title: Evaluating the quality of supportive oncology using patient-reported data.
abstract: OBJECTIVE
  Patient-reported data may provide valuable information for oncology quality measurement. We evaluated applying patient-reported data from the Cancer Care Outcomes Research and Surveillance Consortium national study to quality indicators addressing supportive oncology domains.
  
  
  METHODS
  We analyzed surveys including validated instruments for symptoms and care planning from 4,174 patients newly diagnosed with lung or colorectal cancer. We adapted existing supportive oncology indicators for use with patient-reported data from Cancer Quality-ASSIST and the American Society of Clinical Oncology Quality Oncology Practice Initiative. Where feasible, we examined indicators using medical record data for comparison purposes.
  
  
  RESULTS
  Using patient-reported data, the percentage of patients meeting indicator criteria for screening ranged from 74% (significant depressive symptoms) to 93% (pain, nausea/vomiting). The percentage meeting indicator criteria for symptom treatment ranged from 73% (significant depressive symptoms) to 99% (nausea/vomiting). Symptom severity did not affect the results. Using medical record data, the percentage meeting indicator criteria varied between 4% (significant depressive symptoms) and 23% (pain). For information and care planning, 44% met criteria for discussion about resuscitation and 32% for hospice discussion using survey data. Using medical record data, 11% met criteria for goals-of-care discussion in intensive care and 46% for hospice/pain management/palliative care referral before death.
  
  
  CONCLUSIONS
  Quality of care for symptoms measured using patient self-report was higher than when including medical record data. Use of patient-reported and medical record data allowed measurement of different perspectives on care planning indicators. Patient-reported data provide a complementary, patient-centered perspective on the quality of supportive oncology care.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; University of California, Los Angeles; Veterans Health Administration of Greater Los Angeles, Los Angeles, CA; and Dana-Farber Cancer Institute, Boston, MA sdy@jhsph.edu.
authors.forename: Sydney M
authors.initials: SM
authors.lastname: Dy
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; University of California, Los Angeles; Veterans Health Administration of Greater Los Angeles, Los Angeles, CA; and Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Walling
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; University of California, Los Angeles; Veterans Health Administration of Greater Los Angeles, Los Angeles, CA; and Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Mack
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; University of California, Los Angeles; Veterans Health Administration of Greater Los Angeles, Los Angeles, CA; and Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Malin
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; University of California, Los Angeles; Veterans Health Administration of Greater Los Angeles, Los Angeles, CA; and Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Philip
authors.initials: P
authors.lastname: Pantoja
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; University of California, Los Angeles; Veterans Health Administration of Greater Los Angeles, Los Angeles, CA; and Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Karl A
authors.initials: KA
authors.lastname: Lorenz
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; University of California, Los Angeles; Veterans Health Administration of Greater Los Angeles, Los Angeles, CA; and Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Tisnado
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000628:therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D008875:Middle Aged; D010166:Palliative Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D057566:Self Report; D055815:Young Adult