1. Generic PRO instrument 2. Disease specific 3. Population specific 4. Dimension specific 5. Individualized 6. Summary items 7. Utility measures Full Information : https://bit.ly/2VmTrLs Reference : https://pubrica.com/services/research-services/ Why pubrica? When you order our services, we promise you the following – Plagiarism free, always on Time, outstanding customer support, written to Standard, Unlimited Revisions support and High-quality Subject Matter Experts. Contact us : Web: https://pubrica.com/ Blog: https://pubrica.com/academy/ Email: sales@pubrica.com WhatsApp : +91 9884350006 United Kingdom: +44-74248 10299 Related Topics: Literature gap and future research Meta-Analysis in evidence-based research Biostatistics in clinical research Scientific Communication in healthcare Tags: Medical writing service | Scientific communication services | Scientific research services | Clinical trials | Publication services | Scientific Manuscript editing services

1. Copyright © 2020 pubrica. All rights reserved 1
Pro Instrument and its Types
Dr. Nancy Agens, Head,
Technical Operations, Pubrica
sales@pubrica.com
I. INTRODUCTION
Patient-Reported Outcomes (PROs) is “ a
unique health status indicator that reveals
the current and past scenarios of a ones
health condition by the patient them self,
without any other interpretation (clinician
or care giver). “Patient-Reported
Outcome” (PRO) is considered a broad
phenomenon, encompassing various
factors of perceiving and quantifying a
person’s health status, which includes
health conditions (physical and mental),
health related quality of life (HRQOL),
social well being, clinical trials, functional
status linked with the treatment taken by
the patient etc. This self- appraisal system
is high essential to identify the best
practices of a health care that is qualified
to be a good outcome leading to a patient
centered health care system.
A PRO instrument is a rating scale that
critically evaluates the health outcomes,
satisfaction scores etc in a patients
viewpoint. PRO instruments are
considered as a primordial quality
indicator for health care service, which
gives valuable insights to the policy
makers, demand market and clinical
researchers. Literature has identified
several crucial factors for development of
a PRO instrument namely
1. Study parameters should hold strong
literature support
2. Should possess a conceptual structure
3. Should be drafted based on a end-point
model
4. Study must possess ideal number of
study items
5. The model should conceal identity of
the patients
6. Reproducible at any given point of
time
7. The questionnaire should be simplified
and understandable to the patients
Information’s retrieved by the PRO
instruments are instrumental in enhancing
the relationship between the patient,
his/her family and the doctors on the
whole. Further, the universal availability
of the content is expected to bring upon
striking changes in the policies by the
regulatory authorities, drug developers,
researchers, technologists and be used for
advanced clinical trials over the time.
II. PRO INSTRUMENTS AND ITS
TYPES
Any PRO instrument is developed
adopting four essential steps as approved
by US-FDA. This includes the a.
Hypothesis derivation and drafting of the
framework b. Identifying the
literature gaps and deleting or adding the
components based on it c. critical
content validation of the instrument;
defining of the scoring indices and d.
Final draft of the SOP, evaluation of the
patient response in different perspectives,
need for translation, changes for different
geographical locations will be executed.
Generally PRO instruments are developed
based on the need, intended purpose and
the target population. The commonly
known types of PRO instruments are
 Generic
 Disease specific
 Population specific
 Dimension specific
 Individualized
 Summary items
 Utility measures

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III. GENERIC PRO INSTRUMENT
Generic PRO instruments are used to
measure broad health aspects, illness
outcomes and are applicable for a wide
spectrum of patient groups and population
across the countries. The key benefits of
generic PRO instrument is that they are
ideally suitable to evaluate large number
of health disorders and can be used for
comparative studies among different
patient groups, treatment methods to
determine the competency of the models.
Additionally, generic PRO instrument
finds its applications in normative studies
on large population to assess the health
system, health interventions, to understand
the co-morbidities and to study the effect
of latest health care methodologies,
clinical trials etc. However, this instrument
is less sensitive as compared to other
models. Classic examples may include SF-
36, which studies the physical and mental
component of health in an 8-dimensional
scoring matrix, Psychological General
Well-Being Index (PGWBI)
IV. DISEASE SPECIFIC
This instrument aims to estimate the
patient's view of a specific disease or
disorder Specific instruments are made
developed targeting specific health
ailments. For example: Rheumatoid
Arthritis Quality of Life questionnaire
(RAQoL) developed to evaluate the patient
purview of health care and quality of life
with Rheumatoid Arthritis, The Asthma
Quality of Life Questionnaire contains 32
items yielding four dimension scores from
factors namely symptoms, activity
limitations, emotional function, and
environmental vulnerability.
V. POPULATION SPECIFIC
Population-specific instrument are
developed targeting a specific
demographic group (children or elderly
people) and geographic groups. The term
“Population specific” can be classified
based on disease condition, treatment
methods, population and geography. The
population specific PRO is a sensitive tool
is developed in precise manner to obtain
information’s in a narrowed window.
Example: The Child Health and Illness
Profile/CHIP developed for adolescents;
Cambridge Pulmonary Hypertension
Outcome Review (CAMPHOR)
VI. DIMENSION SPECIFIC
Dimension-specific instrument evaluates a
particular aspect of a person’s health. The
classic examples are physical function,
psychological wellness, personal strengths,
global health perspectives, specific role
based perceptions (house hold works, job,
finance), personal put up (appearance,
spiritual viewpoint, gratification). This
instrument is resourceful in providing
specific information as compared to the
generic or population specific PRO
instruments and they are highly competent.
It provides wide range of reliable data for
a better interpretation. The Beck
Depression Inventory contains 21 items
that effectively address symptoms of
depression.
VII. INDIVIDUALIZED PRO
INSTRUMENT
Individualized instruments enable patients
to frame their own choice of items and can
evaluate the significance of individual
items such as the health issue, other
concerns or factors that are not
predetermined by the evaluator. It
basically responds to the concerns of the
individual patient and not based on any
health standard. Therefore individualized
instruments are known to have higher
content validity. Classic example of this
PRO instrument is: The Patient Generated
Index where the respondents are asked to
list the five most important areas of their

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lives; Schedule for the Evaluation of
Individual Quality of Life (SEIQoL)
VIII. SUMMARY ITEMS
Summary item is a versatile PRO
instrument where respondents are asked to
consolidate the varied aspect of health
condition via a single item or a very small
number of items. It is less time consuming
and is used to get inputs from large sample
groups of a general population leading to
ample correlative evidences. However,
summary item restricts the specific
inferences that can be made on a specific
health disorder, which is due to its
conciseness. Example: Questions
(regarding limiting enduring illness) in
General Household Survey; the General
Household Survey for England and Wales
on chronic illness and disability.
IX. UTILITY MEASURES
Utility measures, involves choice or values
pertaining to an individual health condition
and represents it as a single index/score.
This PRO instrument evaluates the overall
strength of health status in a society and is
used for cost-utility analysis. It is
considered a generic type PRO however
uses specific numerical evaluation
methods to study health in a broad
spectrum. It is used to compare treatment
methods of different health problems and
its economic evaluation. Utility measures
are brief models and not applicable for
large number of states. Example: The
EuroQol EQ-5D contains five items
namely mobility, self-care, main activity,
pain/discomfort and anxiety/depression;
Utility measure for major, unipolar
depression (McSad)