Clinical Relevance of Patient-reported Outcomes – the Cardiologists’ Perspective

Abstract

Reductions in cardiovascular disease (CVD) mortality and morbidity are intended as major targets in cardiology. However, patient-reported outcomes (PROs) such as symptoms of angina or dyspnoea and improvement of health-related quality of life (HRQL) are increasingly accepted as treatment targets for patients with CVD. An important issue is whether information for health care decision making can be derived from HRQL assessment and analyses. We found that increased mortality and poor HRQL scores in patients with ischemic heart disease are associated making information on the relative impact on HRQL of different CVD diagnoses and treatments important. We have found that assessment of HRQL in routine clinical practice to be of limited value in making initial treatment decisions but provides clinical cardiologists with useful additional information about a patient’s perception of comprehensive treatment and the impact of different interventions for the same disease. The major issue remaining is whether HRQL provides sufficient valuable information for cardiologists in routine clinical practice. Currently treatment decisions are primarily determined by haemodynamics or expected prognosis of the disease. However, PRO measures provide additional useful information in the clinical decision-making process and in assessing the benefits of treatment.