Patient-Reported Outcomes Assessment in the Practice Setting

The burden of a questionnaire is often related to its format. An open-ended question would allow the respondent to give a free-text response of up to several sentences. This may result in more information being given, and the obvious disadvantage is that is requires considerably more time and skill to score, requiring subjective judgments. Closed-ended questions are more common and are used in most standardized measures. These include multiple-choice answers that permit one or several responses; the visual analog scale, in which the participant is asked to mark a line at a spot along a continuum from one extreme to another that best represents his or her experience; and the Likert scale, which is commonly used to quantify attitudes, behaviors, and domains of health-related quality of life.7 Closed-ended questions have the disadvantage of limiting the number of response options and leading the respondents in certain directions, unless there is the option to specify another response that is not on the list. However, the closed-ended question format is quicker and easier to answer and the answers are easier to analyze and to tabulate.

In the next column in this series we will discuss how to plan a prospective outcomes assessment in your practice setting using one or more of these instruments.

References

1. 1. Bren L. The importance of patient-reported outcomes…it’s all about the patients. FDA Consumer Magazine, Nov-Dec 2006. www.fda.gov/fdac/features/2006/606_patients.html .
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2. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). Med Care 1992;30(6):473-83.
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3. Bergner M, Bobbitt RA, Gilson BS. The Sickness Impact Profile: development and final revision of a health status measure. Med Care 1981;19(8):787-805.
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4. Health Outcomes Institute. Health outcomes institute outcomes measuremement instrumentation. (Report No. Rev. 11/01/93). Bloomington, MN: Health Outcomes Institute, 1994.
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5. Radosevich DM, Werni TLK. A Practical Guidebook for Implementing, Analyzing, and Reporting Outcomes Measurements. Bloomington, MN: Stratis Health, 1997.
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6. Scientific Advisory Committee of the Medical Outcomes Trust: Assessing health status and quality of life instruments: attributes and review criteria. Quality of Life Research 2002;11:193-205.
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7. Hulley SB, Cummings SR, Browner WS, Grady DB, Newman TB. Designing Clinical Research (3rd ed.). Baltimore: Lippincott Williams & Wilkins, 2007.
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Laryngoscope Highlights

Anatomy-and Variations-of the Sphenopalatine Foramen

Although the success rate of sphenopalatine ligation is greater than 95%, there have been some reports of difficulties in isolating the arteries during endoscopic surgical procedures. Some anatomical variations on the nose lateral wall have been noted with reference to the location of the sphenopalatine foramen (SPF), the presence of an accessory foramen, artery ramification, and SPF dimension and morphology. Francini G. M. Pádua, MD, and Richard L. Voegels, MD, conducted a cadaver study to describe the anatomy of the SPF region and possible anatomical variations.