Patient-Reported Outcomes (Pros) in Surgical Humanitarian Missions to Low- And Middle-Income Countries: A Scoping Review

Cheng H, Webster F, Platt J, Causarano N, Baxter NN and Zhong T

Department of Surgery, University of Toronto, Canada
Departments of Family and Community Medicine, University of Toronto, Canada
Institute of Health Policy, Management, and Evaluation, University of Toronto, Canada
Departments of Surgery and Surgical Oncology, University Health Network, Canada
Department of Surgery and Keenan Research Centre, Li Ka Shing Knowledge Institute, Canada
Institute for Clinical Evaluative Studies (ICES), Canada

^*Correspondance to: Toni Zhong 

 PDF  Full Text DOI: 10.25107/2474-1647.1032

Abstract

Background: Every year, health care personnel from developed nations travel to low- and middleincome countries (LMICs) to provide free surgical care to the local population. While the number of procedures performed by surgical humanitarian missions continues to increase, their impact on patients and their communities is not fully known. In particular, patient-reported outcome (PRO) reporting is lacking in surgical humanitarian missions.Methods: A scoping review was conducted on PROs in surgical humanitarian mission to summarize the existing body of knowledge and identify gaps. The findings were presented at a plenary meeting of the Surgical Missions Outcomes Working Group.Results: There were 43 articles in the literature that reported PROs from surgical humanitarian missions. The majority of studies (81%) were retrospective, and 12% were prospective. Sample sizes ranged from 15 to 18,653 patients. Short-term outcomes were reported in 62% of studies, intermediate outcomes in 41%, and long-term outcomes in 18%. Complication rates (81%) and performance indicators (72%), known as process indicators, were the most common outcome measures reported. Only four studies (9%) collected PROs and in none of the studies were the patient-reported outcome measures (PROMs) validated or pre-tested. At the plenary meeting, working group members reached a consensus that systematic reporting of all relevant mission outcomes and PROs in particular, is currently lacking and requires further research.Conclusions: There is a paucity of literature on PROs for surgical humanitarian missions, with studies reporting mostly process indicators and lacking in long-term follow-up. More research is critically needed to validate existing PROMs or create new ones. Stakeholders involved in surgical humanitarian missions are urged to become aware of the multi-dimensional impact of their activities on patients and communities.

Keywords

Cite the article

Cheng H, Webster F, Platt J, Causarano N, Baxter NN, Zhong T. Patient- Reported Outcomes (Pros) in Surgical Humanitarian Missions to Low- And Middle-Income Countries: A Scoping Review. Clin Surg. 2016; 1: 1032.