Patient defined outcomes: lessons from systematic review S Mathers* +, G McKenzie*, E Robertson*, J Proctor* +, R Chesson + *NHS Grampian + The Health Services Research Group Aberdeen, Scotland, UK.

What aspects of health care can be evaluated? Outcome Change due to intervention Process Intervention e.g. surgery, procedure Structure Resources, facilities organisational settings Donabedian, 1980

...a successful outcome, as defined from the professionals perspective, may not necessarily be regarded as a successful outcome by the patient. Wright, 1999

Patient centred outcome determined solely by health professionals and researchers Patient defined outcome identified by patients as being important Dixon, 1995

Aim To carry out a systematic review of literature to identify: the prevalence, use of patient focused outcome measures in radiology.

Search Strategy Databases searched Abstracts read according to defined criteria Criteria redefined, abstracts to be re-read in light of this Articles to be retrieved Initial paper review Data synthesis 1. Data extraction form 2. Quality checklist Data analysis 1.SPSS 2. Summary tables 3. Meta-analysis Write up and dissemination. Modified from NHS Centre for Reviews and Dissemination, (UK)

47 key words used radiology, diagnostic imaging, x-ray/ outcomes patient satisfaction efficacy outcome measures utilityadverse reaction waiting times quality of care Databases searched e.g. MEDLINE

Results Citations 5516 Citations reviewed111 Patient focused outcome 23

NO paper was found in which patient defined outcome had been used in radiology

Patient focused outcome papers Primary focus of research 4 papers - ALL concerned with lumbar spine imaging

Patient focused outcome papers Secondary focus of research 5 papers - 4 interventional studies - 1 chest imaging

Conclusions Dearth of research into patient centred outcomes in radiology Lack of coherent body of work Demonstrates little patient involvement in radiology research in radiology departments Highlights need for considering patient needs Continuing need for CPD reflecting PFPI agenda

Recommendations Patient engagement should take place in developing patient defined outcome especially in the area of interventional radiology Value of patient defined outcomes incorporated into education, and planning of health care

Acknowledgements The Royal College of Radiologists (UK) (Pump Priming Research Award)