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Patient-centred outcomes of imaging tests: recommendations for patients, clinicians and researchers.

Published version
Peer-reviewed

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Authors

Thompson, Matthew J  ORCID logo  https://orcid.org/0000-0002-4331-3758
Suchsland, Monica Zigman 
Lavallee, Danielle C 
Lord, Sally 

Abstract

BACKGROUND: Imaging tests are one of the most frequently used diagnostic modalities in healthcare, but the benefits of their direct impacts on clinical decision-making have been countered by concerns that they can be overused. Assessing the relative value of imaging tests has largely focused on measures of test accuracy, which overlooks more comprehensive benefits and risks of imaging tests, particularly their impact on patient-centred outcomes (PCOs). We present the findings of the Patient Reported Outcomes of Diagnostics (PROD) research study in response to a methodological gap in the area of diagnostic test comparative effectiveness research. METHODS: Over a 3-year period, the PROD Study engaged with multiple stakeholders to identify existing conceptual models related to PCOs for imaging testing, conducted primary research and evidence synthesis, and developed consensus recommendations to describe and categorise PCOs related to imaging testing. RESULTS: The PROD framework categorises PCOs from imaging studies within four main domains: information or knowledge yielded, physical impact, emotional outcomes and test burden. PCOs interact with each other and influence effects across domains, and can be modified by factors related to the patient, clinical situation, healthcare team and the testing environment. CONCLUSIONS: Using PCOs to inform healthcare decision-making will require ways of collating and presenting information on PCOs in ways that can inform patient-provider decision-making, and developing methods to determine the relative importance of outcomes (including test accuracy) to one another.

Description

Keywords

Original research, 1506, comparative effectiveness research, decision support, clinical, evaluation methodology, patient-centred care, quality improvement methodologies

Journal Title

BMJ Qual Saf

Conference Name

Journal ISSN

2044-5415
2044-5423

Volume Title

Publisher

BMJ Publishing Group

Rights

Embargo: ends 2021-10-05
Sponsorship
Patient-Centered Outcomes Research Institute (PCORI) (ME-1503-29245)