PRiORity: Patient Reported Outcomes Research in Trauma

Priority study logoDeveloping a pathway for the electronic capture of PROMs/PREMs for inclusion within the SRMRC clinical information platform for use in research and routine and ongoing clinical care.

Major trauma is a leading cause of death and trauma mortality is predicted to increase over the next 20 years. However, improvement in survival has been demonstrated in the UK. The consequence of increased survival rates is that more people are living with long-term often life changing disabilities and reduced quality of life. Therefore, the rising number of major trauma survivors has created the need for a change in the approach to clinical practice and rehabilitation for this population.

In order to understand how peoples’ quality of life is affected following a traumatic injury and the effects of that injury on their health and wellbeing, it is important to capture patients’ perspectives of their own health. Patient Reported Outcome Measures (PROMs) can capture patients’ own experience of their health such as symptoms, mobility, mental health and social function.

Electronic capture of PROMs (ePROMs), through online questionnaires, has important advantages over paper PROMs. ePROMs integrated into a clinical information platform can be used for trauma research, to provide patient-centred data to inform, patients, clinicians and policy-makers, and routine and ongoing clinical care of trauma patients, to inform shared decision-making and optimise patient outcomes.

This research will use a mixed-methods approach to inform the development of an ePROM system for trauma care.

This research is funded by the National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC)

Aim of project

To develop and assess the feasibility of an electronic PROM (ePROM) system for inclusion within routine clinical care and TBI research.

Summary of research

Stage 1: Qualitative study

One-to-one, semi-structured interviews will be conducted with: (i) people who have experienced a TBI, (ii) their family members/ carers; (iii) healthcare professionals working in trauma related clinical areas; (iv) TBI researchers; and (v) staff members/ volunteers from third sector organisations who support TBI patients and their families/carers.

Aims: To establish the impact of TBI on quality of life/ symptoms

To explore views on using PROMs to support clinical care and research.

Stage 2: Usability study

Based on the findings from the qualitative study in stage 1, a number of PROMs will be put on an electronic platform. A small number of people with a TBI will be asked to complete these ePROMs. We will then conduct cognitive interviews with them.

Aim: To explore the usability of an ePROM system for patients with TBI. 

Stage 3: Feasibility study

In a single centre one arm study, participants will be asked to complete ePROMs prior to their outpatient appointment either at home (accessing the ePROM system online) or in the waiting room (using a tablet provided). The clinician will review the participants’ ePROM scores prior to their appointment and respond with appropriate clinical action, in line with standard clinical practice.

Aims: To assess the feasibility and acceptability of using the ePROM system;

To assess the feasibility and acceptability of the study design and processes, including recruitment and retention.


McMullan C, Retzer A, Slade A, Kyte D, Jones L, Belli A, Calvert M, Turner GM. Care providers' and patients' attitudes toward using electronic-patient reported outcomes to support patients with traumatic brain injury: a qualitative study (PRiORiTy). Brain Inj. 2020 May 11;34(6):723-731. doi: 10.1080/02699052.2020.1740944. Epub 2020 Mar 29. PMID: 32223338.

Retzer A, Turner G, Slade A, Kyte D, McMullan C, Jones L et al. Electronic patient reported outcomes to support care of patients with traumatic brain injury: PRiORiTy study qualitative protocol. BMJ open. 2019 Jan 25;9(1). e024617.

Turner GM, Slade A, Retzer A, McMullan C, Kyte D, Belli A, Calvert M. An introduction to patient-reported outcome measures (PROMs) in trauma. J Trauma Acute Care Surg. 2019 Feb;86(2):314-320. doi: 10.1097/TA.0000000000002102. PMID: 30376536.

Patient and Public Involvement

We have been working closely with a group of people who had a traumatic brain injury and who have been living with the impact of this injury. They have helped us design and conduct every stage of the study. Their activities have included:

  • contributing to drafting and reviewing patient-facing documents
  • contributing to the design of the electronic platform
  • testing the electronic platform

We also work closely with Headway, the brain injury association.

Latest News

09/02/22 – Dr Christel McMullan was invited to present the PRiORiTy study at the Office for Veterans’ Affairs conference in London. She gave an overview of the study and outlined how the ePRO platform (Aparito Atom5TM) could be used to monitor mental health symptoms in veterans.

29/11/21 – Poster presentation of the PRiORiTy study at the ISOQOL conference

Aparito website: Patient Reported Outcomes Research in Trauma: testing the usability of an ePRO system with the PRiORiTy study

Contact us

If you would like more information about the study please contact:

Dr Christel McMullan

Telephone: +44 (0)121 414 7398