PROMs Need PRIMs: Standardised Outcome Measures Lack the Preference-Sensitivity Needed in Person-Centred Care

A growing number of condition-specific standard outcome sets have been developed by the International Consortium for Health Outcomes Measurement in pursuit of ‘value-based care’. These sets embrace many Patient-Reported Outcome Measures (PROMs), reflecting a simultaneous commitment to ‘patient-centred care’. However, none of these sets embody recognition of the preference-sensitive nature of the decisions that eventually generate the outcome database. ‘Patient-Reported Importance Measures’ (PRIMs) are the valid source of the required preferences. The ICHOM Stroke standard set is input into a hypothetical Multi-Criteria Decision Analysis-based decision support tool to provide simple confirmation that PROMs should be preference-mix adjusted as well as case-mix adjusted. PROMs need PRIMs if value-based care is to be personalised values-based care.