Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design

Objectives To describe the novel concept of, and methods for developing, a ‘universal-reporter’ outcome measure (UROM); a single questionnaire for completion by patients and/or healthcare professionals (HCPs) when views on the same subject are required.Design A mixed methods study with three phases—...

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Main Authors: Cathy Winter, Chris Rogers, Joanna Coast, Dimitrios Siassakos, Leila Rooshenas, Mark Woodward, Christel McMullan, Melanie Calvert, Jane Blazeby, Jenny Donovan, Kerry Avery, Jonathan Mathers, Rachael Gooberman-Hill, Gemma Clayton, Sara Brookes, Tim Draycott, Anne Pullyblank, Rhiannon Macefield, Robert Longman, Tom Pinkney, Barnaby Reeves, Andrew Torrance, Jo Dumville, Daisy Elliott, Rosie Harris, Helen van der Nelson, Nicky Welton
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e029741.full
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author Cathy Winter
Chris Rogers
Joanna Coast
Dimitrios Siassakos
Leila Rooshenas
Mark Woodward
Christel McMullan
Melanie Calvert
Jane Blazeby
Jenny Donovan
Kerry Avery
Jonathan Mathers
Rachael Gooberman-Hill
Gemma Clayton
Sara Brookes
Tim Draycott
Anne Pullyblank
Rhiannon Macefield
Robert Longman
Tom Pinkney
Barnaby Reeves
Andrew Torrance
Jo Dumville
Daisy Elliott
Rosie Harris
Helen van der Nelson
Nicky Welton
author_facet Cathy Winter
Chris Rogers
Joanna Coast
Dimitrios Siassakos
Leila Rooshenas
Mark Woodward
Christel McMullan
Melanie Calvert
Jane Blazeby
Jenny Donovan
Kerry Avery
Jonathan Mathers
Rachael Gooberman-Hill
Gemma Clayton
Sara Brookes
Tim Draycott
Anne Pullyblank
Rhiannon Macefield
Robert Longman
Tom Pinkney
Barnaby Reeves
Andrew Torrance
Jo Dumville
Daisy Elliott
Rosie Harris
Helen van der Nelson
Nicky Welton
author_sort Cathy Winter
collection DOAJ
description Objectives To describe the novel concept of, and methods for developing, a ‘universal-reporter’ outcome measure (UROM); a single questionnaire for completion by patients and/or healthcare professionals (HCPs) when views on the same subject are required.Design A mixed methods study with three phases—phase I: identification of relevant content domains from existing clinical tools, patient questionnaires and in-depth interviews with multistakeholders; phase II: item development using a novel approach that considered plain language in conjunction with medical terminology; and phase III: pretesting with multistakeholders using cognitive interviews.Setting A case study in surgical wound assessment undertaken in two UK hospital trusts and one university setting.Participants Patients who had recently undergone general abdominal surgery and healthcare professionals involved in post-surgical wound care.Results Phase I: In the example case study, 19 relevant content domains were identified from two clinical tools, two patient questionnaires and 19 multistakeholder interviews (nine patients, 10 HCPs). Phase II: Domains were operationalised into items and subitems (secondary components to collect further information, if relevant). The version after pretesting had 16 items, five of which included further subitems. Plain language in conjunction with medical terminology was applicable in nine (27%) items/subitems. Phase III: Pretesting with 28 patients and 14 HCPs found that the UROM was acceptable to both respondent groups. An unanticipated secondary finding of the study was that the combined use of plain language and medical terminology during questionnaire development may be a useful, novel technique for evaluating item interpretation and thereby identifying items with inadequate content validity.Conclusion UROMs are a novel approach to outcome assessment that are acceptable to both patients and HCPs. Combining plain language and medical terminology during item development is a recommended technique to improve accuracy of item interpretation and content validity during questionnaire design. More work is needed to further validate this novel approach and explore the application of UROMs to other settings.
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spelling doaj-art-66f5b8cda33d4966805bd2a5f6cda5552025-08-20T02:23:49ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2019-029741Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire designCathy Winter0Chris Rogers1Joanna Coast2Dimitrios Siassakos3Leila Rooshenas4Mark Woodward5Christel McMullan6Melanie Calvert7Jane Blazeby8Jenny Donovan9Kerry Avery10Jonathan Mathers11Rachael Gooberman-Hill12Gemma Clayton13Sara Brookes14Tim Draycott15Anne Pullyblank16Rhiannon Macefield17Robert LongmanTom Pinkney18Barnaby Reeves19Andrew TorranceJo Dumville20Daisy Elliott21Rosie Harris22Helen van der NelsonNicky Welton23North Bristol NHS Trust, Bristol, UKBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UKPopulation Health Sciences, University of Bristol, Bristol, UK1 Institute for Women`s Health, University College London, London, UKNational Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UKThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, AustraliaInstitute of Applied Health Research, University of Birmingham, Birmingham, UKdirector and centre director and academic leadprofessorPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UKNational Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UKInstitute of Applied Health Research, University of Birmingham, Birmingham, UKNIHR Bristol Biomedical Research Centre, Bristol, UK4 Faculty of Health Sciences, University of Bristol, Bristol, UKInstitute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UKDepartment of Women`s Health, North Bristol NHS Trust, Westbury on Trym, Bristol, UK3 West of England Academic Health Science Network, Bristol, UKNational Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UKInstitute of Applied Health Research, University of Birmingham, Birmingham, UKUniversity of Bristol, Bristol, UKDivision of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UKNational Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK1 Bristol Medical School, University of Bristol Faculty of Health Sciences, Bristol, UKDepartment of Population Health Sciences, Bristol Medical School, Bristol, UKObjectives To describe the novel concept of, and methods for developing, a ‘universal-reporter’ outcome measure (UROM); a single questionnaire for completion by patients and/or healthcare professionals (HCPs) when views on the same subject are required.Design A mixed methods study with three phases—phase I: identification of relevant content domains from existing clinical tools, patient questionnaires and in-depth interviews with multistakeholders; phase II: item development using a novel approach that considered plain language in conjunction with medical terminology; and phase III: pretesting with multistakeholders using cognitive interviews.Setting A case study in surgical wound assessment undertaken in two UK hospital trusts and one university setting.Participants Patients who had recently undergone general abdominal surgery and healthcare professionals involved in post-surgical wound care.Results Phase I: In the example case study, 19 relevant content domains were identified from two clinical tools, two patient questionnaires and 19 multistakeholder interviews (nine patients, 10 HCPs). Phase II: Domains were operationalised into items and subitems (secondary components to collect further information, if relevant). The version after pretesting had 16 items, five of which included further subitems. Plain language in conjunction with medical terminology was applicable in nine (27%) items/subitems. Phase III: Pretesting with 28 patients and 14 HCPs found that the UROM was acceptable to both respondent groups. An unanticipated secondary finding of the study was that the combined use of plain language and medical terminology during questionnaire development may be a useful, novel technique for evaluating item interpretation and thereby identifying items with inadequate content validity.Conclusion UROMs are a novel approach to outcome assessment that are acceptable to both patients and HCPs. Combining plain language and medical terminology during item development is a recommended technique to improve accuracy of item interpretation and content validity during questionnaire design. More work is needed to further validate this novel approach and explore the application of UROMs to other settings.https://bmjopen.bmj.com/content/9/8/e029741.full
spellingShingle Cathy Winter
Chris Rogers
Joanna Coast
Dimitrios Siassakos
Leila Rooshenas
Mark Woodward
Christel McMullan
Melanie Calvert
Jane Blazeby
Jenny Donovan
Kerry Avery
Jonathan Mathers
Rachael Gooberman-Hill
Gemma Clayton
Sara Brookes
Tim Draycott
Anne Pullyblank
Rhiannon Macefield
Robert Longman
Tom Pinkney
Barnaby Reeves
Andrew Torrance
Jo Dumville
Daisy Elliott
Rosie Harris
Helen van der Nelson
Nicky Welton
Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design
BMJ Open
title Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design
title_full Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design
title_fullStr Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design
title_full_unstemmed Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design
title_short Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design
title_sort development of a universal reporter outcome measure urom for patient and healthcare professional completion a mixed methods study demonstrating a novel concept for optimal questionnaire design
url https://bmjopen.bmj.com/content/9/8/e029741.full
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