Capturing and missing the patient's story through outcome measures: a thematic comparison of patient-generated items in PSYCHLOPS with CORE-OM and PHQ-9

Background: There is increasing interest in individualized patient-reported outcome measures (I-PROMS), where patients themselves indicate the specific problems they want to address in therapy and these problems are used as items within the outcome measurement tool. Objective: This paper examined the extent to which 279 items reported in an I-PROM (PSYCHLOPS) added qualitative information which was not captured by two well-established outcome measures (CORE-OM and PHQ-9). Design: Comparison of items was only conducted for patients scoring above the "caseness" threshold on the standardized measures. Setting and patients: 107 patients were participating in therapy within addiction and general psychiatric clinical settings. Main results: Almost every patient (95%) reported at least one item whose content was not covered by PHQ-9, and 71% reported at least one item not covered by CORE-OM. Discussion: Results demonstrate the relevance of individualized outcome assessment for capturing data describing the issues of greatest concern to patients, as nomothetic measures do not always seem to capture the whole story.