When Using Patient-Reported Outcomes in Clinical Practice, the Measure Matters: A Randomized Controlled Trial
When Using Patient-Reported Outcomes in Clinical Practice, the Measure Matters: A Randomized Controlled Trial
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DOI：
10.1200/jop.2014.001413
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发表时间：
2014-09-01
影响因子：
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通讯作者：
Wu, Albert W.
中科院分区：
文献类型：
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作者：
Snyder, Claire F.;Herman, Joseph M.;Wu, Albert W.
背景资料：患者报告的结果（PRO）的措施越来越多地被用于临床实践，以告知个别患者的管理，但证据是需要的PRO是最适合临床use.Methods：这个对照试验随机分配患者接受治疗的乳腺癌和前列腺癌，以完成三个PRO措施之一：欧洲癌症研究和治疗组织生活质量量表-核心30（QLQ-C30），支持性护理需求调查-简表（SCNS-SF 34），或来自患者报告结局测量信息系统（PROMIS）的六个领域。患者在临床访视前完成PRO测量，并将结果提供给患者和临床医生。在治疗结束时，患者和临床医生完成了关于干预的有用性和价值的简短反馈表。对患者（治疗结束时）和临床医生（研究结束时）进行了退出访谈。主要结果是在每个手臂的患者的比例，无论是强烈同意或同意所有的反馈表items.Results：294名合格的患者邀请参加，224（76%）登记（中位年龄66岁，78%白色，72%前列腺）。在完成至少一个反馈表项目的181例患者（81%）中，QLQ-C30研究组的参与者最有可能强烈同意/同意所有项目（74%），其次是PROMIS（61%）和SCNS-SF 34（52%; P = .03）。在完成所有反馈表项目的116名参与者（52%）中，结果相似：QLQ-C30为82%，PROMIS为62%，SCNS-SF 34为56%（P = 0.05）。临床医生不喜欢一个问卷超过others.Conclusion：这些结果表明，当使用PRO在临床实践中的病人管理，措施事项的有用性方面的病人。
Background: Patient-reported outcome (PRO) measures are increasingly being used in clinical practice to inform individual patient management, but evidence is needed on which PROs are best suited for clinical use.Methods: This controlled trial randomly assigned patients with breast and prostate cancer undergoing treatment to complete one of three PRO measures: European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30), Supportive Care Needs Survey-Short Form (SCNS-SF34), or six domains from the Patient-Reported Outcomes Measurement Information System (PROMIS). Patients completed the PRO measures before clinic visits, and the results were provided to both the patient and clinician. At treatment completion, patients and clinicians completed brief feedback forms on the intervention's usefulness and value. Exit interviews were conducted with patients (at end of treatment) and clinicians (at end of study). The primary outcome was the proportion of patients in each arm who either strongly agreed or agreed to all feedback form items.Results: Of 294 eligible patients invited to participate, 224 (76%) enrolled (median age 66 years, 78% white, 72% prostate). Of the 181 patients (81%) who completed at least one feedback form item, participants in the QLQ-C30 study arm were most likely to strongly agree/agree to all items (74%) followed by PROMIS (61%) and SCNS-SF34 (52%; P = .03). Of the 116 participants (52%) who completed all feedback form items, the results were similar: 82% for the QLQ-C30, 62% for PROMIS, and 56% for SCNS-SF34 (P = .05). Clinicians did not prefer one questionnaire over the others.Conclusion: These results suggest that, when using PROs in clinical practice for patient management, the measure matters in terms of usefulness to patients.