title: PRO-ONKO-selection of patient-reported outcome assessments for the clinical use in cancer patients-a mixed-method multicenter cross-sectional exploratory study.
abstract: OBJECTIVE
  Cancer patients frequently suffer from multiple symptoms often impairing functional status and health-related quality of life (HRQOL). A comprehensive assessment including patient-reported outcomes (PROs) is recommended to enable individualized supportive care. However, PRO assessments are still not part of routine clinical practice. Therefore, this project aimed to compile an item pool from validated assessment instruments to facilitate the use of PROs for clinical decision-making in oncology clinics.
  
  
  METHODS
  This qualitative dominant mixed-method cross-sectional exploratory study was carried out in four centers and comprised two stages. Stage I: Six interdisciplinary focus groups were conducted to choose questionnaires meeting particular clinical requirements. Stage II: Adult patients with heterogeneous cancer diagnoses, receiving in- or out-patient treatment were asked to participate and complete the chosen questionnaires (participation 71/74). Resulting PROs were compared with clinical records. Health care professionals (HCPs) and patients rated the usefulness for routine clinical practice.
  
  
  RESULTS
  The European Organisation of Research and Treatment of Cancer (EORTC) QLQ-C30 and Distress Thermometer were chosen for screening and M.D. Anderson Symptom Inventory (MDASI) and EORTC single items for monitoring. Comparison of n = 88 PRO assessments with clinical records showed consistent documentation of side effects like fever and emesis. Symptoms like fatigue, sadness, or sleep disturbance were not documented regularly in the medical records but captured by PRO assessments. Patients and HCPs judged the chosen questionnaires and electronic data collection as useful.
  
  
  CONCLUSIONS
  Future studies should examine how PROs can complement or substitute routine documentation in order to achieve standardized assessment and documentation during the treatment process in different settings and examine possible benefits for patients.
authors.affiliation: Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany. heike.schmidt2@uk-halle.de.
authors.forename: Heike
authors.initials: H
authors.lastname: Schmidt
authors.affiliation: Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Merkel
authors.affiliation: Department of Hematology and Oncology, University Hospital, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Koehler
authors.affiliation: Department of Child and Adolescent Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
authors.forename: Hans-Henning
authors.initials: HH
authors.lastname: Flechtner
authors.affiliation: Scientific IT Consulting, Bettingen, Switzerland.|Reha Chrischona, Bettingen, Switzerland.
authors.forename: Jörg
authors.initials: J
authors.lastname: Sigle
authors.affiliation: Surgical Department, Helios Klinik, Sangerhausen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Klinge
authors.affiliation: Department of Internal Medicine IV, Hematology and Oncology, University Hospital Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Jordan
authors.affiliation: Department of Radiation Oncology, University Hospital Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vordermark
authors.affiliation: Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Margarete
authors.initials: M
authors.lastname: Landenberger
authors.affiliation: Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.|Nursing Research Unit, University Hospital Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Jahn
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003657:Decision Making; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy; D063868:Patient Outcome Assessment; D000071066:Patient Reported Outcome Measures; D011788:Quality of Life; D012107:Research Design; D011795:Surveys and Questionnaires
keywords: Cancer; Monitoring; Patient-reported outcomes; Quality of life; Screening; Supportive therapy