Is there value in routine administration of outcome questionnaires?

摘要

>Study design: Retrospective case-series of prospective routinely collected Short Form 36v2 (SF-36v2) data in an outpatient spine clinic.>Objective: To determine if there is value in routine administration of outcome questionnaires for the patient and/or clinician without a targeted population or monitoring of follow-up.>Method: Retrospective review of Health Outcomes Scoring database.>Results: During an 18-month period 1,863 patients completed 3,124 SF-36v2 questionnaires. The extent of diagnoses and the uneven timing of follow-ups of the completed questionnaires render this data useless both to the patient and for aggregate analysis.>Conclusion: There is no value in routine administration of outcome questionnaires to patient care or clinical research. rules="all" class="rendered small default_table">>Final class of evidence-prognosis> valign="top" align="left" rowspan="1" colspan="1">Study design valign="top" align="center" rowspan="1" colspan="1">> valign="top" align="left" rowspan="1" colspan="1"> RCT valign="top" align="center" rowspan="1" colspan="1">> valign="top" align="left" rowspan="1" colspan="1"> Cohort valign="top" align="center" rowspan="1" colspan="1">> valign="top" align="left" rowspan="1" colspan="1"> Case control valign="top" align="center" rowspan="1" colspan="1">> valign="top" align="left" rowspan="1" colspan="1"> Case series valign="top" align="center" rowspan="1" colspan="1">•> valign="top" align="left" rowspan="1" colspan="1">Methods valign="top" align="center" rowspan="1" colspan="1">> valign="top" align="left" rowspan="1" colspan="1"> Patients at similar point in course of treatment valign="top" align="center" rowspan="1" colspan="1">> valign="top" align="left" rowspan="1" colspan="1"> F/U ≥ 85% valign="top" align="center" rowspan="1" colspan="1">> valign="top" align="left" rowspan="1" colspan="1"> Similarity of treatment protocols for patient groups valign="top" align="center" rowspan="1" colspan="1">•> valign="top" align="left" rowspan="1" colspan="1"> Patients followed up long enough for outcomes to occur valign="top" align="center" rowspan="1" colspan="1">•> valign="top" align="left" rowspan="1" colspan="1"> Control for extraneous risk factors valign="top" align="center" rowspan="1" colspan="1">NA> valign="top" align="left" rowspan="1" colspan="1">>Overall class of evidence valign="top" align="center" rowspan="1" colspan="1">>IV> valign="top" align="left" colspan="2" rowspan="1">The definiton of the different classes of evidence is available on page 63. class="head no_bottom_margin" id="__sec2title">Study RationaleThe routine use of patients' outcomes scoring systems has become common in various specialties, such as spine surgery. The goal of such undertakings is to get a better understanding of patient well-being from a patient perspective as it is impacted by disorders, diseases, and hopefully being helped by interventions. To get a better handle on patient outcomes it has become normal to routinely collect these outcomes data at every clinic visit to hopefully enable a retrospective analysis at a later date. This practice is increasingly doubtful due to the cost involved and the incomplete nature of meaningful outcomes data actually collectable. In our outpatient spine clinic beginning in 2000, a set menu of accepted Health-Related Quality of Life (HRQOL) questionnaires was given to all patients for all visits. Despite aggressive promotion and monitoring of this data collection during 2 years (2003–2004), this may not be an effective use of patient time and clinic resources when critically reviewed for value and economic cost.