Economy · June 24, 2022

What is a “Patient Centered Central Impact Set”? – Health economist

Patients want new treatments to improve their quality of life. However, do the typical patient-reported outcomes adequately capture the impact of the new treatment on the factors patients care about most? An article by Perfetto et al. (2022) argues that the answer is “no”.

The article notes that not only do patients desire better functional status, but also fewer days in the hospital and avoid cases where there is “inability to plan” and work / school interruptions. “In addition, the other proposes development of Patient Centered Central Impact Sets (PC-CIS) What is PC-CIS?

… patient-centered central impact set (PC-CIS) [are] a patient-derived and patient-priority list of the impacts a disease and / or its treatments have on a patient (and / or their family and caregivers). Intentionally broad and inclusive, the term “impacts” includes short- and long-term health outcomes and any other related implications (eg, caregiver / family stress, financial burdens, career loss).

The authors group impacts into disease-related impacts (eg, quality of life, functional status), treatment-related impacts (eg, adverse events, risk of failure), financial (eg, impact career, insurance coverage) and impact on family / caregiver (eg, stress on family, commitment of family time). A number of core result sets (COS) have been developed; in fact, the University of Liverpool’s Core Outcome Measures in Effectiveness Trials (COMET) Initiative hosts a database of published COSs. To move from COS to PC-CIS with priority, the article mentions the National Health Council (NHC) framework for developing a PC-CIS (shown in the figure below).

There are a number of challenges to implementing PC-CIS. These include (i) PC-CIS may need to be developed for each disease, which is a challenge due to the volume of diseases, (ii) PC-CIS for each disease may also vary by country, (iii) exists the lack of a standardized process for the development of PC-CIS and (iv) it is not clear which institute (s) should be responsible for the development of PC-CIS. Despite these challenges, properly measuring the impact of treatments on the outcomes that patients care about most is a laudable goal.