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![Page 1: Challenges in measuring patient defined outcomes in diagnostic radiological investigations S Mathers* +, G McKenzie*, E Robertson*, J Proctor* +, R Chesson.](https://reader034.fdocuments.net/reader034/viewer/2022051819/5515e632550346d46f8b4f33/html5/thumbnails/1.jpg)
Challenges in measuring patient defined outcomes in diagnostic radiological
investigations
S Mathers*+, G McKenzie*, E Robertson*, J Proctor*+, R Chesson+
*NHS Grampian +The Health Services Research GroupAberdeen, Scotland, UK.
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What aspects of health care can be evaluated?
Outcome
Change due to intervention
Process
Intervention e.g.surgery, procedure
Structure
Resources, facilitiesorganisational settings
Donabedian, 1980
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Outcome measures
have been defined
‘... as the results (effects) of processes. They are
that part of the situation pertaining after a process
which can be attributed to the process.’
UK Clearing House on Health Outcomes, 1993
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Why is outcome measurement important?
‘ ... to show that an intervention has been
appropriate and effective’
Austin and Clark, 1993
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Aim
To carry out a systematic review of literature to
identify:
• the prevalence, • use of outcome measures in radiology.
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Search Strategy
▼
Databases searched
▼
Abstracts read according to defined criteria
▼
Criteria redefined, abstracts to be re-read in light of this
▼
Articles to be retrieved
▼
Initial paper review
▼
Data synthesis1. Data extraction form
2. Quality checklist
▼
Data analysis1.SPSS
2. Summary tables3. Meta-analysis
▼
Write up and dissemination.
Modified from NHS Centre for Reviews and Dissemination, (UK)
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• 46 key words used
radiology/diagnostic imaging/x-ray
outcomes patient satisfactionefficacy outcome measuresutility adverse reactionwaiting times quality of care
• Databases searched e.g. MEDLINE
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Results
• Citations 4893
• Publications retrieved 84• Publication by references 25
• Patient focused outcome 22
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Final Scrutiny
Exclude• 8 for a number of reasons
e.g. hypothetical studies
Included• 14 primary patient focused studies
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Patient focused outcome papers
In total 8
• Mammography 2 x USA• Low back pain 2 x UK• Ankle radiography 1 Canada• DCBE/US/Mammography 1 Norway• MRI 1 UK• Effects of radiation dose 1 Canada
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Conclusions
• Dearth of research into patient centred outcomes in radiology
• Lack of coherent body of work
• Demonstrates little patient involvement in radiology research
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Challenges
• Imaging procedure only part of investigations and patient final outcome remote from department Blackmore et al 1999
• Multi-disciplinary approach to research Revicki et al 1999
• Development of suitable outcome measurement tools
• Would benefit from a qualitative methodology
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Future agenda
• It is important that we develop a culture of outcome measurement in radiology
• Patient defined outcome is necessary to evaluate our procedures
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Acknowledgements
The Royal College of Radiologists (UK)
(Pump Priming Research Award)