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Professor Jose Valderas

Professor of Health Services and Policy Research

2755

+44 (0) 1392 722755

Smeall building

Smeall Building, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK

Overview

I am an Academic General Practitioner, with a commitment to research on patient centred care that is relevant for decision making in clinical practice and health policy. I lead the Health Services & Policy Research Group at the University of Exeter Medical School. I am the lead for Education and Training at the Exeter Collaboration for Academic Primary Care (APEx) and a member of the NIHR Applied Research Collaboration South West Peninsula (PenARC).

My current research interests focus on the use of patient reports on their own health for decision making in clinical practice and health policy, and the improvement of processes of care (quality and safety), with a particular interest in patients with multiple conditions. I have been awarded a Clinician Scientist Award awarded by the National Institute of Health Research (NIHR), UK, for a research programme on the use of patient reported outcome measures (PROMs) in improving primary care for people with multi-morbidity. I have participated in over 30 research projects and have authored over 200 publications, including papers, books and book chapters, editorials, letters, and scientific communications. I serve as Field Chief Editor for Frontiers in Health Services.

Since completing my training as a General Practitioner I have maintained active clinical practice in different countries and in a variety of environments, including developing countries for very brief periods. I am also devoted to postgraduate teaching, particularly in areas where research meets clinical practice (Clinical Epidemiology and Evidence Based Practice).

Broad Research Specialisms

My main areas of expertise are in patient centred care, with a particular focus on the use of measures of Patient Reported Outcomes and Experiences (development, adaptation, application, interpretation and clinical applications of PROMs, qualitative methods for content generation, psychometrics and quantitative analyses (classical test theory and Item Response Theory Models), and appraisal of instruments), multi- and co-morbidity, and quality and safety in Primary Care.

Qualifications

• BMBS (University of Barcelona, Spain)
• General Practitioner (Department of Education, Spain)
• MPH (Pompeu Fabra University, Spain)
• PhD (Pompeu Fabra University, Spain)

Career

After combining my PhD (IMIM-Hospital del Mar and Pompeu Fabra University) and my training as a General Practitioner in Barcelona, Spain, I started my post-doctoral research at the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health under the supervision of the late Prof. Barbara Starfield. I then joined the National Primary Care Research and Development Centre, University of Manchester led by Prof. Martin Roland, and in 2010 arrived at the Nuffield Department of Primary Care Health Sciences at the University of Oxford to set up and lead the Health Services and Policy Research Group. In September 2013, I was appointed Chair in Health Services and Policy Research at the University of Exeter Medical School.

For a list of publications with citations, please see here

Research group links

Research

Research interests

Jose's main interest is in the further development of models of care that ensure that care is truly centred around the patients. To that aim his current interests are in Patient Reported Outcomes and Experiences Measurement (with a particular focus on the combined use of individualised and standardized measures), models of care for chronic conditions (with a focus on multi- and co-morbidity), and quality and safety in Primary Care.

Research projects

Improving the management of long term conditions with the clinical use of patient reported outcome measures in Primary Care
National Institute for Health Research, £996,226.00; 1 March 2011-28 February 2016
Role: Principal Investigator (PI)

Functionality and feedback: A realist synthesis of the collation, intepretation and utilisation of PROMs data to improve patient care
NIHR Service Delivery and Organization Programme, £202,881.6, Sart Date 1/1/2014-1/7/2015.
Role: Co-Applicant (PI: Prof. J Greenhalgh, University of Leeds, UK)

Information and value-based commissioning
NIHR Service Delivery and Organization Programme, £518,247, Support period: 2012-2014
Role: Co-applicant (PI: Dr. Barry MacCormick, University of Oxford, UK)

Introducing standardised and evidence based thresholds for hip and knee replacement surgery - the arthroplasty candidacy help engine (the ACHE tool).
National Institute for Health Research, Health Technology Assessment Programme, UK. £799,189 Support period: 1 September 2013-31 August 2016
Role: Co-applicant (PI: Prof. Andrew Price, University of Oxford, UK)

Systems of care and outcomes in TIA and minor stroke in the Hunter Valley, New South Wales
National Health and Medical Research Council, Australia APP1027794; AU$ 1,173,380 (ap. £750K)
Period: 1 January 2012-31 December 2015
Role: Co-applicant (PI: Christopher Levi, University of Newcastle, Australia)

Primary Care Prevention and Health Promotion Research Network
Carlos III Research Institute, Spain: €3,022,478.53
Role: Co-Investigator (PI: Bolivar B, IDIAP Primary Care Research Institute)

Quality and Outcomes of Care for Chronic Conditions in Older Patients Diagnosed with Breast, Colorectal, or Prostate Cancer Compared to Non-Cancer Controls: An Observational Study Using the Clinical Practice Research Datalink (CPRD).
Funder: Cancer Research UK (£296,000.0)
Support period: 1 July 2013-31 December 2015
Role: PI

Prioritising and optimising multiple medications in elderly multi-morbid patients in general practice (PRIMUM). - A pragmatic cluster-randomised controlled trial.
BundesMinisterium fuer Bildung und Forschung, €500,860.00
Period: 1 March 2010-28 February 2012
Role: Scientific Advisory Board (PI: Dr C Muth, Johann Wolfgang Goethe University, Frankfurt am Main, Germany)
Web: http://clinicaltrials.gov/ct2/show/NCT01171339

Developing, testing and implementing the NSPCR Patient Safety Toolkit in general practices in England.
NIHR School for Primary Care Research, England; £569,740.0; 1 October 2011-31 Dec. 2013
Role: Co-applicant (PI: Prof. Tony Avery, University of Nottingham, UK)

Patients’ perspectives and understanding of high-performing, safety conscious general practice: an exploratory study
Support period: 2012-2013, £139,959
NIHR School for Primary Care Research
Role: Co-applicant (PI: Dr. Stephen Campbell, University of Manchester, UK)

An investigation of the Quality and Outcomes Framework (QOF) using the General Practice Research Database (GPRD)
Support period: 2012-2014, £55,523.0
NIHR School for Primary Care Research
Role: Co-applicant (PI: Dr. Evan Kontopantelis, University of Manchester, UK)

Grants/Funding

Patterns of co-morbidity and poly-pharmacy in Primary Care in Catalonia, Spain
Instituto de Salud Carlos III, Spain (PI12/00427): €48,400.00
Period: 1 October 2011-31 December 2012.
Role: Co-Applicant (PI: Dr. Quinti Foguet, IDIAP Jordi Gol, Barcelona, Spain

BiblioPRO: virtual library of patient reported outcomes
RecerCaixa, €99,732.25; 1 January 2011-31 December 2012
Role: Co-Applicant (PI: Prof. J Alonso, Universitat Pompeu Fabra, Spain)
Web: http://bibliopro.imim.es

Safety netting to improve early cancer diagnosis in primary care: development of consensus guidelines.
Department of Health, £19,990.00
Period: 1 January 2011-1 June 2011
Role: Co-Applicant (PI: Dr. C Bankhead, University of Oxford, UK)

Attribution of Patient Reported Outcomes to the effects of care providers
Medical Research Council, £337,675.00; 1 April 2010-31 March 2013
Role: Co-Applicant (PI: Prof. M Sutton, University of Manchester, UK)

Patient and professional experience of managing co-morbid long-term conditions in primary care
NIHR School of Primary Care Research, £200,206.00.
Support period: 2010-2013
Role: Co-applicant (PI: Prof C Salisbury, University of Bristol, UK)
Web: http://www.nspcr.ac.uk/rP3.43

Health status evaluation of the general Spanish population using the International Classification of Functioning, Disability and Health (ICF)
Fondo de Investigación Sanitaria, Spain (PI 061579 and PI 051542)
Role: Co-Applicant (PI: Dr. Montse Ferrer, IMIM-Hospital del Mar, Spain)
Web: http://www.imim.es/programesrecerca/epidemiologia/en_cifrecerca.html

Trajectories of perceived health and use of health care services in a Spanish population sample of children and adolescents 8 to 18 years old.
Instituto de Salud Carlos III, Spain (Red IRYSS G03/202) and Fondo de Investigación Sanitaria (PI042504 y PI042315)
Role: Co- Applicant (Co-PI: Prof. Jordi J Alonso, Universitat Pompeu Fabra, Spain; Dr. Luis Rajmil, Agència d’Avaluació de Tecnologia Mèdica, Spain)

Development, application, and validation of a new tool for the standardized evaluation of patient reported outcome measures (EMPRO)
Instituto de Salud Carlos III, Spain (Red de Investigación Cooperativa IRYSS, G03/202 and CM 300118), PI06/90483 and ETE06/450104884), CIBERESP – MET010)
Role: Co-Applicant (PI: Dr. Montse Ferrer, IMIM-Hospital del Mar, Spain)

RED IRYSS (Health and Health Services Outcomes Research Network)
Instituto de Salud Carlos III, Spain (G03/202)
Support period: 2002-2006
Role: Co-Applicant (PI: Dr JMV Pons, Agència d’Avaluació de Tecnologia Mèdica, Spain)

Developing priority criteria for patients on waiting lists for cataract surgery and hip and knee arthroplasty in Catalonia, Spain
Fondo de Investigación Sanitaria, Spain (01/0921)
Period: 1999-2002
Role: Co-Applicant (PI: Dr. M Espallargues, Agència d’Avaluació de Tecnologia Mèdica, Spain).

Publications

Key publications | Publications by category | Publications by year

Publications by category

Journal articles

Hjollund NHI, Valderas JM, Kyte D, Calvert MJ (In Press). Health Data Processes: a Framework for Analyzing and Discussing Efficient Use and Reuse of Health Data with a Focus on Patient-Reported Outcome Measures (Preprint).

. UNSTRUCTURED
. The collection and use of patient health data are central to any kind of activity in the health care system. These data may be produced during routine clinical processes or obtained directly from the patient using patient-reported outcome (PRO) measures. Although efficiency and other reasons justify data availability for a range of potentially relevant uses, these data are nearly always collected for a single specific purpose. The health care literature reflects this narrow scope, and there is limited literature on the joint use of health data for daily clinical use, clinical research, surveillance, and administrative purposes. The aim of this paper is to provide a framework for discussing the efficient use of health data with a specific focus on the role of PRO measures. PRO data may be used at an individual patient level to inform patient care or shared decision making and to tailor care to individual needs or group-level needs as a complement to health record data, such as that on mortality and readmission, in order to inform service delivery and measure the real-world effectiveness of treatment. PRO measures may be used either for their own sake, to provide valuable information from the patient perspective, or as a proxy for clinical data that would otherwise not be feasible to collect. We introduce a framework to analyze any health care activity that involves health data. The framework consists of four data processes (patient identification, data collection, data aggregation and data use), further structured into two dichotomous dimensions in each data process (level: group vs patient; timeframe: ad hoc vs systematic). This framework is used to analyze various health activities with respect to joint use of data, considering the technical, legal, organizational, and logistical challenges that characterize each data process. Finally, we propose a model for joint use of health data with data collected during follow-up as a base. Demands for health data will continue to increase, which will further add to the need for the concerted use and reuse of PRO data for parallel purposes. Repeated and uncoordinated PRO data collection for the same patient for different purposes results in misuse of resources for the patient and the health care system as well as reduced response rates owing to questionnaire fatigue. PRO data can be routinely collected both at the hospital (from inpatients as well as outpatients) and outside of hospital settings; in primary or social care settings; or in the patient’s home, provided the health informatics infrastructure is in place. In the future, clinical settings are likely to be a prominent source of PRO data; however, we are also likely to see increased remote collection of PRO data by patients in their own home (telePRO). Data collection for research and quality surveillance will have to adapt to this circumstance and adopt complementary data capture methods that take advantage of the utility of PRO data collected during daily clinical practice. The European Union’s regulation with respect to the protection of personal data—General Data Protection Regulation—imposes severe restrictions on the use of health data for parallel purposes, and steps should be taken to alleviate the consequences while still protecting personal data against misuse.
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Abstract.

Valderas Martinez JM, Hjollund NHI, Kyte D, Calvert MJ (In Press). Health data processes. A framework for analysing and discussing efficient use and reuse of health data with focus on Patient Reported Outcome (PRO) measures. Journal of Medical Internet Research Full text.

Lloyd H, Wheat H, Horrell J, Sugavanam T, Fosh B, Valderas JM, Close J (In Press). Patient-Reported Measures for Person-Centered Coordinated Care: a Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation.

. BACKGROUND
. Patient-reported measure (PRM) questionnaires were originally used in research to measure outcomes of intervention studies. They have now evolved into a diverse family of tools measuring a range of constructs including quality of life and experiences of care. Current health and social care policy increasingly advocates their use for embedding the patient voice into service redesign through new models of care such as person-centered coordinated care (P3C). If chosen carefully and used efficiently, these tools can help improve care delivery through a variety of novel ways, including system-level feedback for health care management and commissioning. Support and guidance on how to use these tools would be critical to achieve these goals.
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. OBJECTIVE
. The objective of this study was to develop evidence-based guidance and support for the use of P3C-PRMs in health and social care policy through identification of PRMs that can be used to enhance the development of P3C, mapping P3C-PRMs against an existing model of domains of P3C, and integration and organization of the information in a user-friendly Web-based database.
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. METHODS
. A pragmatic approach was used for the systematic identification of candidate P3C-PRMs, which aimed at balancing comprehensiveness and feasibility. This utilized a number of resources, including existing compendiums, peer-reviewed and gray literature (using a flexible search strategy), and stakeholder engagement (which included guidance for relevant clinical areas). A subset of those candidate measures (meeting prespecified eligibility criteria) was then mapped against a theoretical model of P3C, facilitating classification of the construct being measured and the subsequent generation of shortlists for generic P3C measures, specific aspects of P3C (eg, communication or decision making), and condition-specific measures (eg, diabetes, cancer) in priority areas, as highlighted by stakeholders.
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. RESULTS
. In total, 328 P3C-PRMs were identified, which were used to populate a freely available Web-based database. of these, 63 P3C-PRMs met the eligibility criteria for shortlisting and were classified according to their measurement constructs and mapped against the theoretical P3C model. We identified tools with the best coverage of P3C, thereby providing evidence of their content validity as outcome measures for new models of care. Transitions and medications were 2 areas currently poorly covered by existing measures. All the information is currently available at a user-friendly web-based portal (p3c.org.uk), which includes all relevant information on each measure, such as the constructs targeted and links to relevant literature, in addition to shortlists according to relevant constructs.
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. CONCLUSIONS
. A detailed compendium of P3C-PRMs has been developed using a pragmatic systematic approach supported by stakeholder engagement. Our user-friendly suite of tools is designed to act as a portal to the world of PRMs for P3C, and have utility for a broad audience, including (but not limited to) health care commissioners, managers, and researchers.
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Abstract.

Arias-de la Torre J, Puigdomenech E, García X, Valderas JM, Eiroa-Orosa FJ, Fernández-Villa T, Molina AJ, Martín V, Serrano-Blanco A, Alonso J, et al (In Press). Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review (Preprint). Abstract.

Allan L, Corbett A, Valderas Martinez J (In Press). Social prescribing programmes to prevent or delay frailty in community-dwelling older adults. Geriatrics Full text.

Fellenor J, Britten N, Courtenay M, Payne RA, Valderas J, Denholm R, Duncan P, McCahon D, Tatnell L, Fitzgerald R, et al (2021). A multi-stakeholder approach to the co-production of the research agenda for medicines optimisation. BMC Health Services Research, 21(1). Abstract. Full text.

Arias de la Torre J, Ronaldson A, Valderas JM, Vilagut G, Serrano-Blanco A, Hatch SL, Alonso J, Hotopf M, Dregan A (2021). Diagnostic promiscuity: the use of real-world data to study multimorbidity in mental health. Br J Psychiatry, 1-3. Abstract. Author URL.

Ricci-Cabello I, Gangannagaripalli J, Mounce LTA, Valderas JM (2021). Identifying Factors Leading to Harm in English General Practices: a Mixed-Methods Study Based on Patient Experiences Integrating Structural Equation Modeling and Qualitative Content Analysis. Journal of Patient Safety, 17(1), e20-e27. Full text.

Arias de la Torre J, Vilagut G, Ronaldson A, Dregan A, Ricci-Cabello I, Hatch SL, Serrano-Blanco A, Valderas JM, Hotopf M, Alonso J, et al (2021). Prevalence and age patterns of depression in the United Kingdom. A population-based study. Journal of Affective Disorders, 279, 164-172. Full text.

Arias-de la Torre J, Eiroa-Orosa FJ, Molina AJ, Colell E, Dávila-Batista V, Moreno-Montero F, Robles N, Valderas JM, Martín V (2021). Relación del consumo problemático de cannabis en la población joven de España con el riesgo percibido, los factores ambientales y los factores sociodemográficos. Adicciones, 33(1), 63-63.

Arias-de la Torre J, Jose Eiroa-Orosa F, Molina AJ, Colell E, Davila-Batista V, Moreno-Montero F, Robles N, Valderas JM, Vicente-Martin (2021). Relationship of problematic cannabis use among youth in Spain with perceived risk, environmental factors and sociodemographic factors. ADICCIONES, 33(1), 63-69. Author URL.

Masoli M, Lanario JW, Hyland ME, Menzies-Gow A, Mansur AH, Allen D, Dodd JW, Hayes G, Valderas JM, Lamb SE, et al (2021). The Severe Asthma Questionnaire: sensitivity to change and minimal clinically important difference (MCID). European Respiratory Journal, 2100300-2100300.

la Torre JAD, Vilagut G, Serrano-Blanco A, Martín V, Molina AJ, Valderas JM, Alonso J (2020). Accuracy of self-reported items for the screening of depression in the general population. International Journal of Environmental Research and Public Health, 17(21), 1-10. Abstract.

Arias-de la Torre J, Valderas JM, Benavides FG, Alonso J (2020). Cardboard floor: about the barriers for social progression and their impact on the representativeness of epidemiological studies. Journal of Epidemiology and Community Health Full text.

Müller BS, Uhlmann L, Ihle P, Stock C, von Buedingen F, Beyer M, Gerlach FM, Perera R, Valderas JM, Glasziou P, et al (2020). Development and internal validation of prognostic models to predict negative health outcomes in older patients with multimorbidity and polypharmacy in general practice. BMJ Open, 10(10), e039747-e039747.

BackgroundPolypharmacy interventions are resource-intensive and should be targeted to those at risk of negative health outcomes. Our aim was to develop and internally validate prognostic models to predict health-related quality of life (HRQoL) and the combined outcome of falls, hospitalisation, institutionalisation and nursing care needs, in older patients with multimorbidity and polypharmacy in general practices.MethodsDesign: two independent data sets, one comprising health insurance claims data (n=592 456), the other data from the PRIoritising MUltimedication in Multimorbidity (PRIMUM) cluster randomised controlled trial (n=502). Population: ≥60 years, ≥5 drugs, ≥3 chronic diseases, excluding dementia. Outcomes: combined outcome of falls, hospitalisation, institutionalisation and nursing care needs (after 6, 9 and 24 months) (claims data); and HRQoL (after 6 and 9 months) (trial data). Predictor variables in both data sets: age, sex, morbidity-related variables (disease count), medication-related variables (European Union-Potentially Inappropriate Medication list (EU-PIM list)) and health service utilisation. Predictor variables exclusively in trial data: additional socio-demographics, morbidity-related variables (Cumulative Illness Rating Scale, depression), Medication Appropriateness Index (MAI), lifestyle, functional status and HRQoL (EuroQol EQ-5D-3L). Analysis: mixed regression models, combined with stepwise variable selection, 10-fold cross validation and sensitivity analyses.ResultsMost important predictors of EQ-5D-3L at 6 months in best model (Nagelkerke’s R² 0.507) were depressive symptoms (−2.73 (95% CI: −3.56 to −1.91)), MAI (−0.39 (95% CI: −0.7 to −0.08)), baseline EQ-5D-3L (0.55 (95% CI: 0.47 to 0.64)). Models based on claims data and those predicting long-term outcomes based on both data sets produced low R² values. In claims data-based model with highest explanatory power (R²=0.16), previous falls/fall-related injuries, previous hospitalisations, age, number of involved physicians and disease count were most important predictor variables.ConclusionsBest trial data-based model predicted HRQoL after 6 months well and included parameters of well-being not found in claims. Performance of claims data-based models and models predicting long-term outcomes was relatively weak. For generalisability, future studies should refit models by considering parameters representing well-being and functional status.

Abstract. Full text.

Arias-de la Torre J, Zioga EAM, Macorigh L, Muñoz L, Estrada O, Mias M, Estrada M-D, Puigdomenech E, Valderas JM, Martín V, et al (2020). Differences in Results and Related Factors Between Hospital-at-Home Modalities in Catalonia: a Cross-Sectional Study. J Clin Med, 9(5). Abstract. Author URL. Full text.

Violán C, Fernández-Bertolín S, Guisado-Clavero M, Foguet-Boreu Q, Valderas JM, Vidal Manzano J, Roso-Llorach A, Cabrera-Bean M (2020). Five-year trajectories of multimorbidity patterns in an elderly Mediterranean population using Hidden Markov Models. Scientific Reports, 10(1). Abstract. Full text.

Arias-de la Torre J, Alonso J, Martín V, Valderas JM (2020). Hospital-at-Home as an Alternative to Release the Overload of Healthcare Systems During the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic. J Am Med Dir Assoc, 21(7), 990-991. Author URL.

Rijken M, Valderas JM, Heins M, Schellevis F, Korevaar J (2020). Identifying high-need patients with multimorbidity from their illness perceptions and personal resources to manage their health and care: a longitudinal study. BMC Fam Pract, 21(1). Abstract. Author URL. Full text.

Arias-de la Torre J, Smith K, Dregan A, Valderas JM, Evans JP, Prieto-Alhambra D, Lozano L, Molina AJ, Martín V, Domingo L, et al (2020). Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty. BMC Musculoskeletal Disorders, 21(1). Full text.

Aith F, Castilla Martínez M, Cho M, Dussault G, Harris M, Padilla M, Tomblin Murphy G, Tomlin P, Valderas JM (2020). Is COVID-19 a turning point for the health workforce?. Revista Panamericana de Salud Pública, 44, 1-1. Full text.

Oemrawsingh A, Swami N, Valderas JM, Hazelzet JA, Pusic AL, Gliklich RE, Bergmark RW (2020). Patient-Reported Morbidity Instruments: a Systematic Review. Value in Health, 23(6), 791-811. Abstract. Full text.

van Oppen JD, Valderas JM, Mackintosh NJ, Conroy SP (2020). Patient-reported outcome and experience measures in geriatric emergency medicine. Zeitschrift fuer Gerontologie und Geriatrie: Organ der Deutschen Gesellschaft fuer Gerontologie und Geriatrie Full text.

Klapproth CP, van Bebber J, Sidey-Gibbons CJ, Valderas JM, Leplege A, Rose M, Fischer F (2020). Predicting EQ-5D-5L crosswalk from the PROMIS-29 profile for the United Kingdom, France, and Germany. Health and Quality of Life Outcomes, 18(1). Abstract. Full text.

Bowman K, Jones L, Masoli J, Mujica-Mota R, Strain D, Butchart J, Valderas JM, Fortinsky RH, Melzer D, Delgado J, et al (2020). Predicting incident delirium diagnoses using data from primary-care electronic health records. Age Ageing, 49(3), 374-381. Abstract. Author URL. Full text.

Arias-de la Torre J, Puigdomenech E, García X, Valderas JM, Eiroa-Orosa FJ, Fernández-Villa T, Molina AJ, Martín V, Serrano-Blanco A, Alonso J, et al (2020). Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review. Journal of Medical Internet Research, 22(8), e16388-e16388. Abstract. Full text.

Tomari S, Magin P, Lasserson D, Quain D, Valderas JM, Dewey HM, Barber PA, Spratt NJ, Cadilhac DA, Feigin VL, et al (2020). The Characteristics of Patients with Possible Transient Ischemic Attack and Minor Stroke in the Hunter and Manning Valley Regions, Australia (the INSIST Study). Frontiers in Neurology, 11 Abstract. Full text.

Leiva-Fernández F, Prados-Torres JD, Prados-Torres A, del-Cura-González I, Castillo-Jimena M, López-Rodríguez JA, Rogero-Blanco ME, Lozano-Hernández CM, López-Verde F, Bujalance-Zafra MJ, et al (2020). Training primary care professionals in multimorbidity management: Educational assessment of the eMULTIPAP course. Mechanisms of Ageing and Development, 192, 111354-111354.

Evans JP, Porter I, Gangannagaripalli JB, Bramwell C, Davey A, Smith CD, Fine N, Goodwin VA, Valderas JM (2019). Assessing Patient-Centred Outcomes in Lateral Elbow Tendinopathy: a Systematic Review and Standardised Comparison of English Language Clinical Rating Systems. Sports Medicine - Open, 5

© 2019, the Author(s). Background: Lateral elbow tendinopathy (LET) is a common condition affecting adults. Although a lack of treatment consensus continues to prompt numerous effectiveness studies, there is a paucity of clear guidance on the choice of outcome measure. Our aim was to undertake a standardised evaluation of the available clinical rating systems that report patient-centred outcomes in LET. Methods: a systematic review of studies reporting the development, assessment of metric properties and/or use of instruments aiming to quantify LET-specific patient-centred outcome measures was conducted in MEDLINE, Embase and CINAHL (inception-2017) adhering to PRISMA guidance. The evidence for each instrument was independently assessed by two reviewers using the standardised evaluating measures of patient-reported outcomes (EMPRO) method evaluating overall and attribute-specific instrument performance (metric properties and usability). EMPRO scores > 50/100 were considered indicative of high performance. Results: Out of 7261 references, we identified 105 articles reporting on 15 instruments for EMPRO analysis. Median performance score was 41.6 (range 21.6–72.5), with four instruments meeting high-performance criteria: quick Disabilities of the Arm Shoulder and Hand score (qDASH) (72.5), DASH (66.9), Oxford Elbow Score (OES) (66.6) and Patient-Rated Tennis Elbow Evaluation (PRTEE) (57.0). One hundred seventy-nine articles reported instrument use internationally with DASH as the most frequent (29.7% articles) followed by PRTEE (25.6%), MEPS (15.1%) and qDASH (8.1%). The correlation between frequency of use and performance was r = 0.35 (95%CI − 0.11; 0.83). Conclusions: This is the first study to provide standardised guidance on the choice of measures for LET. A large number of clinical rating systems are both available and being used for patients with LETs. Robust evidence is available for four measures, the DASH, QDASH, PRTEE and OES. The use of instruments in the literature is only in part explained by instrument performance.

Abstract. Full text.

Valderas Martinez JM, Catala-Lopez F, Forres-Martos J, Driver JA, Page MJ, Hutton B, Ridao M, Alonso-Arroyo A, Saint-Gerons DM, Genova-Maleras R, et al (2019). Association of anorexia nervosa with risk of cancer. A systematic review and meta-analysis. JAMA Network Open, 2 Full text.

Arias-de la Torre J, Puigdomenech E, Valderas JM, Evans JP, Martín V, Molina AJ, Rodríguez N, Espallargues M (2019). Availability of specific tools to assess patient reported outcomes in hip arthroplasty in Spain. Identifying the best candidates to incorporate in an arthroplasty register. A systematic review and standardized assessment. PLoS One, 14(4). Abstract. Author URL. Full text.

Arana MA, Valderas JM, Solomon J (2019). Being tested but not educated - a qualitative focus group study exploring patients' perceptions of diabetic dietary advice. BMC Fam Pract, 20(1). Abstract. Author URL. Full text.

Serrano-Ripoll MJ, Ripoll J, Llobera J, Valderas JM, Pastor-Moreno G, Olry de Labry Lima A, Ricci-Cabello I (2019). Development and evaluation of an intervention based on the provision of patient feedback to improve patient safety in Spanish primary healthcare centres: study protocol. BMJ Open, 9(12).

INTRODUCTION: Despite the enormous potential for adverse events in primary healthcare (PHC), the knowledge about how to improve patient safety in this context is still sparse. We describe the methods for the development and evaluation of an intervention targeted at PHC professionals to improve patient safety in Spanish PHC centres. METHODS AND ANALYSIS: the intervention will consist in using the patient reported experiences and outcomes of safety in primary care (PREOS-PC) survey to gather patient-reported experiences and outcomes concerning the safety of the healthcare patients receive in their PHC centres, and feed that information back to the PHC professionals to help them identify opportunities for safer healthcare provision. The study will involve three stages. Stage 1 (developing the intervention) will involve: (i) qualitative study with 40 PHC providers to optimise the acceptability and perceived utility of the proposed intervention; (ii) Spanish translation, cross-cultural adaptation and validation of the PREOS-PC survey; (iii) developing the intervention components; and (iv) developing an online tool to electronically administrate PREOS-PC and automatically generate feedback reports to PHC centres. Stage 2 (piloting the intervention) will involve a 3-month feasibility (one group pre-post) study in 10 PHC centres (500 patients, 260 providers). Stage 3 (evaluating the intervention) will involve: (i) a 12-month, two-arm, two-level cluster randomised controlled trial (1248 PHC professionals within 48 PHC centres; with randomisation at the centre level in a 1:1 ratio) to evaluate the impact of the intervention on patient safety culture (primary outcome), patient-reported safety experiences and outcomes (using the PREOS-PC survey), and avoidable hospitalisations; (ii) qualitative study with 20 PHC providers to evaluate the acceptability and perceived utility of the intervention and identify implementation barriers. ETHICS AND DISSEMINATION: the study was approved by the Ethics Committee of the Balearic Islands (CEI IB: 3686/18) with the 1964 Helsinki Declaration and its later amendments. The results will be disseminated in peer-reviewed publications and national and international conferences. TRIAL REGISTRATION NUMBER: NCT03837912; pre-results.

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Professor Jose Valderas

Professor of Health Services and Policy Research

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Journal articles

Abstract:Health Data Processes: a Framework for Analyzing and Discussing Efficient Use and Reuse of Health Data with a Focus on Patient-Reported Outcome Measures (Preprint)

Abstract:Patient-Reported Measures for Person-Centered Coordinated Care: a Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation (Preprint)

Abstract:Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review (Preprint)

Abstract:A multi-stakeholder approach to the co-production of the research agenda for medicines optimisation

Abstract:Diagnostic promiscuity: the use of real-world data to study multimorbidity in mental health.

Abstract:Accuracy of self-reported items for the screening of depression in the general population

Abstract:Development and internal validation of prognostic models to predict negative health outcomes in older patients with multimorbidity and polypharmacy in general practice

Abstract:Differences in Results and Related Factors Between Hospital-at-Home Modalities in Catalonia: a Cross-Sectional Study.

Abstract:Five-year trajectories of multimorbidity patterns in an elderly Mediterranean population using Hidden Markov Models

Abstract:Identifying high-need patients with multimorbidity from their illness perceptions and personal resources to manage their health and care: a longitudinal study.

Abstract:Patient-Reported Morbidity Instruments: a Systematic Review

Abstract:Predicting EQ-5D-5L crosswalk from the PROMIS-29 profile for the United Kingdom, France, and Germany

Abstract:Predicting incident delirium diagnoses using data from primary-care electronic health records.

Abstract:Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review

Abstract:The Characteristics of Patients with Possible Transient Ischemic Attack and Minor Stroke in the Hunter and Manning Valley Regions, Australia (the INSIST Study)

Abstract:Assessing Patient-Centred Outcomes in Lateral Elbow Tendinopathy: a Systematic Review and Standardised Comparison of English Language Clinical Rating Systems

Abstract:Availability of specific tools to assess patient reported outcomes in hip arthroplasty in Spain. Identifying the best candidates to incorporate in an arthroplasty register. A systematic review and standardized assessment.

Abstract:Being tested but not educated - a qualitative focus group study exploring patients' perceptions of diabetic dietary advice.

Abstract:Development and evaluation of an intervention based on the provision of patient feedback to improve patient safety in Spanish primary healthcare centres: study protocol.

Abstract:Differences in Risk of Revision and Mortality Between Total and Unicompartmental Knee Arthroplasty. The Influence of Hospital Volume.

Abstract:Evidence supporting the best clinical management of patients with multimorbidity and polypharmacy: a systematic guideline review and expert consensus.

Abstract:Influence of Hospital Volume of Procedures by Year on the Risk of Revision of Total Hip and Knee Arthroplasties: a Propensity Score-Matched Cohort Study.

Abstract:Safety and Effectiveness of Shoulder Arthroplasties in Spain: a Systematic Review.

Abstract:The International comparison of Systems of care and patient outcomes in minor Stroke and Tia (InSIST) study: a community-based cohort study

Abstract:Validation of hip osteoarthritis diagnosis recording in the UK Clinical Practice Research Datalink.

Abstract:Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography

Abstract:Clinical rating systems in elbow research—a systematic review exploring trends and distributions of use

Abstract:Comparative analysis of methods for identifying multimorbidity patterns: a study of 'real-world' data.

Abstract:Effectiveness of a complex intervention on Prioritising Multimedication in Multimorbidity (PRIMUM) in primary care: results of a pragmatic cluster randomised controlled trial.

Abstract:From programme theory to logic models for multispecialty community providers: a realist evidence synthesis

Abstract:How do aggregated patient-reported outcome measures data stimulate health care improvement? a realist synthesis.

Abstract:How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? a realist synthesis.

Abstract:Identifying Primary Care Pathways from Quality of Care to Outcomes and Satisfaction Using Structural Equation Modeling

Abstract:Measurement invariance and general population reference values of the PROMIS Profile 29 in the UK, France, and Germany.

Abstract:Multimorbidity patterns with K-means nonhierarchical cluster analysis.

Abstract:Patient-Reported Measures for Person-Centered Coordinated Care: a Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation.

Abstract:Predicting Incident Multimorbidity.

Abstract:Quality of diabetes care in breast, colorectal, and prostate cancer.

Abstract:The French PROMIS-29. Psychometric validation and population reference values

Abstract:The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS): a view from the UK.

Abstract:Anorexia nervosa and cancer: a protocol for a systematic review and meta-analysis of observational studies.

Abstract:Can agent-based simulation be used as a tool to support polypharmacy prescribing practice?

Abstract:Cancer and central nervous system disorders: protocol for an umbrella review of systematic reviews and updated meta-analyses of observational studies.

Abstract:Collaborative action for person-centred coordinated care (P3C): an approach to support the development of a comprehensive system-wide solution to fragmented care.

Abstract:Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records.

Abstract:Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy: study protocol of a cluster randomized clinical trial (Multi-PAP project).

Abstract:Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach.

Abstract:Identifying patient-centred recommendations for improving patient safety in General Practices in England: a qualitative content analysis of free-text responses using the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire.

Abstract:Outcomes of preexisting diabetes mellitus in breast, colorectal, and prostate cancer

Abstract:Patients' evaluations of patient safety in English general practices: a cross-sectional study.

Abstract:Pharmacological control of diabetes and hypertension comorbidity in the elderly: a study of "real world" data.

Abstract:Associations between exemption and survival outcomes in the UK's primary care pay-for-performance programme: a retrospective cohort study.

Abstract:Framework and guidance for implementing patient-reported outcomes in clinical practice: evidence, challenges and opportunities.

Abstract:Measuring Patient Safety in Primary Care: the Development and Validation of the "Patient Reported Experiences and Outcomes of Safety in Primary Care" (PREOS-PC).

Abstract:Patient-reported outcomes: pathways to better health, better services, and better societies.

Abstract:Patients' perceptions and experiences of patient safety in primary care in England.

Abstract:Pilot study to test the feasibility of a trial design and complex intervention on PRIoritising MUltimedication in Multimorbidity in general practices (PRIMUMpilot).

Abstract:[Multimorbidity patterns in young adults in Catalonia: an analysis of clusters].

Abstract:Any versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12.

Abstract:Developing a research agenda for patient safety in primary care. Background, aims and output of the LINNEAUS collaboration on patient safety in primary care.

Abstract:Impact of multi-morbidity on quality of healthcare and its implications for health policy, research and clinical practice. A scoping review.

Abstract:Impact of the Prevalence of Concordant and Discordant Conditions on the Quality of Diabetes Care in Family Practices in England.

Abstract:Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.

Abstract:Measuring experiences and outcomes of patient safety in primary care: a systematic review of available instruments.

Abstract:Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: a Cluster Analysis.

Abstract:Patients' responses to transient ischaemic attack symptoms: a cross-sectional questionnaire study in Australian general practices.

Abstract:
Health Data Processes: a Framework for Analyzing and Discussing Efficient Use and Reuse of Health Data with a Focus on Patient-Reported Outcome Measures (Preprint)

Abstract:
Patient-Reported Measures for Person-Centered Coordinated Care: a Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation (Preprint)

Abstract:
Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review (Preprint)

Abstract:
A multi-stakeholder approach to the co-production of the research agenda for medicines optimisation

Abstract:
Diagnostic promiscuity: the use of real-world data to study multimorbidity in mental health.

Abstract:
Accuracy of self-reported items for the screening of depression in the general population

Abstract:
Development and internal validation of prognostic models to predict negative health outcomes in older patients with multimorbidity and polypharmacy in general practice

Abstract:
Differences in Results and Related Factors Between Hospital-at-Home Modalities in Catalonia: a Cross-Sectional Study.

Abstract:
Five-year trajectories of multimorbidity patterns in an elderly Mediterranean population using Hidden Markov Models

Abstract:
Identifying high-need patients with multimorbidity from their illness perceptions and personal resources to manage their health and care: a longitudinal study.

Abstract:
Patient-Reported Morbidity Instruments: a Systematic Review

Abstract:
Predicting EQ-5D-5L crosswalk from the PROMIS-29 profile for the United Kingdom, France, and Germany

Abstract:
Predicting incident delirium diagnoses using data from primary-care electronic health records.

Abstract:
Relationship Between Depression and the Use of Mobile Technologies and Social Media Among Adolescents: Umbrella Review

Abstract:
The Characteristics of Patients with Possible Transient Ischemic Attack and Minor Stroke in the Hunter and Manning Valley Regions, Australia (the INSIST Study)

Abstract:
Assessing Patient-Centred Outcomes in Lateral Elbow Tendinopathy: a Systematic Review and Standardised Comparison of English Language Clinical Rating Systems

Abstract:
Availability of specific tools to assess patient reported outcomes in hip arthroplasty in Spain. Identifying the best candidates to incorporate in an arthroplasty register. A systematic review and standardized assessment.

Abstract:
Being tested but not educated - a qualitative focus group study exploring patients' perceptions of diabetic dietary advice.

Abstract:
Development and evaluation of an intervention based on the provision of patient feedback to improve patient safety in Spanish primary healthcare centres: study protocol.

Abstract:
Differences in Risk of Revision and Mortality Between Total and Unicompartmental Knee Arthroplasty. The Influence of Hospital Volume.

Abstract:
Evidence supporting the best clinical management of patients with multimorbidity and polypharmacy: a systematic guideline review and expert consensus.

Abstract:
Influence of Hospital Volume of Procedures by Year on the Risk of Revision of Total Hip and Knee Arthroplasties: a Propensity Score-Matched Cohort Study.

Abstract:
Safety and Effectiveness of Shoulder Arthroplasties in Spain: a Systematic Review.

Abstract:
The International comparison of Systems of care and patient outcomes in minor Stroke and Tia (InSIST) study: a community-based cohort study

Abstract:
Validation of hip osteoarthritis diagnosis recording in the UK Clinical Practice Research Datalink.

Abstract:
Antibiotic prescribing for acute respiratory tract infections in primary care: an updated and expanded meta-ethnography

Abstract:
Clinical rating systems in elbow research—a systematic review exploring trends and distributions of use

Abstract:
Comparative analysis of methods for identifying multimorbidity patterns: a study of 'real-world' data.

Abstract:
Effectiveness of a complex intervention on Prioritising Multimedication in Multimorbidity (PRIMUM) in primary care: results of a pragmatic cluster randomised controlled trial.

Abstract:
From programme theory to logic models for multispecialty community providers: a realist evidence synthesis

Abstract:
How do aggregated patient-reported outcome measures data stimulate health care improvement? a realist synthesis.

Abstract:
How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? a realist synthesis.

Abstract:
Identifying Primary Care Pathways from Quality of Care to Outcomes and Satisfaction Using Structural Equation Modeling

Abstract:
Measurement invariance and general population reference values of the PROMIS Profile 29 in the UK, France, and Germany.

Abstract:
Multimorbidity patterns with K-means nonhierarchical cluster analysis.

Abstract:
Patient-Reported Measures for Person-Centered Coordinated Care: a Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation.

Abstract:
Predicting Incident Multimorbidity.

Abstract:
Quality of diabetes care in breast, colorectal, and prostate cancer.

Abstract:
The French PROMIS-29. Psychometric validation and population reference values

Abstract:
The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS): a view from the UK.

Abstract:
Anorexia nervosa and cancer: a protocol for a systematic review and meta-analysis of observational studies.

Abstract:
Can agent-based simulation be used as a tool to support polypharmacy prescribing practice?

Abstract:
Cancer and central nervous system disorders: protocol for an umbrella review of systematic reviews and updated meta-analyses of observational studies.

Abstract:
Collaborative action for person-centred coordinated care (P3C): an approach to support the development of a comprehensive system-wide solution to fragmented care.

Abstract:
Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records.

Abstract:
Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy: study protocol of a cluster randomized clinical trial (Multi-PAP project).

Abstract:
Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach.

Abstract:
Identifying patient-centred recommendations for improving patient safety in General Practices in England: a qualitative content analysis of free-text responses using the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire.

Abstract:
Outcomes of preexisting diabetes mellitus in breast, colorectal, and prostate cancer

Abstract:
Patients' evaluations of patient safety in English general practices: a cross-sectional study.

Abstract:
Pharmacological control of diabetes and hypertension comorbidity in the elderly: a study of "real world" data.

Abstract:
Associations between exemption and survival outcomes in the UK's primary care pay-for-performance programme: a retrospective cohort study.

Abstract:
Framework and guidance for implementing patient-reported outcomes in clinical practice: evidence, challenges and opportunities.

Abstract:
Measuring Patient Safety in Primary Care: the Development and Validation of the "Patient Reported Experiences and Outcomes of Safety in Primary Care" (PREOS-PC).

Abstract:
Patient-reported outcomes: pathways to better health, better services, and better societies.

Abstract:
Patients' perceptions and experiences of patient safety in primary care in England.

Abstract:
Pilot study to test the feasibility of a trial design and complex intervention on PRIoritising MUltimedication in Multimorbidity in general practices (PRIMUMpilot).

Abstract:
[Multimorbidity patterns in young adults in Catalonia: an analysis of clusters].

Abstract:
Any versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12.

Abstract:
Developing a research agenda for patient safety in primary care. Background, aims and output of the LINNEAUS collaboration on patient safety in primary care.

Abstract:
Impact of multi-morbidity on quality of healthcare and its implications for health policy, research and clinical practice. A scoping review.

Abstract:
Impact of the Prevalence of Concordant and Discordant Conditions on the Quality of Diabetes Care in Family Practices in England.

Abstract:
Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care.

Abstract:
Measuring experiences and outcomes of patient safety in primary care: a systematic review of available instruments.

Abstract:
Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: a Cluster Analysis.

Abstract:
Patients' responses to transient ischaemic attack symptoms: a cross-sectional questionnaire study in Australian general practices.

Abstract:
Routine provision of information on patient-reported outcome measures to healthcare providers and patients in clinical practice

Abstract:
Time spent on health-related activities by senior Australians with chronic diseases: what is the role of multimorbidity and comorbidity?

Abstract:
Evaluation of shoulder-specific patient-reported outcome measures: a systematic and standardized comparison of available evidence.

Abstract:
Functionality and feedback: a protocol for a realist synthesis of the collation, interpretation and utilisation of PROMs data to improve patient care.

Abstract:
Impact of undetected comorbidity on treatment and outcomes of breast cancer.

Abstract:
Multimorbidity and comorbidity of chronic diseases among the senior Australians: prevalence and patterns.

Abstract:
Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies.

Abstract:
Undiagnosed diabetes in breast, colorectal, lung, and prostate cancer: incidence and risk factors.

Abstract:
Withdrawing performance indicators: retrospective analysis of general practice performance under UK Quality and Outcomes Framework.

Abstract:
Increasing clinical, community, and patient-centered health research for preventing and managing multimorbidity.

Abstract:
Using health status to measure NHS performance: another step into the dark for the health reform in England.

Abstract:
Multimorbidity, service organization and clinical decision making in primary care: a qualitative study.

Abstract:
Routine care provided by specialists to children and adolescents in the United States (2002-2006).

Abstract:
Development of EMPRO: a tool for the standardized assessment of patient-reported outcome measures.