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J Gastrointest Surg (2017) 21:892895 DOI 10.1007/s11605-016-3342-5
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Patient-Centered Outcomes in Surgical Research and Practice
Blake Fernandez1 & Livingstone Dore1 & Vic Velanovich1
Received: 7 November 2016 /Accepted: 14 December 2016 /Published online: 20 January 2017 # 2016 The Society for Surgery of the Alimentary Tract
Keywords Patient-centered outcomes . Quality of life .
Symptom severity
Medical outcomes have been traditionally measured by Bobjective^ physiological results such as survival, complications, recurrences, and etc. However, there has been increasing emphasis on the inclusion of patients in the discussion of treatment decisions for their medical conditions. This is a crucial element in the concept of patient autonomy which gives patients the right to freely make decisions regarding their medical care. In recent years, there has been an effort to take the concept of patient inclusion and autonomy a step further and evaluate the impacts of diseases and their treatments as it directly relates to how patients experience life. One of the key components of these efforts has been the evaluation of patient-centered outcomes, also referred to as patient-reported outcomes.
In 2010, the Patient-Centered Outcomes Research Institute was created to promote and fund PCO research as part of the Patient Protection and Affordable Care Act.1 The Food and Drug Administration (FDA) in recent years has published official guidance regarding the use of patient-reported outcome instruments and their use in the evaluation and labeling of medical products.2
These are just two of many examples which highlight the recognition of the significance of patient-centered outcomes in helping practitioners and their patients make treatment decisions.
The purpose of this article is to review the basic principles of patient-centered outcomes in research and clinical practice, providing researchers and clinicians a way to assess patient-centered outcome instruments.
What are Patient-Centered Outcomes?
The concept of patient-centered outcomes on the one hand is easy to understand, and yet can be very difficult to formally define. Several definitions have been suggested by various groups, but there is not a single universally accepted definition.24 The FDA offers the following definition:
A patient-reported outcome is any report of the status of a patients health condition that comes directly from the patient without interpretation of the patients response by...