FAQ on the QPROMs
- Do I need to pay to use these tools within my practice?
- What is the research evidence for the use of Q-PROM rather than other PROM tools?
- What tool should I use for my procedure?
- Why are you only recommending Q-PROMs for selected procedures?
- Do I have to collect pre-operative and post-operative Q-PROM data from patients?
- How should I collect Q-PROMs data?
- Can I translate the Q-PROMs into a new language?
- Can I delete or change the wording in any of the Q-PROM questionnaires?
- Can I add any items to the Q- PROMs?
- Who helps patients to complete the questionnaire in clinic?
- What should I do if the patient has trouble understanding a question?
- What should I do if the patient does not want to answer some or all of the questions or refuses to do so?
- What should I do if a patient asks why the Q-PROM has to be filled out on more than one occasion (if administering pre and post-operatively)?
- How do I score my completed questionnaires?
- What if we cannot obtain the post-operative forms from the patients?
- What do I do if there are data missing from the completed questionnaires?
- What do I do if a patient has selected more than one response to a question?
- What do I do if a patient has selected ‘not applicable’ or written ‘not applicable’ on the questionnaire?
- Do I need local ethics board approval to use Q-PROMs?
- How do I find out more about Q-PROMs and their developer?
- Why are you not recommending the use of a generic PROM tool?
Memorial Sloan Kettering Cancer Center does not charge clinicians or non-profit researchers for the use of these scales. Others should contact the developers directly to request permission.
What is the research evidence for the use of Q-PROM rather than other PROM tools?
A summary of a meta-analysis of all available PROMs for cosmetic surgery has been carried out by The University of Oxford Patient Reported Outcome Measurement Group in 2013.
Further research is listed in the back of the service user manuals.
What tool should I use for my procedure?
The Q-PROMs that have been identified for use within cosmetic surgical practice are:
- BREAST-Q – Augmentation mammoplasty
- FACE-Q – Rhinoplasty
- FACE-Q – Blepharoplasty
- FACE-Q – Rhytidectomy
- BODY-Q – Abdominoplasty
- BODY-Q – Liposuction
Why are you only recommending Q-PROMs for selected procedures?
Q-PROMs were chosen because research exists that supports their reliability and validity of use within cosmetic practice. Q-PROM tools have been developed and validated for use in some of the most common cosmetic surgical procedures performed within the UK (according to latest figures within the British Association of Aesthetic Plastic Surgeons’ (BAAPS) annual audit). However not all procedures will be covered with these tools.
Do I have to collect pre-operative and post-operative Q-PROM data from patients?
You do not have to capture both pre-operative and post-operative Q-PROM data from patients, although this will allow for most effective measurement of impact. The most important Q-PROM is the post-operative questionnaire, which can be analysed alone to develop a database of scores that can then be linked to different patient demographics and types of surgery.
How should I collect Q-PROMs data?
Q-PROMs tools should be completed by the patient and ideally collected pre and post-operatively.
Post-operative questionnaires should either be emailed or posted to patients approximately three months post-surgery. The post-operative version includes all the pre-operative items in addition to items that address unique post-operative issues, e.g. scars.
Can I translate the Q-PROMs into a new language?
For translation of the Q-PROM questionnaires scales contact firstname.lastname@example.org
Can I delete or change the wording in any of the Q-PROM questionnaires?
No, you cannot delete or modify any items in Q-PROM questionnaires. There are three main reasons why deleting or modification is not allowed:
- This would nullify the psychometric properties of Q-PROM questionnaire scales.
- It would then not be possible to score the questionnaire and you would not be able to compare findings with those of others.
- Changing the questionnaires is prohibited under copyright laws.
Can I add any items to the Q- PROMs?
No, you cannot add any items in Q-PROM scales for the same three reasons that you cannot delete or modify these (see above).
You may however ask any additional questions that you wish as long as they are separate from the Q-PROM scales. You cannot consider these questions to be part of the Q-PROM.
Who helps patients to complete the questionnaire in clinic?
The Q-PROM scales are designed for patients to complete themselves and it is important that providers and surgeons do not influence the way patients complete the tools. All patients should answer the questions based on their own understanding of the items.
What should I do if the patient has trouble understanding a question?
You can help by asking them to explain why they are having difficulty responding, and read the question verbatim for them. Do not try to explain what the question means, rather suggest that the patient uses their own interpretation of the question.
Do not rephrase the question. If they are still having difficulty completing the form, advise them to leave out that question.
What should I do if the patient does not want to answer some or all of the questions or refuses to do so?
Patients have a right to refuse to complete the questionnaires.
You can explain that the data obtained from the PROM tools will allow the service to improve its quality and ensure that patients are getting the best treatment options.
Patients can also use it to guide questions they may have about the planned procedure and the likely benefits for them. You can emphasise that the Q-PROMS are quick and simple to complete.
If the patient does not like a particular question, or thinks it is unnecessary or inappropriate, they can write their comment on the Q-PROM form.
It is still possible to score all the Q-PROMs questionnaires with missing data.
What should I do if a patient asks why the Q-PROM has to be filled out on more than one occasion (if administering pre and post-operatively)?
Explain that patients must complete the same Q-PROM at additional visits in order to see if their answers change with time. This will give a more complete picture of how their health-related quality of life and satisfaction changes over time.
How do I score my completed questionnaires?
Please use the scoring tables provided.
Each answer that is ticked by a patient has a corresponding Q-PROM score.
Add together the scores from all answers in the Q-PROM tool to produce a total Q-PROM score.
Convert the Q-PROM score to a Rasch score (scored 0 to 100).
The greater the value of the Rasch score, the greater the patient satisfaction or health-related quality of life.
It is important to note that a single pre and post-operative score for an individual patient cannot be interpreted, beyond a general indication of improvement.
More scores over time would need to be included or the scores for all patients having the same procedure interpreted together.
There is further advice about implementing PROMs in practice, scoring and analysis available within the service user guides.
Read our guidance for further information on how the data gathered from use of PROMs can be used.
What if we cannot obtain the post-operative forms from the patients?
It may be difficult to obtain post-operative Q-PROM surveys from patients. We suggest you stress the importance of the completion of this form at the pre-operative stage and send them a reminder two weeks after the survey is sent, to prompt completion. It is always best practice to check via the NHS Spine or an alternative system prior to sending out surveys, especially if a significant period of time has lapsed since the patient was last seen, in order to identify any patient who has died in the intervening period.
What do I do if there are data missing from the completed questionnaires?
Missing data should be left as a ‘blank’.
What do I do if a patient has selected more than one response to a question?
If the patient has selected more than one response to a question the patient has not responded properly to the question and the response should be left as a ‘blank’.
What do I do if a patient has selected ‘not applicable’ or written ‘not applicable’ on the questionnaire?
If the patient has indicated their response to a question is ‘not applicable’ leave this section blank in your scoring table.
Do I need local ethics board approval to use Q-PROMs?
If your intent is to collect Q-PROMs data for research purposes, a local ethics board must review your methods, patient recruitment, consent and privacy. If you are administering the Q-PROMs tools for clinical care, ethics board approval is generally not required. If in doubt, contact your local ethics board.
How do I find out more about Q-PROMs and their developer?
These PROM tools have been developed by Dr Andrea Pusic, MD, of Memorial Sloan Kettering Cancer Center. Further information and contact details are available within the service user manuals.
Why are you not recommending the use of a generic PROM tool?
We acknowledge that it is best practice for a generic and procedure specific PROM to be collected at the same time, in order to measure patient outcomes. However, at present there is insufficient evidence for the use of any one 'generic' PROM tool in cosmetic surgery. For this reason we have not specified that a generic PROM be routinely used at this time. We will raise the requirement for further research in this area as a priority.