Patient-reported outcomes in cancer

Thursday, June 13, 2019

David Cella, PhD, of Northwestern University in Chicago, joins Blood & Cancer as the guest host for a conversation on patient-reported outcomes and how to apply them in oncology clinical practice with Ethan Basch, MD, of the University of North Carolina, Chapel Hill.

In Clinical Correlation, Ilana Yurkiewicz, MD, of Stanford (Calif.) University, talks about invisible illness and what it’s like for a patient to be dying but appear outwardly healthy.

Show notes

By Emily Bryer, DO, resident in the department of internal medicine, University of Pennsylvania, Philadelphia

  • Patients understand how they are doing better than clinicians do.
  • Subjective patient outcomes (pain, fatigue, myalgias) are difficult for clinicians to classify and are often discordant with patient reports.
  • In routine practice and clinical trials, the clinician reporting of adverse events/patient symptomatic side effects is inconsistent and incomplete.
  • Physicians may not know about symptoms and side effects of patients undergoing treatment because:
    • Patients are scared their dose will be reduced or discontinued.
    • Patients don’t want to let their doctors down.
    • Patients think feeling ill after chemo is “normal.”
  • Questionnaires produce more accurate reports of patient symptoms than conversations with providers.
  • CTCAE = Common Terminology Criteria for Adverse Events (provider version).
  • PRO-CTCAE = Patient-reported outcomes version of the Common Terminology Criteria for Adverse Events.
    • It is a library of individual items asking patients directly about symptomatic events.
    • It is used in many clinical trials to monitor patient-reported adverse events.
  • Monitoring patient-reported outcomes (PROs) systematically during visits decreases rates of emergency department visits and hospitalizations.
  • Nurses and patient advocates often alert providers to PROs.

Resources:

CTCAE

PRO-CTCAE

Improving the Management of symPtoms during And following Cancer Treatment (IMPACT) consortium

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David Henry, MD
David Henry, MD, FACP, is a clinical professor of medicine at the University of Pennsylvania and vice chairman of the department of medicine at Pennsylvania Hospital in Philadelphia. He received his bachelor’s degree from Princeton University and his MD from the University of Pennsylvania, then completed his internship, residency, and fellowship at the Hospital of the University of Pennsylvania. After 2 years as an attending in the U.S. Air Force, he was drawn to practicing as a hem-onc because of the close patient contact and interaction, and his belief that, win or lose with each patient, one can always make a difference in their care and lives. Follow Dr. Henry on Twitter: @davidhenrymd. Dr. Henry reported being on the advisory board for Amgen, AMAG Pharmaceuticals, and Pharmacosmos. He reported institutional funding from the National Institutes of Health and FibroGen.



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