What we do
Rationale
In current elective healthcare, treatment decisions are usually not based on individual patient data, but on clinician preferences and generic guidelines. These guidelines are largely based on group averages, assuming the same threshold for treatment success in all patients and not accounting for individual treatment goals and needs. As a result, treatment decisions are insufficiently individualised and at risk of being suboptimal. A surgeon may, for example, prioritise pain relief in hand osteoarthritis, while the patient prioritises functional improvement; such misalignment can result in a treatment plan that does not fit the patient's goals and needs.
The Patient-Specific Needs Evaluation (PSN)
To address this, we developed the Patient-Specific Needs Evaluation (PSN): an ultra-brief, patient-specific yet generic digital instrument that identifies a patient's most important information need, their most important treatment goal, and the individual threshold they need to reach to be satisfied with the treatment results. At follow-up, the PSN evaluates whether this personal threshold has been reached.
Extending the PSN to new patient populations
The PSN was originally developed for, and validated in, patients with hand and wrist conditions. In this project, we adapt the PSN to three additional patient populations: orthopaedics, breast reconstruction, and stroke rehabilitation, in close collaboration with Erasmus MC, Xpert Clinics, and Rijndam Rehabilitation.
By making individual treatment goals explicit, the PSN supports shared decision-making and realistic expectation management. It has the potential to increase the probability of offering patients the most appropriate ‘first-time-right’ treatment, and to help prevent ineffective or unnecessary treatment, thereby contributing to more personalised, value-based healthcare.
Instrument adaptation
For each new patient population, the PSN is adapted in collaboration with clinicians, patients, and methodological experts, following a structured, user-centred development process to ensure content validity and comprehensibility.
Reliability and validity testing
We evaluate the test-retest reliability of the PSN and examine whether achieving one's personal treatment goal is more strongly associated with treatment satisfaction than existing outcome thresholds.
Implementation in clinical practice
The PSN is integrated into the electronic data infrastructure already in use at participating sites, enabling clinicians to access outcomes directly within routine consultations.
Evaluating clinical impact
Finally, we investigate whether the implementation of the PSN measurably improves shared decision-making and patient-reported experiences of care.
Principal Investigators
Postdocs
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J. W. (Joost) Colaris, MD PhD
Orthopaedic surgeon, Associate professor
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R.W. (Ruud) Selles, PhD
Professor
