Patient-Reported Outcomes in Cardiothoracic Surgery

• Type of Material: Article
• Authors: Melanie Subramanian, Washington University St. Louis; Benjamin D. Kozower, Washington University St. Louis; Lisa M. Brown, University of California Davis; Onkar Khullar, Emory University; Felix Fernandez, Emory University
• Language: English
• Date: 2019-01-01
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 The Society of Thoracic Surgeons
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.athoracsur.2018.06.005
• Title of Journal or Parent Work: ANNALS OF THORACIC SURGERY
• Volume: 107
• Issue: 1
• Start Page: 294
• End Page: 301
• Keywords: RECOVERY; RESECTION; Cardiovascular System & Cardiology; FOLLOW-UP; QUALITY-OF-LIFE; SOCIETY; Respiratory System; Science & Technology; Life Sciences & Biomedicine; SURGICAL-TREATMENT; Surgery; ASSISTED THORACIC-SURGERY; CLINICAL-PRACTICE; Cardiac & Cardiovascular Systems; AORTIC-VALVE-REPLACEMENT; LUNG-CANCER
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Oncology

Abstract

Background: Current studies in cardiothoracic clinical research frequently fail to use end points that are most meaningful to patients, including measures associated with quality of life. Patient-reported outcomes (PROs) represent an underused but important component of high-quality patient-centered care. Our objective was to highlight important principles of PRO measurement, describe current use in cardiothoracic operations, and discuss the potential for and challenges associated with integration of PROs into large clinical databases. Methods: We performed a literature review by using the PubMed/EMBASE databases. Clinical articles that focused on the use of PROs in cardiothoracic surgical outcomes measurement or clinical research were included in this review. Results: PROs measure the outcomes that matter most to patients and facilitate the delivery of patient-centered care. When effectively used, PRO measures have provided detailed and nuanced quality-of-life data for comparative effectiveness research. However, further steps are needed to better integrate PROs into routine clinical care. Conclusions: Incorporation of PROs into routine clinical practice is essential for delivering high-quality patient-centered care. Future integration of PROs into prospectively collected registries and databases, including that The Society of Thoracic Surgeons National Database, has the potential to enrich comparative effectiveness research in cardiothoracic surgery.