A fundamental component of any ePRO implementation is the selection of relevant, evidence-based PROMs that support clinical goals for patient care (please see the Goal Alignment guideline). Governance can ensure adherence to this principle by providing guidance on measurement selection to end-users as well as creating a repository of endorsed ePROs available.
There are several considerations when selecting one or more PROMs for use in clinical practice, with well-known guidance available (see ISOQOL User’s Guide in the Tools and Resources section). This includes, but is not limited to, the following:
- type of PROM to use (i.e., generic versus condition-specific measure, also clinical domain)
- psychometric properties (i.e., validity and reliability)
- available evidence of the specific PROM use in practice
- pragmatic issues related to administration (e.g., time for completion, resources for administration)
When possible establish common or core domains of PROM instruments available as enterprise resources. Organize the core domains into a catalog of recommended ePROs.
In the traditional research context, the selection of which PROMs to use is driven by theoretical frameworks that explain the relationships between measurable constructs within a specific clinical domain and the health phenomenon of interest. For health systems, the use of ePROs across settings and stakeholders may drive the adoption of common (or core) domains with a multitude of potential uses, rather than discrete uses within specific clinical domains.
Aggregating ePROs by core measurement domains (e.g., health-related quality of life, function, depression, pain, or substance use) allows for the identification of common areas of interest across diverse healthcare settings, for which enterprise resources would be beneficial.