(PROMs) and to investigate the practicality of using PROMs in a surgical office

Background: After a Ministry of Health conference on outcome analysis, a study was proposed to explore the value of incorporating patientreported outcome measures into the daily activity of a surgical office. Methods: Subjective survey and objective clinical testing methods were used. Patients undergoing hip or knee total joint replacement at a nonacademic centre were asked to complete outcome questionnaires before and after surgery and the results were compared with clinical assessments by a physiotherapist. Most hip and knee patients had primary joint replacement, but some had revision surgery. A small cohort of patients undergoing shoulder surgery for rotator cuff repair was studied as well. The relationships between the subjective and objective test results were analyzed using a 2-tailed Pearson correlation test. The relationships identified were then displayed in scatter plot graphs, with each circle on the graph A study to assess patientreported outcome measures (PROMs) and to investigate the practicality of using PROMs in a surgical office “If you cannot measure it, you cannot improve it.” —Sir William Thomson, Lord Kelvin Dr Stanger is an orthopaedic surgeon practising with RebalanceMD, a team of physicians and adjunct health professionals serving patients in the Vancouver Island Health Authority. Ms Christine Morrison is a physiotherapist and former project manager for patient-reported outcome measures at Island Health. Dr Yazganoglu is a physician and former senior analyst for the Surgical Patient Registry of the Provincial Health Services Authority. Dr Bhalla is a public health administrator and former director of Surgical and Anaesthetic Services, Health Services Policy and Quality Assurance Division, Ministry of Health. indicating the data comparing one test with another for one patient. The data were also subjected to further statistical analysis. Results: The subjective patientreported results for total joint replacements correlated closely with the objective clinical assessments, indicating that patient-reported results are sufficient on their own to show outcomes. There was a correlation between results from two subjective tests for rotator cuff repairs. However, no correlation was found when results from subjective and objective tests for shoulder patients were compared. The evaluation concept of “minimum clinically important difference” was found to be useful and more meaningful when assessing results for the hip and knee patients. Conclusions: The use of patientreported outcome measures with values for minimum clinically important difference is recommended for evaluating outcomes and assessing appropriateness for any surgical or medical intervention. Patientreported outcome measures can also assist clinicians in their selfassessment and be an adjunct to their continuing professional development. The province should take a leading role in implementing the use of patient-reported outcome measurement in the offices of surgeons and other practitioners. Implementation would involve helping with statistical analysis and establishing ways to obtain consent and handle collection and sharing of patient data to ensure privacy. This article has been peer reviewed.