What Do Patients Want? Outcome Measures in a Diverse World
Abstract
Purpose: Quantifying outcomes of medical interventions has evolved but challenges remain in hand surgery. Initially, hand surgeons used concrete assessments like range of motion and/or pinch strength. With a shift toward patient-centered care, numerous pathology-specific patient-reported outcome measures (PROMs) were developed. These measures typically used standardized closed-ended outcomes and mostly originated from western countries. However, it is unclear how well measures with specific items capture diverse patients' values. Therefore, we used an open-ended PROM, the Patient-Specific Functional Scale (PSFS), to assess patients' difficulties associated with daily living for two common hand diagnoses, carpal tunnel syndrome (CTS) and trigger finger (TF), allowing us to evaluate the breadth of variation of experiences and treatment goals across cultures.
Methods: We conducted a multi-institutional, international study on patients with diagnosis of CTS and TF. Patient desires were recorded using the PSFS. Data were qualitatively interrogated using template analysis.
Results: Patient responses from 225 PSFS scores from three continents and five countries were evaluated. Patients provided diverse functional impacts from CTS/TF that were categorized according to the International Classification of Functioning. There were diverse patient responses with variations in the proportion of domains represented in each country. Closed-ended PROMs (Quick Disabilities of the Arm,…
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