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Toward patient-centered care: a systematic review of how to ask questions that matter to patients.

Rosenzveig A, Kuspinar A, Daskalopoulou SS, Mayo NE - Medicine (Baltimore) (2014)

Bottom Line: Validity and reliability was observed for the items when compared with clinical interviews or well-validated measures.Articles that did not have this as the primary objective may have been missed.This information would be useful for regular long-term monitoring.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical Epidemiology (AR, NEM), McGill University Health Centre; School of Physical and Occupational Therapy (AK, NEM); and Department of Medicine (SSD), Faculty of Medicine, McGill University, Montreal, QC, Canada.

ABSTRACT
Clinicians rarely systematically document how their patients are feeling. Single item questions have been created to help obtain and monitor patient relevant outcomes, a requirement of patient-centered care.The objective of this review was to identify the psychometric properties for single items related to health aspects that only the patient can report (health perception, stress, pain, fatigue, depression, anxiety, and sleep quality). A secondary objective was to create a bank of valid single items in a format suitable for use in clinical practice.Data sources used were Ovid MEDLINE (1948 to May 2013), EMBASE (1960 to May 2013), and the Cumulative Index to Nursing and Allied Health Literature (1960 to May 2013).For the study appraisal, 24 articles were systematically reviewed. A critical appraisal tool was used to determine the quality of articles.Items were included if they were tested as single items, related to the construct, measured symptom severity, and referred to recent experiences.The psychometric properties of each item were extracted. Validity and reliability was observed for the items when compared with clinical interviews or well-validated measures. The items for general health perception and anxiety showed weak to moderate strength correlations (r = 0.28-0.70). The depression and stress items showed good area under the receiver operating characteristic curve of 0.85 and 0.73-0.88, respectively, with high sensitivity and specificity. The fatigue item demonstrated a strong effect size and correlations up to r = 0.80. The 2 pain items and the sleep item showed high reliability (intraclass correlation coefficient [ICC] = 0.85, κ = 0.76, ICC = 0.9, respectively).The search targeted articles about psychometric properties of single items. Articles that did not have this as the primary objective may have been missed. Furthermore, not all the articles included had the complete set of psychometric properties for each item.There is sufficient evidence to warrant the use of single items in clinical practice. They are simple, easily implemented, and efficient and thus provide an alternative to multi-item questionnaires. To facilitate their use, the top performing items were combined into the visual analog health states, which provides a quick profile of how the patient is feeling. This information would be useful for regular long-term monitoring.

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Related in: MedlinePlus

How are you today? Visual analog health states.
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Related In: Results  -  Collection

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Figure 2: How are you today? Visual analog health states.

Mentions: Although there was a range of values for psychometric properties, for each domain assessed, there was at least 1 study showing strong relationship with the intended construct, all studies supporting a positive relationship (Figure 2). There is sufficient validity for these single items to warrant asking them in clinical practice. However, no one response set was tested. The most frequent option was the VAS. The VAS is widely used as a metric and has had a presence in the literature for almost a century.60,61 By compiling the 7 single items identified in this literature review and using the VAS metric, we have created the visual analog health state (VAHS) form, which is presented in Figure 2.


Toward patient-centered care: a systematic review of how to ask questions that matter to patients.

Rosenzveig A, Kuspinar A, Daskalopoulou SS, Mayo NE - Medicine (Baltimore) (2014)

How are you today? Visual analog health states.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4616320&req=5

Figure 2: How are you today? Visual analog health states.
Mentions: Although there was a range of values for psychometric properties, for each domain assessed, there was at least 1 study showing strong relationship with the intended construct, all studies supporting a positive relationship (Figure 2). There is sufficient validity for these single items to warrant asking them in clinical practice. However, no one response set was tested. The most frequent option was the VAS. The VAS is widely used as a metric and has had a presence in the literature for almost a century.60,61 By compiling the 7 single items identified in this literature review and using the VAS metric, we have created the visual analog health state (VAHS) form, which is presented in Figure 2.

Bottom Line: Validity and reliability was observed for the items when compared with clinical interviews or well-validated measures.Articles that did not have this as the primary objective may have been missed.This information would be useful for regular long-term monitoring.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical Epidemiology (AR, NEM), McGill University Health Centre; School of Physical and Occupational Therapy (AK, NEM); and Department of Medicine (SSD), Faculty of Medicine, McGill University, Montreal, QC, Canada.

ABSTRACT
Clinicians rarely systematically document how their patients are feeling. Single item questions have been created to help obtain and monitor patient relevant outcomes, a requirement of patient-centered care.The objective of this review was to identify the psychometric properties for single items related to health aspects that only the patient can report (health perception, stress, pain, fatigue, depression, anxiety, and sleep quality). A secondary objective was to create a bank of valid single items in a format suitable for use in clinical practice.Data sources used were Ovid MEDLINE (1948 to May 2013), EMBASE (1960 to May 2013), and the Cumulative Index to Nursing and Allied Health Literature (1960 to May 2013).For the study appraisal, 24 articles were systematically reviewed. A critical appraisal tool was used to determine the quality of articles.Items were included if they were tested as single items, related to the construct, measured symptom severity, and referred to recent experiences.The psychometric properties of each item were extracted. Validity and reliability was observed for the items when compared with clinical interviews or well-validated measures. The items for general health perception and anxiety showed weak to moderate strength correlations (r = 0.28-0.70). The depression and stress items showed good area under the receiver operating characteristic curve of 0.85 and 0.73-0.88, respectively, with high sensitivity and specificity. The fatigue item demonstrated a strong effect size and correlations up to r = 0.80. The 2 pain items and the sleep item showed high reliability (intraclass correlation coefficient [ICC] = 0.85, κ = 0.76, ICC = 0.9, respectively).The search targeted articles about psychometric properties of single items. Articles that did not have this as the primary objective may have been missed. Furthermore, not all the articles included had the complete set of psychometric properties for each item.There is sufficient evidence to warrant the use of single items in clinical practice. They are simple, easily implemented, and efficient and thus provide an alternative to multi-item questionnaires. To facilitate their use, the top performing items were combined into the visual analog health states, which provides a quick profile of how the patient is feeling. This information would be useful for regular long-term monitoring.

Show MeSH
Related in: MedlinePlus