## 3 Results
### PRO as Patient-Centred Care  
In 2001, the Institute of Medicine (Washington D.C., US) accentuated the importance of patient-centered care [56] and defined it as: \"... care that respects and responds to the individual patient's preferences, needs and values and ensures that clinical decision incorporates patients' values\" [57]. Thus, there is a conceptual connection between patient-centred care and PRO-based VBHC, since values, needs and preferences are focal in both cases.  
Patient-centered care is a holistic approach focusing on the well-being of patients, preferably reflected in every action taken by healthcare professionals [58], what PRO then enables are the patients to get involved and take a central position in their healthcare [25, 49]. Consequently, patient-centered care might result in more independent and active patients with improved management of their health, which is a paradigmatic shift compared to the traditional provider paternalism, where patients were placed as passive, non-responsible receivers of healthcare [33, 59]. Therefore, as part of a patient-centered approach, the collaboration between physicians and patients is supposed to transform into a sort of partnership, which however rests on active and genuine engagement by the actors involved [57, 60, 61].  
This demonstrates that there are common grounds between PRO and patient-centered care. Thus, as part of clinical practice, PRO might facilitate a more holistic care approach and an environment promoting patient engagement [49, 62, 63]. Moreover, PRO is known to promote patient-centered care by capturing and explicating issues that matter to the majority of patients [16, 25], since it integrates the patient voice and facilitates patient involvement in health care [64, 65]; thus, evidence supports that PRO enhances physician-patient communication [66, 67] and that PRO encourage and affects the degree of shared decision-making (SDM) in clinical practice [32, 46, 50, 68]. Furthermore, PRO's facilitation of patient participation might have an empowering effect on patients [3, 69, 70] and ensure that patients are recognized and treated as individuals, and not merely as diagnoses [18].  
In this context, the definition of PRO presented by a Danish expert group, hosted by the Danish Knowledge Center for User Involvement in Health Care (ViBIS) in 2016, is of relevance, since they interpret PRO as: \"Data concerning the patient's health condition such as physical and mental health, symptoms, health-related quality of life and functional ability reported directly by the patients themselves\" [7]. Once more, a definition essentially complying with the FDA version; however, a more detailed version of what constitutes a PRO. Furthermore, PROs interpretative evolvement is interesting as it, based on the presented definitions in this article, chronologically shifts from being \"any report,\" \"measurement,\" to \"data.\" Therefore, it is deliberate that VIBiS definition is placed in this section since the emphasis on PRO as data arguably is linked to a more patient-oriented focus; hence, it is the use of PRO data that might promote patient's engagement, empowerment, and self-management.