Measuring outcomes in primary care: a patient generated measure, MYMOP, compared with the SF-36 health survey.

BMJ (Clinical research ed.). 1996;312(7037):1016-20

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Plain language summary

The patient's personal experience of illness, as well as the influence of the wide variety of help and treatments they seek, needs to be incorporated into the measurement process. The aim of the study was to test the instrument, the "measure yourself medical outcome profile"—MYMOP—alongside the SF-36 health survey for responsiveness, validity, and clinical usefulness in primary care. The study’s sample consisted of 265 patients, of whom 218 were recruited by general practitioners and 47 by complementary practitioners. MYMOP was designed and piloted in the practice over four months. It consists of four items, each scored by the patient on a seven-point scale. Results indicate that the instrument was applicable to all patients presenting with symptoms to conventional and complementary practitioners, and it elicited high response and completion rates. Responsiveness to change of the SF-36 health survey was poor no matter what the method of assessment. Authors conclude that the MYMOP questionnaire and chart can be used to visually chart progress and quantify outcomes in case studies.

Abstract

OBJECTIVE To assess the sensitivity to within person change over time of an outcome measure for practitioners in primary care that is applicable to a wide range of illness. DESIGN Comparison of a new patient generated instrument, the measure yourself medical outcome profile (MYMOP), with the SF-36 health profile and a five point change score; all scales were completed during the consultation with' practitioners and repeated after four weeks. 103 patients were followed up for 16 weeks and their results charted; seven practitioners were interviewed. SETTING Established practice of the four NHS general practitioners and four of the private complementary practitioners working in one medical centre. SUBJECTS Systematic sample of 218 patients from general practice and all 47 patients of complementary practitioners; patients had had symptoms for more than seven days. OUTCOME MEASURES Standardised response mean and index of responsiveness; view of practitioners. RESULTS The index of responsiveness, relating to the minimal clinically important difference, was high for MYMOP 1.4 for the first symptom, 1.33 for activity, and 0.85 for the profile compared with < 0.45 for SF-36. MYMOP's validity was supported by significant correlation between the change score and the change in the MYMOP score and the ability of this instrument to detect more improvement in acute than in chronic conditions. Practitioners found that MYMOP was practical and applicable to all patients with symptoms and that its use increased their awareness of patients' priorities. CONCLUSION MYMOP shows promise as an outcome measure for primary care and for complementary treatment. It is more sensitive to change than the SF-36 and has the added bonus of improving patient-practitioner communication.

Lifestyle medicine

Fundamental Clinical Imbalances : Neurological
Patient Centred Factors : Triggers/Impact assessment
Environmental Inputs : Mind and spirit
Personal Lifestyle Factors : Not applicable
Functional Laboratory Testing : Not applicable

Methodological quality

Allocation concealment : Not applicable

Metadata

Nutrition Evidence keywords : Measure yourself medical outcome profile ; MYMOP