title: Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors.
abstract: BACKGROUND
  This review focused on the identification of patient-reported outcome measures (PROMs) used in routine cancer clinical practice, the impact on patient, provider, and system outcomes, and the implementation factors influencing uptake.
  
  
  METHODS
  A scoping review of the published health literature was conducted using empirical databases, namely, Ovid Medline (2003 to September 2013), CINAHL (2003-2013) and PsycINFO (2003-2013). Scoping reviews are systematic literature reviews in a broad topic area that provide relevant and quantified results about the knowledge available on a particular topic and aim to rapidly map and synthesize the evidence to emphasize what is known.
  
  
  RESULTS
  From a total of 2447 unique publications, 30 articles that met eligibility criteria were reviewed. PRO use appears to be acceptable to patients, enables earlier detection of symptoms and may improve communication between clinicians and patients. However, the impact of routine PROMs collection on health outcomes is less clear and high-quality research is still warranted.
  
  
  CONCLUSIONS
  PROMs use in routine cancer clinical practice is growing with improvements on essential care processes shown but a number of implementation barriers must still be addressed. The lack of standardization in PROMs used in cancer organizations may make it difficult to use these data for quality monitoring in the future.
authors.affiliation: Nursing, University Health Network (Princess Margaret Cancer Centre), Toronto. Electronic address: doris.howell@uhn.on.ca.
authors.forename: D
authors.initials: D
authors.lastname: Howell
authors.affiliation: Symptom Management, Cancer Care Ontario, Toronto.
authors.forename: S
authors.initials: S
authors.lastname: Molloy
authors.affiliation: Symptom Management, Cancer Care Ontario, Toronto.
authors.forename: K
authors.initials: K
authors.lastname: Wilkinson
authors.affiliation: Nursing and Psychosocial Oncology, Cancer Care Ontario, Toronto.
authors.forename: E
authors.initials: E
authors.lastname: Green
authors.affiliation: Evidence Search and Review Service, Cancer Care Ontario, Toronto, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Orchard
authors.affiliation: Evidence Search and Review Service, Cancer Care Ontario, Toronto, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Wang
authors.affiliation: Evidence Search and Review Service, Cancer Care Ontario, Toronto, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Liberty
mesh_terms: D003142:Communication; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D057566:Self Report; D016896:Treatment Outcome
keywords: cancer; implementation barriers; patient reported-outcomes; review; routine practice