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Patient-reported outcomes

Health care can be improved when patients share how a treatment has impacted their life. Patient-reported outcome measures provide a way of measuring health outcomes from the patient's perspective.

Why do we measure outcomes from the patient’s perspective?

Patients are personally affected by health outcomes. Their quality of life, daily functioning, symptoms, and other aspects of their health and wellbeing can be impacted for better or worse.

By measuring health outcomes reported by patients, health professionals can see if treatment has led to positive or negative impacts for that patient.

Health professionals can then use this feedback to reconsider or introduce different treatments, establish better safety and quality measures if needed, and provide overall better person-centred care.
 

How do we measure patient-reported outcomes?

Health outcomes from patient’s perspective are measured by collecting patient-reported outcome measures (PROMs), which are questionnaires that focus on various aspects of a patient’s health, such as symptoms, daily functioning, and quality of life.

These questionnaires are usually completed on two or more occasions to see comparisons over time and they typically ask patients to respond using rating scales.

There are typically two categories of PROMs:

Generic PROMs measure aspects of health that most patients have in common or are expected to experience, and can be used across health conditions, treatments and populations.

Specific PROMS which can be:

  • Condition-specific PROMs that have questions directly relating to specific health conditions and their associated treatments. For example, some PROMs enable patients to report the severity of the symptoms.
  • Population-specific PROMs that apply to specific service sectors or segments of the population. For example, some PROMs have been designed to be used with children.

PROMs are different from patient-reported experience measures (PREMs) in that PREMs measure a patient’s experience when receiving care and PROMs measure the outcomes.
 

Selecting a patient-reported outcome measure

Patient-reported outcome measures (PROMs) can serve many purposes. They can enhance interactions between patients and health professionals, compare the effects of different treatments, identify variation among healthcare providers, and can be used for population surveillance and informing policy. 

There are hundreds of PROMs available so it’s important to spend time considering which PROM is right for you and your patient.

Download our lists of PROMs
 

Key considerations

Before selecting a PROM, you need to be clear about why you’re collecting the information.

Both types have benefits, and many programs use a generic PROM plus a condition‑specific PROM.

  • Generic PROMs look at health issues that apply to most people.
    • Useful across different illnesses, treatments, and patient groups.
    • Help compare the impact of one condition or treatment with another.
  • Specific PROMs are designed for one condition or patient group.
    • Ask questions that matter more to that group.
    • Detect small but meaningful changes in their health.

Many PROMs have been carefully tested to make sure:

  • They measure what they’re supposed to (validity).
  • They give consistent results (reliability).
  • They can pick up changes over time (responsiveness).

Changing the questions by adding, removing, or rewriting them can weaken the measure and make results unreliable or impossible to compare with standard versions.
If wording isn’t suitable for your patients (for example, unfamiliar terms), it’s better to choose a different PROM or get expert advice before making changes.

Do the questions matter to patients?

PROMs should ask about outcomes that patients actually care about. When questions reflect their experiences and priorities, patients are more likely to complete them.

Are they easy for patients to use?

PROMs should be:

  • Easy to understand
  • Free of jargon
  • Short enough to complete in about 12–15 minutes
  • Accessible to people with low literacy, who speak other languages, who have cognitive or vision challenges, or who need alternative formats

Avoid duplication

Using both generic and specific PROMs can be helpful data but can also result in asking the same questions. Patients may get frustrated if they feel they’re repeating themselves.

Ways to collect PROMs

Patients can complete PROMs:

  • Online
  • On tablets in clinic
  • On paper
  • By interview (in person or by phone)

Electronic options make collection and processing faster and easier.

Fitting PROMs into clinical workflows

Whatever method you use, it must work smoothly within routine clinical processes. Getting PROMs completed and processed in time for consultations can be challenging, but new digital solutions are making this easier.

Who helps collect and process PROMs?

Depending on the setting, PROMs may be managed by:

  • Specialised staff (e.g., in registries)
  • Clinical team members
  • Automated digital systems

Using smartphones or clinic‑based devices can streamline both collection and, in some cases, processing.

In clinical care

PROMs results should be easy for clinicians and patients to read and understand. The scores should lead to clear actions. For example:

  • Better‑than‑expected physical recovery might lead to updating a recovery plan.
  • Worse‑than‑expected mental health scores might prompt a discussion or referral.

PROMs work best when combined with other clinical information.

In quality improvement and policy

When PROMs are used for system‑level purposes, results are usually analysed at a group level, not per patient. Advanced analysis, such as risk adjustment, is often used so comparisons between healthcare providers are fair.

PROMs results can be compared with:

  • The patient’s past scores
  • Scores from large groups of similar people

Norms are often available for the general population and for people with specific health conditions. These comparisons help show how a patient is doing relative to others.

PROM Recommendations

There are hundreds of well‑tested PROMs available, and new ones are being developed all the time. To help clinicians and health services choose the right PROMs for specific health conditions, we have created evidence‑based recommendations that explain:

  • which outcomes matter most to people with a particular condition
  • which existing PROMs best measure those outcomes
  • when these PROMs should be collected

PROM Recommendations for Low Back Pain

Low back pain affects most people at some point in their lives. It often leads to psychological distress, poorer quality of life, and is the leading case of disability worldwide. 

Using patient-reported outcome measures (PROMs) can support clinicians to:

How we develop condition-specific PROM recommendations

A literature review is conducted to identify existing PROMs that are collected from people with a specified condition.

An environmental scan is conducted to identify existing PROM collection practices, programs, and standards across Australia and internationally. This scan is supplemented by informant interviews conducted with experts in collecting and using PROMs for the specified condition.

An environmental scan is conducted to identify existing PROM collection practices, programs, and standards across Australia and internationally. This scan is supplemented by informant interviews conducted with experts in collecting and using PROMs for the specified condition.

Based on the findings of the literature review and environmental scan, candidate PROMs are identified and assessed on its psychometric properties such as reliability and construct validity.

A panel consisting of clinicians and lived experience consumers considers findings from the literature review, environmental scan, and psychometric assessment to build consensus on PROMs to collect for the specified condition. The panel assess candidate PROMs against criteria such as interpretability and clinical relevance. The panel also considers alignment with best practices in existing programs in Australia and internationally. The panel provides advice on time points for administration of PROMs and how to meet diverse needs.

The Commission publishes recommendations on patient reported outcomes that are important to patients with the specific condition, and what PROMs to use to measure those outcomes.

Recommendations are based on current evidence and practices and input from clinicians with extensive experience using PROMs in their clinical practice. It is expected that new evidence and validation studies will emerge over time that either support recommended PROMs or support newer PROMs that demonstrate superior psychometric properties. The Commission will review and refine its recommendations as more high-quality evidence and validation studies are published, and PROM collection practices evolve.

Last updated: 13 March 2026