Conclusion Our findings suggest that people with low literacy skills or learning disabilities are left out of the development of PROMs .
Background  Patient-reported outcome measures ( PROMs ) are intended to reflect outcomes relevant to patients .
They are increasingly used for healthcare quality improvement .
To produce valid measures , patients should be involved in the development process but it is unclear whether this usually includes people with low literacy skills or learning disabilities .
Measuring functional status in chronic lung disease: conclusions from a randomized control trial.
The optimal method of assessing the effect of treatment on the day-to-day function of patients with chronic airflow limitation is not established . Therefore , we examined the performance of the Six Minute Walk test , a rating of dyspnea following the test and three different question naires measuring dyspnea in daily activities , in a controlled trial of inhaled salbutamol and oral theophylline in 24 patients with primarily fixed chronic airflow limitation . Clinical ly important and statistically significant effects of salbutamol and theophylline on dyspnea during day-to-day activities were detected by each measure , but the Chronic Respiratory Question naire ( CRQ ) appeared more powerful than either the Oxygen Cost Diagram or the Medical Research Council Dyspnea Question naire as modified by the R and Corporation . Changes in the CRQ dyspnea score showed a higher correlation with changes in spirometry , walk test score , dyspnea following the walk test , and global ratings of dyspnea than did the other two measures . Results of the walk test demonstrated statistically significant salbutamol and theophylline effects , but suggested that no added benefit could be obtained with both drugs ; the rating of dyspnea following the walk test , however , was consistent with an additive effect . We conclude that the CRQ is a responsive , valid measure of functional status for clinical trials in chronic lung disease , and that when the six minute walk is used as a measure of outcome , dyspnea following the walk test should be measured
Conclusion Our findings suggest that people with low literacy skills or learning disabilities are left out of the development of PROMs .
Background  Patient-reported outcome measures ( PROMs ) are intended to reflect outcomes relevant to patients .
They are increasingly used for healthcare quality improvement .
To produce valid measures , patients should be involved in the development process but it is unclear whether this usually includes people with low literacy skills or learning disabilities .