Patient Reported Outcome Measures (PROMs): Do the Scores Matter?

Patients generally will fill out outcome measurement tools to help score their respective pain, disability, and functional limitations.  These forms are important tools to help clinicians understand what patients are currently experiencing.  However, we must not look at these scores at face value.  These outcome measures can tell us a lot more than meets the eye.

These tools indicate specific problems with daily tasks and overall function.  Scores are also used for insurance companies to help determine the required number of visits allotted for treatment. However, total scores don’t always tell us the whole story.  In fact, many clinicians may look past the details when analyzing patient progress through outcome measures.

We shouldn’t look at the total score, as there may be some specific areas that are of more importance:

For example, let’s say a patient scores a 20 on the Oswestry Disability Index (ODI).  The ODI consists of 10 items, each scoring from 0-5, covering daily activities including standing, walking, and sitting. A score of 20 is considered low disability.  However, the patient scored a couple of the items with a 4/5. The question is, do we look at the total score, or should we examine those couple specific areas of importance?

Perhaps the clinicians need to spend more time on these specific areas, as this will make the plan of care more specific, but importantly, more meaningful. This also opens the door to more meaningful communication between the clinician and the patient. Ultimately, the patient may feel that their practitioner is listening to them and demonstrating compassion. 

So, when is the right time to give patients, patient reported outcome measures?

The short answer is it depends.  However, there are some benefits depending on when these tools are provided during the episode of care:

Before – Provides an initial baseline without bias.  This can also help clinicians understand what the patient is experiencing when receiving subjective information. 

During – Able to allow the patient to become an active participant during the session.  Also, the patient and clinician and discuss areas of the outcome measure

After – Patient may have a better understanding of what they are currently experiencing and thus providing more reliable answers

Patient reported outcome measures are clearly a helpful tool to help guide clinical practice.  These tools should be implemented into everyone’s practice. Outcome measures should be implemented throughout the episode of care to determine if there are any meaningful clinical changes. Utilizing these tools can be helpful to help improve clinical outcomes.

Article Written By Eric Trauber, PT, DPT, OCS, CSCS, FAAOMPT