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1、TheUseofaBlockchaintoFostertheDevelopmentofPatient-ReportedOutcomeMeasuresJASONC.GOLDWATER,MA,MPAAugust8,2016IntroductiontoPatientRelatedOutcomeMeasuresPatient-relatedoutcomemeasures(PROMs),whichfocusonoutcomesthataredirectlyrelatedtothepatient,haveta
2、kenonaddedimportanceandsignificanceoverthepastseveralyears.[1]Thisisdue,inpart,totheincreasedattentionfocusedonthepatientexperienceofcareandtoprovideapatient-focusedassessmentontheburdenandimpactofdisease.PROMscanincludesymptomsandotheraspectsofhealth
3、–relatedqualityoflifeindicatorssuchasphysicalorsocialfunction,treatmentadherence,andsatisfactionwithtreatment.Theycanalsofacilitatemoreaccuratepatient-physiciancommunicationintermsoftheburdenoftreatment-relatedmorbiditiesbyprovidingamoredetailedandcom
4、pleteevaluationoftreatmentsforspecificconditions,suchascancerormultiplesclerosis.[2]PROMsaredistinctfromtraditionalclinicalefficacymeasures(e.g.,survivalincancer,smokingcessation)becausetheydirectlyreflecttheimpactofdiseaseanditstreatmentfromthepatien
5、t’sperspective.[1]Itcanexaminethebalancebetweentheefficiencyofthetreatmentanditsburdenonthepatient.Itisalsoeffectiveinlookingatareassuchasphysicalfunctioningandoverallwell-being,andhighlightingtheefficacyandsafetyoftreatmentsinrelationtoitsoverallclin
6、icalbenefit.Becausethemeasuresthemselvesaredevelopedfromthepatient’sperspective,itcanalsofacilitategreaterpatientinvolvementintreatmentdecision-makingaswellasprovidingguidanceforhealthcaredecisions.[1]However,thereisdifficultyinthedevelopment,implemen
7、tationandsustainabilityofPROMsoverthelong-term.[3]Thesuccessofawell-developedPROMthatadequatelyandaccuratelyreflectthatpatient’sperspectivereliesontheuseofaninstrumentthatispsychometricallytestedandvalidatedandcancapturetheburdenofdiseaseortreatment.T
8、hismeanstheinstrumentmustbereliable,inthatthePROMyieldsthesamemetricforevaluationeachtimeitisadministered,providingthattheconstructbeingmeasuredhasnotchanged.Additionally,thePROMmustalwaysmeasureitsintendedobjective,andnotdemonstratesignifican
