Patient-reported outcome measures for follow-up after gynaecological cancer treatment

Abstract

Cancer is a leading cause of death worldwide. Gynaecologic cancer treatment is known to have the potential for a major impact on quality of life (QoL). Patient-reported outcome measures (PROMs) is an umbrella term that covers a range of potential types of measurement but is used specifically to refer to self reports by the patient of their health and well-being. Use of QoL and cancer-specific questionnaires as alternatives to follow-up may have immense psychological benefit to the patient and cost benefit to the healthcare system. To evaluate the effectiveness of PROMs as an alternative to routine follow-up of women after treatment for gynaecological cancers to identify recurrences, affect overall survival and assess psychological benefit. We searched the Cochrane Gynaecological Cancer Group Trials Register, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) up to November 2012. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of review articles. We searched for randomised controlled trials (RCTs) and non-RCTs with concurrent comparison groups (of adequate quality that used statistical adjustment for baseline case mix using multivariable analyses) that compared PROMs or QoL questionnaires versus traditional follow-up with multiple visits to the hospital in women after treatment for gynaecological cancers. Studies that involved women completing PROMs at intervals and submitting results for assessment by their cancer care team or structured interviews of women during their follow-up were included in the analysis. Two review authors independently assessed whether potentially relevant studies met the inclusion criteria. We found no studies and therefore analysed no data. The search strategy identified 2524 unique references, of which all were excluded. We found no evidence to make an informed decision about PROMs for follow-up after gynaecological cancer. Ideally, RCTs which are multicentre or multinational or both, or well-designed non-randomised studies are needed that use multivariable analysis to adjust for baseline imbalances, to compare follow-up strategies and improve current knowledge.