7. Interpretation of Patient-Reported Outcome data
What else is important for interpretation in daily clinical practice?
Keep in mind: direct consultation with the patient is essential for final interpretation of individual PRO data!
For interpretation of PRO data in clinical practice, the following aspects should also be considered:
Depending on the profession, specific PRO scales might be of particular interest. For example, a psycho-oncologist might look first at scales such as emotional functioning or role functioning, an oncologist might check for side effects such as pain, nausea or fatigue, and a nurse might focus on physical functioning, which also determines the ability to self-care - regardless of whether a threshold is exceeded.
Keep the situation of the patient in mind, e.g. the current treatment and health/social status. Is the person in acute therapy or aftercare? Which therapy or medication does the patient receive? Are there any comorbidities with a potential influence on the results?
Besides reviewing the latest scores, having a look at the data over time may be worthwhile:
Are there any conspicuous symptoms/progressions?
Can a pattern be identified?
This may generate hypotheses and facilitate discussions with the patient.
Looking more closely at the answers to individual questions of a scale can help to identify whether there are any answers that are particularly influential on the scale score. This could help focus discussions and further exploration with the patient: What might have triggered or caused a deterioration/improvement of the scale score?
Although PRO data provide a good insight into the patient's perspective, asking patients what is most important for them remains important to ensure that discussions are focused on the patients' needs.
Did the patient score high on scales, which usually co-occur?
For example: If a patient reports high fatigue scores, scores for pain and insomnia, as well as physical, emotional, and cognitive functioning, should also be considered, as these domains are known to be interrelated and further exploration may help inform the next steps in symptom management.
Particular attention should be paid to scores seeming unusual. Such scores demand in-depth exploration with the patient. For example, to clarify whether sudden and severe diarrhoea is likely to be due to the treatment or is more likely to be caused by an infection. If necessary, additional diagnostics may be considered.
