Table 6.

A Proposed Pathway for Identification and Selection of dPROs and dPROMs in Prosthetic Dentistry (Adapted from

Outcome Parameter	Steps	Application
dPRO	1. Identify the clinical problem of interest (eg, rehabilitation of edentulous subjects with implants).	Include input from all stakeholders, including professionals, patients, relatives, caregivers, insurance companies, industry, and others, that has an interest in decisions made.
	2. Identify outcomes that are meaningful to the target population and are amenable to change due to the specific clinical care	Ask persons who are receiving the care and services Identify evidence from the literature that the outcome responds to the selected intervention
	3. Determine whether patient-reported information (PRO) is the best way to assess the outcome of interest	In case the select outcome is unethical or unfeasible to be assessed, consider the use of surrogate endpoints If a PRO is appropriate, proceed to step 4
dPROM	4. Identify existing PROMs for measuring the outcome (PRO) in the target population of interest	Many PROMs (instrument, scale or single-item) were developed and tested primarily for research in the field of the study A comprehensive literature search is essential to identify disease-specific or generic PROMs that are suitable for the purpose of the study
	5. Select a PROM suitable for use in the target population	Identify reliability, validity, responsiveness, feasibility of the instrument
	6. Use the PROM in the real world with the intended target population and study setting	Assess status or response to intervention, provide feedback for self-management, plan and manage care or services, share decision-making Test feasibility of using and collecting PROM data to develop and test an outcome performance measure

Note: Data from National Quality Forum.18