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      How to routinely collect data on patient-reported outcome and experience measures in renal registries in Europe: an expert consensus meeting

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          Abstract

          Despite the potential for patient-reported outcome measures (PROMs) and experience measures (PREMs) to enhance understanding of patient experiences and outcomes they have not, to date, been widely incorporated into renal registry datasets. This report summarizes the main points learned from an ERA-EDTA QUEST-funded consensus meeting on how to routinely collect PROMs and PREMs in renal registries in Europe. In preparation for the meeting, we surveyed all European renal registries to establish current or planned efforts to collect PROMs/PREMs. A systematic review of the literature was performed. Publications reporting barriers and/or facilitators to PROMs/PREMs collection by registries were identified and a narrative synthesis undertaken. A group of renal registry representatives, PROMs/PREMs experts and patient representatives then met to (i) share any experience renal registries in Europe have in this area; (ii) establish how patient-reported data might be collected by understanding how registries currently collect routine data and how patient-reported data is collected in other settings; (iii) harmonize the future collection of patient-reported data by renal registries in Europe by agreeing upon preferred instruments and (iv) to identify the barriers to routine collection of patient-reported data in renal registries in Europe. In total, 23 of the 45 European renal registries responded to the survey. Two reported experience in collecting PROMs and three stated that they were actively exploring ways to do so. The systematic review identified 157 potentially relevant articles of which 9 met the inclusion criteria and were analysed for barriers and facilitators to routine PROM/PREM collection. Thirteen themes were identified and mapped to a three-stage framework around establishing the need, setting up and maintaining the routine collection of PROMs/PREMs. At the consensus meeting some PROMs instruments were agreed for routine renal registry collection (the generic SF-12, the disease-specific KDQOL™-36 and EQ-5D-5L to be able to derive quality-adjusted life years), but further work was felt to be needed before recommending PREMs. Routinely collecting PROMs and PREMs in renal registries is important if we are to better understand what matters to patients but it is likely to be challenging; close international collaboration will be beneficial.

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          Most cited references55

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          The estimation of a preference-based measure of health from the SF-12.

          The SF-12 is a multidimensional generic measure of health-related quality of life. It has become widely used in clinical trials and routine outcome assessment because of its brevity and psychometric performance, but it cannot be used in economic evaluation in its current form. We sought to derive a preference-based measure of health from the SF-12 for use in economic evaluation and to compare it with the original SF-36 preference-based index. The SF-12 was revised into a 6-dimensional health state classification (SF-6D [SF-12]) based on an item selection process designed to ensure the minimum loss of descriptive information. A sample of 241 states defined by the SF-6D (of 7500) have been valued by a representative sample of 611 members of the UK general population using the standard gamble (SG) technique. Models are estimated of the relationship between the SF-6D (SF-12) and SG values and evaluated in terms of their coefficients, overall fit, and the ability to predict SG values for all health states. The models have produced significant coefficients for levels of the SF-6D (SF-12), which are robust across model specification. The coefficients are similar to those of the SF-36 version and achieve similar levels of fit. There are concerns with some inconsistent estimates and these have been merged to produce the final recommended model. As for the SF-36 model, there is evidence of over prediction of the value of the poorest health states. The SF-12 index provides a useful tool for researchers and policy makers wishing to assess the cost-effectiveness of interventions.
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            An integrative model of shared decision making in medical encounters.

            Given the fluidity with which the term shared decision making (SDM) is used in teaching, assessment and research, we conducted a focused and systematic review of articles that specifically address SDM to determine the range of conceptual definitions. In April 2005, we ran a Pubmed (Medline) search to identify articles published through 31 December 2003 with the words shared decision making in the title or abstract. The search yielded 681 citations, 342 of which were about SDM in the context of physician-patient encounters and published in English. We read and reviewed the full text of all 342 articles, and got any non-redundant references to SDM, which yielded an additional 76 articles. Of the 418 articles examined, 161 (38.5%) had a conceptual definition of SDM. We identified 31 separate concepts used to explicate SDM, but only "patient values/preferences" (67.1%) and "options" (50.9%) appeared in more than half the 161 definitions. Relatively few articles explicitly recognized and integrated previous work. Our review reveals that there is no shared definition of SDM. We propose a definition that integrates the extant literature base and outlines essential elements that must be present for patients and providers to engage in the process of SDM. The integrative definition of SDM is intended to provide a useful foundation for describing and operationalizing SDM in further research.
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              The estimation of a preference-based measure of health from the SF-36.

              This paper reports on the findings of a study to derive a preference-based measure of health from the SF-36 for use in economic evaluation. The SF-36 was revised into a six-dimensional health state classification called the SF-6D. A sample of 249 states defined by the SF-6D have been valued by a representative sample of 611 members of the UK general population, using standard gamble. Models are estimated for predicting health state valuations for all 18,000 states defined by the SF-6D. The econometric modelling had to cope with the hierarchical nature of the data and its skewed distribution. The recommended models have produced significant coefficients for levels of the SF-6D, which are robust across model specification. However, there are concerns with some inconsistent estimates and over prediction of the value of the poorest health states. These problems must be weighed against the rich descriptive ability of the SF-6D, and the potential application of these models to existing and future SF-36 data set.
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                Author and article information

                Journal
                Nephrol Dial Transplant
                Nephrol. Dial. Transplant
                ndt
                ndt
                Nephrology Dialysis Transplantation
                Oxford University Press
                0931-0509
                1460-2385
                October 2015
                16 May 2015
                16 May 2015
                : 30
                : 10
                : 1605-1614
                Affiliations
                [1 ]UK Renal Registry, Southmead Hospital , Bristol, UK
                [2 ]Leeds Institute of Health Sciences, School of Medicine, University of Leeds , Leeds, UK
                [3 ]Health Services Research Unit, Nuffield Department of Population Health, University of Oxford , Oxford, UK
                [4 ]European Renal Best Practice, Methods Support Team, University Hospital Ghent , Ghent, Belgium
                [5 ]Health eResearch Centre, Farr Institute for Health Informatics Research, University of Manchester , Manchester, UK
                [6 ]The National Kidney Federation , Shireoaks, Worksop, UK
                [7 ]CHU de Nancy, Epidémiologie et évaluation cliniques, Inserm CIC 1433 , Nancy, France
                [8 ]‘Dr Carol Davila’ Teaching Hospital of Nephrology , Bucharest, Romania
                [9 ]European Renal Association–European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
                [10 ]Section of Nephrology, Department of Organ Transplantation, Oslo University Hospital Rikshospitalet , Oslo, Norway
                [11 ]Renal Unit, Royal Infirmary of Edinburgh , Edinburgh, UK
                [12 ]The Scottish Renal Registry , Glasgow, UK
                [13 ]School of Public Health, The University of Sydney , Sydney, Australia
                [14 ]Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford , Headington, UK
                [15 ]Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute , London, UK
                [16 ]Swedish Renal Registry , Jönköping, Sweden
                [17 ]Department of Internal Medicine, Hospital of Helsingborg , Helsingborg, Sweden
                [18 ]Dumfries and Galloway Royal Infirmary , Dumfries, UK
                [19 ]2nd Department of Medicine, 3rd Faculty of Medicine, Charles University , Prague, Czech Republic
                [20 ]Diaverum Renal Services Group , Lund, Sweden
                [21 ]National Cancer Registry Ireland , Cork, Ireland
                [22 ]CHU Nancy, Pôle QSP2, Epidémiologie et Evaluation Cliniques , Nancy, France
                [23 ]Université de Lorraine, Université Paris Descartes , Nancy, France
                [24 ]Arbor Research Collaborative for Health , Ann Arbor, MI, USA
                [25 ]School of Social and Community Medicine, University of Bristol , Bristol, UK
                Author notes
                Correspondence and offprint requests to: Fergus J. Caskey; E-mail: fjcaskey@ 123456doctors.org.uk
                Article
                gfv209
                10.1093/ndt/gfv209
                4569391
                25982327
                f0b9a712-fecc-44c3-8675-c011adfaeedc
                © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 31 January 2015
                : 13 April 2015
                Categories
                Cutting-Edge Renal Science
                Ndt Perspectives

                Nephrology
                patient-reported measures,quality indicators,registry
                Nephrology
                patient-reported measures, quality indicators, registry

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