Guest guest Posted March 13, 2012 Report Share Posted March 13, 2012 All,When thinking about " outcomes " , whether in research study design, or application of outcomes in clinical practice with individual patients, the notion of Disease Oriented Outcomes (DOOs) and Patient Oriented Outcomes (POOs) is worth considering. DOOs tend to be measures of some kind such as lab values, orthopedic tests, measures of subluxation, and the like. As opposed to POOs that are relative to the patient's experience of outcomes. A recent example form acupuncture research comes to mind (don't have the citation in front of me) where the result of the acu intervention in asthmatics was no change in the DOO (peak flow, O2 saturation) but marked improvement in the POO...the acu treated asthmatics actually felt better in terms of POOs. This has an interesting discussion in a recent NEJM piece here http://www.nejm.org/doi/full/10.1056/NEJMp1113631 Perhaps the most important barrier to goal-oriented care is that medicine is deeply rooted in a disease-outcome–based paradigm. Rather than asking what patients want, the culture has valued managing each disease as well as possible according to guidelines and population goals. A. Simpson, DC | Vice President, Medical DirectorThe CHP Group | Smart Solutions. Healthy Results. Like us on Facebook | Follow us on Twitter | Follow us on LinkedIn | www.chpgroup.com csimpson@... 503-619-2041 O | 503-367-0872 C6600 SW 105th Ave, Ste 115 | Beaverton, OR 97008 Quote Link to comment Share on other sites More sharing options...
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