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A brief patient-reported outcome instrument for primary care: German translation and validation of the Measure Yourself Medical Outcome Profile (MYMOP).
Hermann, K, Kraus, K, Herrmann, K, Joos, S
Health and quality of life outcomes. 2014;12:112
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Plain language summary
Patient-reported outcomes (PROs) are important tools for evaluating the effectiveness of patient-centred care. The Measure Yourself Medical Outcome Profile (MYMOP) is a short 4-item questionnaire which allows patients themselves to nominate up to two symptoms that are concerning them most, and to subjectively assess the change of these symptoms over time following a therapeutic intervention. The aim of this study was to translate the MYMOP from English into German and pilot its use in a primary care setting. 567 participants (476 patients from 34 general practices and 91 patients from 11 CAM practices) were included in this study and completed a MYMOP questionnaire as well as a quality of life questionnaire (called EQ-5D). Out of these, 341 patients (60.1%) completed follow-up questionnaires. 161 of the follow-up patients also rated the change of symptoms on direct questioning on a scale from “much better” to “much worse”. The validity of the German translation of the MYMOP was shown by a high correlation between MYMOP-D and EQ-5D and patient reported change of symptoms. Due to only a small number of patients reporting a worsening of symptoms, validity was only established for patients whose symptoms improved or stayed the same. The authors conclude that the MYMOP-D proved to be a valid tool for assessing patient-centred care and because of its brevity and simplicity, could easily be incorporated into primary health care settings.
Abstract
BACKGROUND Measure Yourself Medical Outcome Profile (MYMOP) is a patient-generated outcome instrument capable of measuring effects from a wide range of health care interventions. This paper reports the translation of this instrument into German (MYMOP-D) and the assessment of validity and sensitivity to change for the MYMOP-D. The instrument was piloted in a German primary care context. METHODS The translation process was conducted according to international guidelines. Recruited patients of both general practitioners and non-medical Complementary and Alternative Medicine (CAM) practitioners ("Heilpraktiker") in the German state of Baden-Wuerttemberg completed a questionnaire comprised of the MYMOP-D and the EQ-5D. Responses were analysed to assess construct validity. For assessing the instrument's sensitivity to change, patients received the MYMOP-D again after four weeks at which point they were also asked for their subjective views on change of symptoms. Correlation between MYMOP-D and EQ-5D and sensitivity to change as gradient in score change and as standardized response mean (SRM) were calculated. RESULTS 476 patients from general practices and 91 patients of CAM practitioners were included. Construct validity of the MYMOP-D was given with a correlation of r = .47 with the EQ-5D. Sensitivity to change for subjective change of symptoms could only be analysed for improvement or no change of symptoms, as only 12 patients reported deterioration of symptoms. Results showed the expected smooth gradient with 2.2, 1.3, and 0.5 points of change for large, little improvement and no change, respectively. SRM for MYMOP-D Profile Score was 0.88. CONCLUSIONS The MYMOP-D shows excellent construct validity. It is able to detect changes when symptoms in patients improve or remain unchanged. Deterioration of symptoms could not be evaluated due to too few data. With its brevity and simplicity, it might be an important tool for enhancing patient-centred care in the German health care context.