Despite a   lack of a theoretical/epistemic underpinning in their development and application, the nomothetic approach, positivism is the epistemological philosophy underpinning patient-reported outcome measurement. Inherent in this approach to research is the view that it is possible to measure behaviour independent of context and where social phenomena are “things” that can be viewed objectively, and researchers can take a “scientific” perspective when observing social behaviour.

In my thinking my aim is not a rejection of empiricism - an epistemology that gives a central place to perception and perceptual experience - but to take a pragmatic approach bringing together the central areas of philosophy like metaphysics and empiricism to provide an epistemology that gives the best understanding and explanation of patient experience and behaviour.

 

 

Meadows, K. (2021). Interpreting Patient-Reported Outcome Measures: Narrative and the "Fusion of Horizons;. Philosophy of Medicine, 2(2).

Meadows, K.A. A philosophical perspective on the development and application of patient-reported outcomes measures (PROMs). Qual Life Res (2021).

Meadows K. Patient-reported Outcome Measures – A Call for More Narrative Evidence. Journal of Patient Experience. October 9th 2021.

 

Meadows K. Cognitive Interviewing Methodologies. Clinical Nursing Research. 2021;30(4):375-379.

Meadows K. Do Patient-Reported Outcome Measures Tell Us the Full Story? Clinical Nursing Research. 2022;31(2):159-162.
 

Meadows KA, Reaney M. Bringing the patient's perspectives forward in drug development and health-care evaluation. Expert Rev Pharmacoecon Outcomes Res. 2023;23(3):267-271. doi:10.1080/14737167.2023.2166492

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Meadows KA, Reaney M. Understanding the unique patient-causal singularism and patient reported outcomes. Qual Life Res. 2025;34(5):1221-1231. doi:10.1007/s11136-025-03905-2

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Meadows KA, Ferrante N, Geršić T. Cognitive Interviews: Recommendations for Best Practices in Clinical Outcome Assessment (COA) Measure Development and Validation. Patient. Published online July 24, 2025. doi:10.1007/s40271-025-00752-8