Placing patient-reported outcomes at the centre of cardiovascular clinical practice: implications for quality of care and management.
Moons P., Norekvål TM., Arbelo E., Borregaard B., Casadei B., Cosyns B., Cowie MR., Fitzsimons D., Fraser AG., Jaarsma T., Kirchhof P., Mauri J., Mindham R., Sanders J., Schiele F., Torbica A., Zwisler AD.
Patient-reported outcomes (PROs) provide important insights into patients' own perspectives about their health and medical condition, and there is evidence that their use can lead to improvements in the quality of care and to better-informed clinical decisions. Their application in cardiovascular populations has grown over the past decades. This statement describes what PROs are, and it provides an inventory of disease-specific and domain-specific PROs that have been developed for cardiovascular populations. International standards and quality indices have been published, which can guide the selection of PROs for clinical practice and in clinical trials and research; patients as well as experts in psychometrics should be involved in choosing which are most appropriate. Collaborations are needed to define criteria for using PROs to guide regulatory decisions, and the utility of PROs for comparing and monitoring the quality of care and for allocating resources should be evaluated. New sources for recording PROs include wearable digital health devices, medical registries, and electronic health record. Advice is given for the optimal use of PROs in shared clinical decision-making in cardiovascular medicine, and concerning future directions for their wider application.