# Clinical Measure Repository Quality Management System

This repository contains template documents for implementing a Quality Management System (QMS) specifically designed for **Clinical Outcome Measures** and **Patient-Reported Outcomes (PRO)** repositories.

## 📊 Designed For

- Clinical Research Organizations managing outcome measures
- Academic Medical Centers with measure development programs
- Healthcare Quality Improvement departments
- Psychometric Validation Teams
- PRO/eCOA Implementation Teams
- Clinical Trial Operations using validated measures
- Registry Programs tracking clinical outcomes
- Health Economics and Outcomes Research (HEOR) groups

## Repository Structure

```
measure-repository/
├── Policies/                  # Quality policies for measure management
├── SOPs/                      # Standard Operating Procedures
│   ├── Licensing/             # License agreements & copyright management
│   ├── Validation/            # Psychometric validation procedures
│   ├── Administration/        # Measure administration protocols
│   ├── Translation/           # Translation & linguistic validation
│   ├── Data-Management/       # Data collection, scoring, storage
│   └── General/               # General quality operations
├── Work Instructions/         # Detailed protocols and procedures
├── Forms/                     # Record forms and templates
│   ├── License-Tracking/      # License agreements & renewals
│   ├── Validation-Records/    # Validation study documentation
│   ├── Training/              # Administrator training records
│   └── Scoring/               # Scoring algorithms & interpretations
└── Templates/                 # Document templates
```

## Outcome Measure Types Covered

- **PRO** - Patient-Reported Outcomes (e.g., SF-36, PROMIS, PHQ-9)
- **ClinRO** - Clinician-Reported Outcomes (e.g., CGI-S, YBOCS)
- **ObsRO** - Observer-Reported Outcomes (caregiver/proxy reports)
- **PerfO** - Performance Outcomes (objective assessments, e.g., 6MWT, cognitive tests)

## Document Numbering Convention

- **POL-XXX**: Policies
- **SOP-LIC-XXX**: Licensing SOPs
- **SOP-VAL-XXX**: Validation SOPs
- **SOP-ADM-XXX**: Administration SOPs
- **SOP-TRN-XXX**: Translation SOPs
- **SOP-DM-XXX**: Data Management SOPs
- **SOP-GEN-XXX**: General SOPs
- **WI-XXX**: Work Instructions / Protocols
- **FRM-XXX**: Forms and Records
- **LIC-XXX**: License Agreements/Tracking
- **VAL-XXX**: Validation Reports
- **SCR-XXX**: Scoring Algorithms

## 🤖 AI-Powered Document Creation

This template includes **AtomicAI** integration. Create an issue and mention `@atomicai` to:
- Generate SOPs for measure licensing and copyright management
- Create validation study protocols and documentation
- Draft training materials for measure administrators
- Develop scoring algorithms and interpretation guides
- Create translation and linguistic validation procedures
- Generate electronic vs paper administration protocols

## Getting Started

1. Create a new repository using this template
2. Customize documents with your organization's information
3. Add your validated measures to appropriate directories
4. Create issues with `@atomicai` to generate new documents
5. Review and approve AI-generated content via Pull Requests

## Compliance & Best Practices

These templates support compliance with:
- **FDA PRO Guidance** (2009) - Patient-Reported Outcome Measures
- **FDA BEST Framework** - Biomarkers, EndpointS, and other Tools
- **ICH E9** - Statistical Principles for Clinical Trials
- **ISPOR Guidelines** - Translation and Linguistic Validation
- **COSMIN** - COnsensus-based Standards for the selection of health Measurement INstruments
- **PROMIS** Standards - Patient-Reported Outcomes Measurement Information System
- **21 CFR Part 11** - Electronic Records (for eCOA)
- **HIPAA** - Health Information Privacy
- **GDPR** - Data Protection (international studies)

## Key Quality Considerations

### Psychometric Properties
- **Reliability**: Internal consistency, test-retest, inter-rater
- **Validity**: Content, construct, criterion, known-groups
- **Responsiveness**: Ability to detect meaningful change
- **Interpretability**: Minimal clinically important difference (MCID), normative data

### Licensing & Copyright
- Track proprietary measure licenses and renewals
- Maintain permissions for use, modification, and translation
- Document copyright restrictions and attribution requirements
- Manage royalty agreements for commercial use

### Translation Management
- Forward-backward translation methodology
- Cultural adaptation and cognitive debriefing
- Linguistic validation certificates
- Version control for multi-language instruments

### Administration Standards
- Training and certification requirements for administrators
- Paper vs electronic administration equivalence
- Recall period and timing specifications
- Instructions and response option standardization

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