PRM197 - A Role For Pro-Based Patient Treatment Simulators In Observing Physician Treatment Of Pain And Discomfort

Abstract

There has been much research about the use of patient-reported outcomes (PROs) in clinical practice. However, it has been difficult to quantify the impact of PROs on clinical practice due to methodological concerns as well as heterogeneity of study designs on the subject (Valderas 2008). This paper demonstrates the value of developing a patient simulator to better observe the impact of PROs- and in particular, HRQoL measures- on real-world treatment decisions. Although questionnaires can accurately capture physician behaviour in clinical practice (Rethans 1987), they are limited in the amount of information they can provide about a patient without risking respondent fatigue. Simulation combines many of the benefits of a questionnaire with those of observing a physician in clinical practice, providing a robust sample size of both doctors and simulated patients, rich information, and an engaging task for respondents. In 2015, we began creating a patient simulator designed to mimic the richness and detail characteristic of a typical doctor’s visit. The simulation is designed to study treatment patterns of several conditions- in this publication, we focus on osteoarthritis, an area with significant unmet need (Sofat 2014) and with well-established PRO measures (most notably the WOMAC pain score) (Davies 1999). Within the simulation, doctors are presented with patient profiles containing a basic profile and photo with demographic information, medical and treatment history, radiographic scans, and patient complaints based on items contained in the WOMAC evaluation. Beyond osteoarthritis, this design helps researchers understand how management of conditions involving pain and discomfort is influenced by use of PRO measures. By observing how doctors treat various patient cases presented in the simulation, we can determine how specific measures impact treatment decisions and goals. These decisions can then be used to evaluate the impact of PROs on compliance with best practices, as well as patient outcomes.