TY - JOUR
T1 - Patient-centred outcomes of imaging tests
T2 - recommendations for patients, clinicians and researchers
AU - Thompson, Matthew J.
AU - Suchsland, Monica Zigman
AU - Hardy, Victoria
AU - Lavallee, Danielle C.
AU - Lord, Sally
AU - Devine, Emily Beth
AU - Jarvik, Jeffrey G.
AU - Findlay, Steven
AU - Trikalinos, Thomas A.
AU - Walter, Fiona M.
AU - Chou, Roger
AU - Green, Beverly B.
AU - Wernli, Karen J.
AU - Fitzpatrick, Annette L.
AU - Bossuyt, Patrick M.
N1 - Publisher Copyright:
© 2023 BMJ Publishing Group. All rights reserved.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Background Imaging tests are one of the most frequently used diagnostic modalities in healthcare, but the benefits of their direct impacts on clinical decision-making have been countered by concerns that they can be overused. Assessing the relative value of imaging tests has largely focused on measures of test accuracy, which overlooks more comprehensive benefits and risks of imaging tests, particularly their impact on patient-centred outcomes (PCOs). We present the findings of the Patient Reported Outcomes of Diagnostics (PROD) research study in response to a methodological gap in the area of diagnostic test comparative effectiveness research. Methods Over a 3-year period, the PROD Study engaged with multiple stakeholders to identify existing conceptual models related to PCOs for imaging testing, conducted primary research and evidence synthesis, and developed consensus recommendations to describe and categorise PCOs related to imaging testing. Results The PROD framework categorises PCOs from imaging studies within four main domains: information or knowledge yielded, physical impact, emotional outcomes and test burden. PCOs interact with each other and influence effects across domains, and can be modified by factors related to the patient, clinical situation, healthcare team and the testing environment. Conclusions Using PCOs to inform healthcare decision-making will require ways of collating and presenting information on PCOs in ways that can inform patient-provider decision-making, and developing methods to determine the relative importance of outcomes (including test accuracy) to one another.
AB - Background Imaging tests are one of the most frequently used diagnostic modalities in healthcare, but the benefits of their direct impacts on clinical decision-making have been countered by concerns that they can be overused. Assessing the relative value of imaging tests has largely focused on measures of test accuracy, which overlooks more comprehensive benefits and risks of imaging tests, particularly their impact on patient-centred outcomes (PCOs). We present the findings of the Patient Reported Outcomes of Diagnostics (PROD) research study in response to a methodological gap in the area of diagnostic test comparative effectiveness research. Methods Over a 3-year period, the PROD Study engaged with multiple stakeholders to identify existing conceptual models related to PCOs for imaging testing, conducted primary research and evidence synthesis, and developed consensus recommendations to describe and categorise PCOs related to imaging testing. Results The PROD framework categorises PCOs from imaging studies within four main domains: information or knowledge yielded, physical impact, emotional outcomes and test burden. PCOs interact with each other and influence effects across domains, and can be modified by factors related to the patient, clinical situation, healthcare team and the testing environment. Conclusions Using PCOs to inform healthcare decision-making will require ways of collating and presenting information on PCOs in ways that can inform patient-provider decision-making, and developing methods to determine the relative importance of outcomes (including test accuracy) to one another.
KW - clinical
KW - comparative effectiveness research
KW - decision support
KW - evaluation methodology
KW - patient-centred care
KW - quality improvement methodologies
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U2 - 10.1136/bmjqs-2021-013311
DO - 10.1136/bmjqs-2021-013311
M3 - Article
C2 - 34615733
AN - SCOPUS:85146396363
SN - 2044-5415
VL - 32
SP - 536
EP - 545
JO - BMJ Quality and Safety
JF - BMJ Quality and Safety
IS - 9
ER -