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Routine Prospective Collection of Patient-Reported Outcomes Can Be Adopted Widely

Conference Correspondent

Although collecting patient-reported outcomes (PROs) in people with cancer has been associated with improved overall survival, routine collection of PROs is still not widely adopted. According to Rachel Clark Sisodia, MD, who described initial findings from a large-scale PRO program in patients with gynecologic malignancy at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer, prospectively collecting digital PROs can be quite seamless, but for this practice to be adopted routinely in cancer centers, clear algorithms and technological competence are needed.

Perhaps a more important finding of the study, as reported by Dr Clark Sisodia and colleagues from Massachusetts General Hospital, is that patients with gynecologic malignancy do not report worsened quality of life after surgery.

Their Boston-based practice implemented routine, periodic collection of PROs for all medical and surgical patients with gynecologic malignancy. Nearly 2000 patients in the study received the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and the Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional and Instrumental Support Questionnaires. They also received 1 of 4 disease-specific patient-reported outcome measures (PROMs): the EORTC Ov-28 (ovary), the EORTC-Cx 24 (cervix), the EORTC En-24 (uterus), or the FACT-V (vulva).

Patients could access their disease-specific PROMs either online prior to their appointment or on a tablet in the clinic. Results were immediately made available to providers in the electronic health record (EHR). Only English was supported by the EHR, so other spoken languages required an interpreter to complete.

A total of 1811 patients were assigned PROMs between January 2018 and May 2019. Of these patients, 84% were white and 58% had private insurance. Most patients had cancer of the ovary (30.85%), followed by the uterus (24.6%), the cervix (22.7%), and the vulva (6.2%). PROMs were completed by 77% (n = 1393) of participants.

All age-groups had high response rates, and there was no difference in response rates by disease site or among black, white, and Asian patients. However, Hispanic patients were less likely to complete PROMs. More specifically, Spanish-speaking women were less likely to complete PROMs, suggesting the necessity of administering them in a patient’s spoken language.

Patients’ level of preoperative social infrastructure, quantified by their preoperative emotional/instrumental support scores, did not predict postoperative complications, the investigators reported. Patients in the study reported no difference in “overall quality of life in the past week” between the pre- and postoperative periods.

SGO 2020 Annual Meeting on Women’s Cancer. Abstract 84.

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