT REPORTED OUTCOME MEASURES
• PRACTICALITY
• QUESTIONNAIRES
• PSYCHOMETRICS
• MUSCULOSKELETAL