Journal Article

Measuring what matters to rare disease patients – reflections on the work by the IRDiRC taskforce on patient-centered outcome measures

Morel, Thomas, Cano, Stefan J.

2017

Overview

Our ability to evaluate outcomes which genuinely reflect patients’ unmet needs, hopes and concerns is of pivotal importance. However, much current clinical research and practice falls short of this objective by selecting outcome measures which do not capture patient value to the fullest. In this Opinion, we discuss Patient-Centered Outcomes Measures (PCOMs), which have the potential to systematically incorporate patient perspectives to measure those outcomes that matter most to patients. We argue for greater multi-stakeholder collaboration to develop PCOMs, with rare disease patients and families at the center. Beyond advancing the science of patient input, PCOMs are powerful tools to translate care or observed treatment benefit into an ‘interpretable’ measure of patient benefit, and thereby help demonstrate clinical effectiveness. We propose mixed methods psychometric research as the best route to deliver fit-for-purpose PCOMs in rare diseases, as this methodology brings together qualitative and quantitative research methods in tandem with the explicit aim to efficiently utilise data from small samples. And, whether one opts to develop a brand-new PCOM or to select or adapt an existing outcome measure for use in a rare disease, the anchors remain the same: patients, their daily experience of the rare disease, their preferences, core concepts and values. Ultimately, existing value frameworks, registries, and outcomes-based contracts largely fall short of consistently measuring the full range of outcomes that matter to patients. We argue that greater use of PCOMs in rare diseases would enable a fast track to Patient-Centered Care.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Achievement tests / Advisory Committees - standards / Care and treatment / Clinical outcome assessments / Clinical outcomes / Clinical trials / Drug Discovery - methods / Drug Discovery - standards / FDA approval / Hemophilia / Human Genetics / Humans / Medical research / Medicine / Medicine & Public Health / Patient Outcome Assessment / Patient-centered care / Patient-Centered Care - methods / Patient-Centered Care - standards / Patient-centered outcome measures / Patient-focused drug development (PFDD) / Patient-relevant outcomes / Patient-reported outcomes / Patients / Pharmacology/Toxicology / Position Statement / Prescription drugs / Pulmonary fibrosis / Quality of life / Rare diseases / Rare Diseases - diagnosis / Rare Diseases - therapy / Regulatory agencies / Regulatory approval / Studies / Systemic lupus erythematosus / Task forces