Patient-reported outcome measures in the emergency department: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify and characterize validated patient-reported outcome measures used to assess adult patients' health status in the emergency department to support clinical decision-making and to develop individual care and treatment plans. INTRODUCTION: In recent years, the workload in emergency departments has increased and patient management is characterized by a fast pace. The accelerated approach may lead to unintentional negligence by health care professionals of patient-reported signs and symptoms in the emergency department. Thus, use of patient-reported outcome measures in the emergency department may improve health care professionals' attention to the needs and health status of patients. INCLUSION CRITERIA: Studies assessing adult patients' health status in the emergency department using patient-reported outcome measures will be considered. The patient-reported outcome measures should be self-reported, assisted by a proxy, or administered through interviews. Only studies reporting on the measurement properties of patient-reported outcome measures will be included. Moreover, health-related information retrieved using patient-reported outcome measures should be applicable at an individual patient level. METHODS: A systematic literature search will be performed primarily in the databases MEDLINE, Embase, CINAHL, and PsycINFO. Both published and unpublished sources of information will be considered. Studies published from 2000 onwards in Danish, Swedish, Norwegian, German, and English will be included. Using the JBI methodology for scoping reviews, two reviewers will independently perform the study selection and data extraction. The results will be presented in a tabular form together with a narrative summary.

Completeness in the recording of vital signs in ambulances increases over time.

INTRODUCTION: In 2006, the North Denmark Region implemented the electronic prehospital patient medical record (PPR), amPHI, in the region's prehospital emergency medical service. In 2015, a new nationwide version was implemented. Our aim was to investigate the completeness and correctness of registrations of vital sign data in the PPR after the initial introduction and after the implementation of the new PPR version. METHODS: This was a descriptive registry-based study including patients to whom an ambulance was dispatched after an emergency call in the North Denmark Region in the periods 2007-2014 and 2016-2017. We examined vital sign data defined as blood pressure (BP), heart rate (HR), blood oxygen saturation (SpO2), respiratory rate (RR), Glasgow Coma Scale (GCS) score and numeric rating scale (NRS) for pain. We defined incorrect vital sign values according to clinical plausibility. We used a trend analysis and Pearson's χ2. RESULTS: We included 253,169 PPRs. The proportion of PPR with registration of vital signs from 2007-2014 compared with 2016-2017 was BP: 73-86%, 81-82%; HR: 76-88%, 82-83%; SpO2: 72-85%, 82-83%; RR: 34-82%, 77-79%; GCS score: 54-92%, 81-84%; NRS for pain: 0-16%, 24-26%. The increase from 2007-2014 and 2016-2017 was significant as were the differences between 2014 and 2016. We found few defined outliers (0.5%). CONCLUSIONS: The completeness of registration increased gradually but decreased slightly after implementation of the new version. A high completeness combined with few implausible outliers and concordance indicate correctness of the vital sign registrations. FUNDING: none. TRIAL REGISTRATION: Approval for the use of data was given by the medical director of the Emergency Medical Services, the North Denmark Region.

Improved Patient-Reported Quality of Life and Hip Function After Cementless 1-Stage Revision of Chronic Periprosthetic Hip Joint Infection.

BACKGROUND: Limited information is available on health-related quality of life (HRQoL) and patient-reported hip function following treatment for a chronic periprosthetic hip joint infection. The purpose of this study is to evaluate changes in HRQoL and patient-reported hip function 2 years following a cementless 1-stage revision for chronic periprosthetic hip joint infection. METHODS: Patients (n = 52) enrolled in a previously published clinical study on cementless 1-stage revision in chronic periprosthetic hip joint infection prospectively answered the EuroQol-5D, Short-Form Health Survey 36 (SF-36), and Oxford Hip Score preoperatively and at 3, 6, 12, and 24 months follow-up. Results were compared to age-matched and gender-matched population norm. RESULTS: A significant improvement in HRQoL and patient-reported hip function appeared in the first 3 months after surgery and reached a plateau after 6 months. The patients statistically reached age-matched and gender-matched population norm after 3 to 12 months follow-up on most items, except for Physical Functioning and Social Functioning on the SF-36. The largest effect sizes were found for Oxford Hip Score at 1.8 and for Role Limitation, Physical and Bodily Pain on the SF-36 at 1.5 and 1.6, respectively. CONCLUSION: Patients treated with a cementless 1-stage revision for chronic periprosthetic hip joint infection experienced a marked increase in HRQoL and patient-reported hip function, and matched population norms on many parameters.