The measure developer should evaluate outcome measures, including those based on patient-reported outcomes (PROs), against standard criteria in the same way that measure developers evaluate all measures under development. Some of the unique considerations (in addition to the others in each category) that apply to evaluating PRO-PMs include

• Importance — The measures must be patient-centered. Patients must be involved in identifying the PROs used for performance measurement.
• Scientific Acceptability — Specifications must include methods of administration, handling of proxy responses, response rate calculations, and how the responses affect results. The measure developer must establish reliability and validity not only for the data measurement instrument (i.e., PROM) but also for the derived performance measurement (i.e., PRO-PM).
• Feasibility—Minimize burden to respondents. Illness may complicate accessibility issues. Measure developers should consider language, literacy, and cultural issues.
• Usability and Use—Not only must patients find the results of PRO-PMs useful, but measured entities must also be able to use the information to improve quality of care.

Evaluation for PRO-PMs is a special case of overall outcome measure evaluation. See the Measure Evaluation Criteria section for more detail.

Key Points

PROMs are quality measures derived from patient-reported outcomes and are a high priority for CMS and other organizations. These measures present some design challenges and require measure developers to construct PRO-PMs that apply patient outcome data to measure quality of care. PRO tools measure developers can use include PROMIS, HOS, and FOTO. The same measure evaluation criteria and justification principles that apply to other outcome measures also apply to PRO-PMs. It is important for measure developers to create patient-centered PROMs and produce data that measured entities can use to improve quality of care.