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Truthfulness in patient-reported outcomes: factors affecting patients’ responses and impact on data quality

Authors Chang EM, Gillespie EF, Shaverdian N

Received 24 January 2019

Accepted for publication 2 May 2019

Published 11 June 2019 Volume 2019:10 Pages 171—186

DOI https://doi.org/10.2147/PROM.S178344

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Robert Howland


Eric M Chang,1 Erin F Gillespie,2 Narek Shaverdian2

1Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA; 2Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Abstract: The use of patient-reported outcome (PRO) measures in research and clinical care has expanded dramatically, reflective of an increasing recognition of patient-centeredness as an important aspect of high-quality health care. Given this rapid expansion, ensuring that data collected using PRO measures is of high quality is crucial for their continued successful application. Because of the subjective nature of the outcomes assessed, there are many factors that may influence patients’ responses and thus challenge the overall quality of the data. In this review, we discuss the multiple factors that may affect patients’ responses on PRO measures. These factors may arise during instrument development and administration or secondary to patient-level response behaviors. We further examine the relevant literature to delineate how these factors may impact data quality and review methods for accounting for these factors. Consideration of such factors is critical to ensuring data collected truthfully reflects patients’ evaluations and provides accurate conclusions.

Keywords: patient-reported outcomes, data quality, bias, research practices


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