Single-encounter elicitation framework for diagnostic excellence patient-reported measures: SEE-Dx-PRM

Abstract

Objective: To create a conceptual framework for assessing patient-reported diagnostic excellence of a single diagnostic encounter. Methods: We held multiple expert panel meetings to prioritize a priori identified diagnostically relevant patient-reported experience and outcome domains. We combined and synthesized expert feedback with our experience in measure development and the reflections of a patient focus group. We then developed the framework, SEE-Dx-PRM (Single-Encounter Elicitation Framework for Diagnostic Excellence Patient-Reported Measures). Results: We defined the SEE-Dx-PRM's scope as intended for a single diagnostic encounter in emergency or urgent care, prospective and agnostic of the health condition, and with a timeframe of within several days up to a month from the encounter. The SEE-Dx-PRM's diagnostic excellence outcomes are: (1) accurate diagnosis and (2) either final, or working diagnosis, or specific next steps to establish diagnosis that were communicated and comprehended by patients. SEE-Dx-PRM encompasses 2 domains associated with accurate diagnosis, 5 domains of patient perception of iterative diagnostic process, 5 domains associated with communication and comprehension, and a domain associated with uncertainty. Conclusion: SEE-Dx-PRM-informed measures might support quality improvement, prompt system response, and research on diagnostic excellence. Innovation: SEE-Dx-PRM presents a novel patient-centered framework for the emerging diagnostic excellence construct and its measurement.

Keywords

• Diagnostic excellence
• Patient-reported experience
• Patient-reported outcome
• Emergency care
• Urgent care