Results Summary

PCORI funded the Pilot Projects to explore how to conduct and use patient-centered outcomes research in ways that can better serve patients and the healthcare community. Learn more.

Background

Knowing what is important to patients being treated for back or stomach pain—and how they feel about their experience—can help doctors to give better care. But there is little research about what’s most important to patients or how to obtain this information.

Project Purpose

Researchers wanted to find out what information was most important to patients who got a computed tomography (CT) or magnetic resonance imaging (MRI) scan for back or stomach pain. The researchers also wanted to get feedback from family members. The researchers planned to compare the opinions of the patients, caregivers, and doctors.

The researchers then wanted to figure out the best place to find the information that patients want.

Methods

The team did interviews and surveys with 40 patients who had recently undergone CT or MRI scans for back or stomach pain. They also interviewed 11 family members. To find participants, the research team randomly called patients at a large healthcare practice in Minnesota.

The patients and family members identified possible outcomes from their health problem and its treatment. They rated the importance of each outcome on a scale of 1 (not at all important) to 5 (extremely important). The research team looked at the patients’ electronic health records and insurance claims to find out what outcomes they had experienced.

Later, the researchers called 367 patients (201 with stomach pain, 166 with back pain) and asked questions about whether the outcomes that mattered most to them had actually happened and if they were satisfied with their care.

Findings

Patients and family members strongly agreed that each of the following 21 outcomes was important:

  • Find out the cause of the pain
  • Trust that the treatment plan is appropriate   
  • Return to normal life functions
  • Feel satisfied with results of care
  • Understand what may happen because of the problem
  • Prevent this problem from occurring again
  • Prevent long-term loss of function
  • Return to work and productivity as soon as possible 
  • Feel satisfied with how care was delivered
  • Experience no complications or side effects
  • Be assured that no unexpected or unrelated problems develop
  • Get rapid and complete relief from pain and other symptoms
  • Avoid being hospitalized
  • Avoid surgery
  • Avoid placing a burden or stress on family members
  • Minimize or avoid the need for further tests and medical visits
  • Minimize radiation exposure in the course of care
  • Avoid personal costs for care
  • Minimize or avoid use of medication
  • Return to leisure and sports activities as soon as possible
  • Minimize discomfort from the tests used to assess the pain

In phone surveys, most patients told the researchers that, in most respects, they had received the care they wanted. Patients who got at least seven of the outcomes they wanted were more likely to say they were satisfied with their health care.

Patient surveys were the best way to find out most of the outcomes that are important to patients. Only a few of these most important outcomes were also listed in patients’ electronic health records. A few outcomes could best be found in insurance information.

For most of the outcomes that were deemed most important to patients, medical records or claims data were not adequate sources of information.

Limitations

This study included only a small number of patients, and most of the patients in this study were similar to each other—for example, most were well educated. All of the patients had one of the same two health problems. The findings may be different for a larger group or for different kinds of patients.

Conclusions

The outcomes that matter most to patients with back and stomach pain are not usually found in electronic health records or insurance claims.

Sharing the Results

The research team has published journal articles on the study (see below). The research team plans to set up a new system in the medical practice where the study was done. It will make it easier for doctors to get and use information that’s important to patients. The team also presented the findings to local medical groups.

Project Information

Leif I. Solberg, MD
HealthPartners Research Foundation
$660,832
Measuring Patient Outcomes from High Tech Diagnostic Imaging Studies

Key Dates

June 2012
June 2015
2012
2015

Study Registration Information

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Last updated: March 4, 2022