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Challenges in measuring patient defined outcomes in diagnostic radiological investigations

Challenges in measuring patient defined outcomes in diagnostic radiological investigations. S Mathers* + , G McKenzie*, E Robertson*, J Proctor* + , R Chesson + *NHS Grampian + The Health Services Research Group Aberdeen, Scotland, UK. What aspects of health care can be evaluated?.

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Challenges in measuring patient defined outcomes in diagnostic radiological investigations

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  1. Challenges in measuring patient defined outcomes in diagnostic radiological investigations S Mathers*+, G McKenzie*, E Robertson*, J Proctor*+, R Chesson+ *NHS Grampian +The Health Services Research Group Aberdeen, Scotland, UK.

  2. What aspects of health care can be evaluated? Structure Resources, facilities organisational settings Process Intervention e.g. surgery, procedure Outcome Change due to intervention Donabedian, 1980

  3. Outcome measures have been defined ‘... as the results (effects) of processes. They are that part of the situation pertaining after a process which can be attributed to the process.’ UK Clearing House on Health Outcomes, 1993

  4. Why is outcome measurement important? ‘ ... to show that an intervention has been appropriate and effective’ Austin and Clark, 1993

  5. Aim To carry out a systematic review of literature to identify: • the prevalence, • use of outcome measures in radiology.

  6. Modified from NHS Centre for Reviews and Dissemination, (UK)

  7. 46 key words used radiology/diagnostic imaging/x-ray outcomes patient satisfaction efficacy outcome measures utility adverse reaction waiting times quality of care • Databases searched e.g. MEDLINE

  8. Results • Citations 4893 • Publications retrieved 84 • Publication by references 25 • Patient focused outcome 22

  9. Final Scrutiny Exclude • 8 for a number of reasons e.g. hypothetical studies Included • 14 primary patient focused studies

  10. Patient focused outcome papers In total 8 • Mammography 2 x USA • Low back pain 2 x UK • Ankle radiography 1 Canada • DCBE/US/Mammography 1 Norway • MRI 1 UK • Effects of radiation dose 1 Canada

  11. Conclusions • Dearth of research into patient centred outcomes in radiology • Lack of coherent body of work • Demonstrates little patient involvement in radiology research

  12. Challenges • Imaging procedure only part of investigations and patient final outcome remote from department Blackmore et al 1999 • Multi-disciplinary approach to research Revicki et al 1999 • Development of suitable outcome measurement tools • Would benefit from a qualitative methodology

  13. Future agenda • It is important that we develop a culture of outcome measurement in radiology • Patient defined outcome is necessary to evaluate our procedures

  14. Acknowledgements The Royal College of Radiologists (UK) (Pump Priming Research Award)

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