Abstract
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.
| Original language | English |
|---|---|
| Article number | e029741 |
| Number of pages | 9 |
| Journal | BMJ open |
| Volume | 9 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 24 Aug 2019 |
Bibliographical note
Collaborators: The Bluebelle Study Group consists of the following members: Bluebelle grant co-applicants: Lazaros Andronis (Division of Health Sciences, University of Warwick), Jane Blazeby (Bristol Medical School, University of Bristol; University Hospitals Bristol NHS Foundation Trust), Natalie Blencowe (Bristol Medical School, University of Bristol; University Hospitals Bristol NHS Foundation Trust), Melanie Calvert (Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, and NIHR, Birmingham Biomedical Research Centre, University of Birmingham), Joanna Coast (Bristol Medical School, University of Bristol), Tim Draycott (North Bristol NHS Trust), Jenny Donovan (Bristol Medical School, University of Bristol; NIHR Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS Trust), Rachael Gooberman-Hill (Bristol Medical School, University of Bristol), Robert Longman (University Hospitals Bristol NHS Foundation Trust), Jonathan Mathers (Institute of Applied Health Research, University of Birmingham), Tom Pinkney (Academic Department of Surgery, Queen Elizabeth Hospital, University of Birmingham), Barnaby Reeves (Bristol Medical School, University of Bristol), Chris Rogers (Bristol Medical School, University of Bristol), Andrew Torrance (Institute of Applied Health Research, University of Birmingham), Mark Woodward (University Hospitals Bristol NHS Foundation Trust). Other members of the Bluebelle study group: Kate Ashton (Clinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol), Gemma Clayton (Clinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol), Madeleine Clout (Clinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol), Jo Dumville (School of Nursing, Midwifery & Social Work, University of Manchester), Daisy Elliott (Bristol Medical School, University of Bristol), Lucy Ellis (Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol), Rosie Harris (Clinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol), Richard Lovegrove (Worcestershire Acute Hospitals NHS Trust), Christel McMullan (Institute of Applied Health Research, University of Birmingham), Helen van der Nelson (North Bristol NHS Trust), Caroline Pope (Clinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol), Anne Pullyblank (North Bristol NHS Trust), Leila Rooshenas (Bristol Medical School, University of Bristol), Dimitrios Siassakos (University College London Hospital), Sean Strong (Bristol Medical School, University of Bristol), Helen Talbot (Clinical Trials and Evaluation Unit, Bristol Trials Centre, Bristol Medical School, University of Bristol), Nicky Welton (Bristol Medical School, University of Bristol), Cathy Winter (North Bristol NHS Trust).© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Keywords
- content validity
- item construction
- outcome measurement
- patient-reported outcome
- questionnaire development
ASJC Scopus subject areas
- General Medicine