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Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion : a mixed methods study demonstrating a novel concept for optimal questionnaire design

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Macefield, Rhiannon C., Brookes, Sara T., Blazeby, Jane M. and Avery, Kerry N. L. (2019) Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion : a mixed methods study demonstrating a novel concept for optimal questionnaire design. BMJ Open, 9 (8). e029741. doi:10.1136/bmjopen-2019-029741 ISSN 2044-6055.

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Official URL: http://dx.doi.org/10.1136/bmjopen-2019-029741

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Abstract

Objectives: To describe the novel concept of, and methods for developing, a ‘universal-reporter’ outcome measure (UROM); a single questionnaire for completion by patients and/or healthcare professionals (HCPs) when views on the same subject are required.

Design: A mixed methods study with three phases—phase I: identification of relevant content domains from existing clinical tools, patient questionnaires and in-depth interviews with multistakeholders; phase II: item development using a novel approach that considered plain language in conjunction with medical terminology; and phase III: pretesting with multistakeholders using cognitive interviews.

Setting: A case study in surgical wound assessment undertaken in two UK hospital trusts and one university setting.

Participants: Patients who had recently undergone general abdominal surgery and healthcare professionals involved in post-surgical wound care.

Results: Phase I: In the example case study, 19 relevant content domains were identified from two clinical tools, two patient questionnaires and 19 multistakeholder interviews (nine patients, 10 HCPs). Phase II: Domains were operationalised into items and subitems (secondary components to collect further information, if relevant). The version after pretesting had 16 items, five of which included further subitems. Plain language in conjunction with medical terminology was applicable in nine (27%) items/subitems. Phase III: Pretesting with 28 patients and 14 HCPs found that the UROM was acceptable to both respondent groups. An unanticipated secondary finding of the study was that the combined use of plain language and medical terminology during questionnaire development may be a useful, novel technique for evaluating item interpretation and thereby identifying items with inadequate content validity.

Conclusion: UROMs are a novel approach to outcome assessment that are acceptable to both patients and HCPs. Combining plain language and medical terminology during item development is a recommended technique to improve accuracy of item interpretation and content validity during questionnaire design. More work is needed to further validate this novel approach and explore the application of UROMs to other settings.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Medical care -- Evaluation -- Methodology, Clinical medicine -- Methodology, Outcome assessment (Medical care)
Journal or Publication Title: BMJ Open
Publisher: BMJ
ISSN: 2044-6055
Official Date: 2019
Dates:
DateEvent
2019Published
24 August 2019Available
24 July 2019Accepted
Volume: 9
Number: 8
Article Number: e029741
DOI: 10.1136/bmjopen-2019-029741
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 7 August 2019
Date of first compliant Open Access: 12 August 2019
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
MR/K025643/1[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
12/200/04[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Contributors:
ContributionNameContributor ID
Research GroupBluebelle Study Group, UNSPECIFIED
ResearcherAndronis, L. (Lazaros) 81433

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