PhD student: Raquel Correia
Title: The impact of patient-reported outcomes measures (PROMs) on the appropriateness of care in France
Supervisor(s): Isabelle Durand-Zaleski, Olivier Chassany
Doctoral school: ED 393 Epidemiology and Biomedical Information Sciences, Université Paris Cité
Promotion: 2023
Funding: CIFRE
Thesis abstract
Background: The French healthcare system predominantly measures healthcare interventions by the resources used rather than the patient-perceived outcomes achieved. Cataract surgery, which affects nearly one million people in France, exemplifies this issue. Although it is the most frequently performed surgery in the country, variations in intervention rates do not reflect patient-perceived improvements in visual comfort and quality of life—factors that the French National Health Authority deems crucial for determining surgical relevance.
Objectives: Conducted within the PromTime cataract experiment (Article 51), this doctoral research aims to quantify the “appropriateness” of care through a “Health Gain” score. This metric will capture the perceived patient benefit in terms of functional recovery and quality of life, using both clinician-reported (CROMs) and patient-reported outcome measures (PROMs).
Methods: By stratifying patients according to their initial severity, it will be possible to objectively compare Health Gains and identify the clinical practices and interventions that deliver the greatest patient-perceived value at an equivalent cost. Grounded in the principles of Value-Based Health Care (VBHC), widely adopted in Anglo-Saxon and Scandinavian countries, this project introduces a patient-centered measure of care value in France.
Implications: This thesis represents the first assessment of a VBHC model applied to cataract surgery in France. It will examine the medico-economic, psychometric, and practice-changing impacts of such an approach. The findings are expected to inform health policy decisions and support a shift toward a more value-oriented, sustainable healthcare system that places the patient’s quality of life at its core.
