Using Patient-Reported Outcome Measures for Improved Decision-Making in Patients with Gastrointestinal Cancer – the Last Clinical Frontier in Surgical Oncology?

Kjetil Søreide,Annbjørg H Søreide

doi:10.3389/fonc.2013.00157

Abstract

The genomic era has introduced concepts of “personalized medicine” and “targeted therapy” in the field of oncology. Medicine has become increasingly complex with a plethora of potential dilemmas in diagnosis, treatment, and management. The focus on classical outcomes for clinical decision-making is now increasingly being replaced by patient-reported outcome measures (PROMs). PROMs should increasingly now be in the center of patient-centered decision-making, based on valid, reliable, and clinically useful measures delivered directly by the patient to the caregiver. Surgeons’ ability to interpret and apply PROMs and quality of life results must improve by education and further research, and has an unreleased potential to contribute to a better understanding of the patients’ well-being. A number of caveats must be addressed before this can be brought to fruition; standardization for valid items; appropriate use of instruments; correct timing of the application; missing data handling, compliance, and respondent drop-outs are but a few issues to be addressed. Based on the apparent lack of use in both research and clinical work, it should call for an educational effort to address this among surgeons caring for patients with cancer.

Highlights

The genomic era has swept the medical community since the beginning of the twenty-first century, leading to an advent of “personalized medicine” and “targeted therapy” in particular within the field of oncology
The growing demands for quality and safety in health care have refocused attention on patient outcomes(Lipscomb et al, 2007; Sloan et al, 2007; Trotti et al, 2007; Wagner et al, 2007; Blazeby, 2010; Williamson et al, 2012a; Macefield et al, 2013). This perspectives article will briefly discuss the rationale; the definitions and perceived concepts; the need for standards; issues related to surgical oncology; and, eventually, some future directions for patient-centered outcomes measures in health research
A recently released draft of recommendations for selected standards for the conduct of research leading to evidence-based, patient-centered health interventions has been reported

Summary

Introduction

The genomic era has swept the medical community since the beginning of the twenty-first century, leading to an advent of “personalized medicine” and “targeted therapy” in particular within the field of oncology. The patient-reported outcomes should have an increased role in decision-making, but must be based on valid, reliable, and clinically useful measures (Lipscomb et al, 2007).

Results

Conclusion