The NIH's Promis Global tool is much simpler, asking only 10 questions that perhaps more easily assess a patient's functional outcome before and after an episode of care. For example, question 7 asks: "To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair?" Such a question would be appropriate to understand both a patient's baseline activities, and compare them with activities after a procedure.
"With this tool, one could know that the patient was, for example, just like an average person who gets a joint replacement, and that after (the operation) they indicated how they felt and whether they improved," explains, Melanie P. Mastanduno, Director of Population Health Measurement for the Dartmouth Institute for Health Policy and Clinical Practice. "That's not something the doctor can measure."
In theory at least, the patient would be able to answer these questions "in a private and confidential way, say, through their desktop computer, an iPad or a kiosk, and not have someone hovering over them while they answered," Mastanduno says.
The history of functional outcome surveys has been "kind of like a Tower of Babel," acknowledges San Keller, NIH principal research scientist for Promis, to explain the reason such survey tools are needed. "There have been so many different investigators and sponsors of these measures over the years, some developing different measures for the same thing, they come up with different questions, different answers and with scores in different domains...One asks about severity of pain, the other frequency."