title: Developing a core set of patient-reported outcomes in pancreatic cancer: A Delphi survey.
abstract: BACKGROUND
  Patient-reported outcomes (PROs) are amongst the most relevant outcome measures in pancreatic cancer care and research. However, it is unknown which out of the numerous PROs are most important to patients and health care professionals (HCPs) in this setting. The aim of this study was to identify a core set of PROs to be incorporated in a nationwide prospective multidisciplinary pancreatic cancer registry.
  
  
  METHODS
  We performed a two-round Delphi survey among 150 patients diagnosed with pancreatic or periampullary cancer (treated either with curative intent or in palliative setting) and 78 HCPs (surgeons, medical oncologists, gastroenterologists, radiotherapists, nurses, and dietitians) in The Netherlands. In round 1, participants were invited to rate the importance of 53 PROs, which were extracted from 17 different PRO measures and grouped into global domains, on a 1-9 Likert scale. PROs rated as very important (score 7-9) by the majority (≥ 80%) of curative and/or palliative patients as well as HCPs were considered sufficiently important to be incorporated in the core set. PROs not fulfilling these criteria in round 1 were presented again to the participants in round 2 along with individual and group feedback.
  
  
  RESULTS
  A total of 97 patients (94%) in curative-intent setting, 38 patients (81%) in palliative setting and 73 HCPs (94%) completed both rounds 1 and 2. After the first round, 7 PROs were included in the core set: general quality of life, general health, physical ability, satisfaction with caregivers, satisfaction with services and care organisation, coping and defecation. After the second round, 10 additional PROs were added: appetite, ability to work/do usual activities, medication use, weight changes, fatigue, negative feelings, positive feelings, fear of recurrence, relationship with partner/family, and pancreatic enzyme replacement therapy use.
  
  
  CONCLUSIONS
  This study provides a core set of PROs selected by patients and HCPs, which may be incorporated in pancreatic cancer care and research. Validation outside the Dutch context is recommended for generalisation and use in international studies.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands; Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Arja
authors.initials: A
authors.lastname: Gerritsen
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Marc
authors.initials: M
authors.lastname: Jacobs
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Henselmans
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Jons
authors.initials: J
authors.lastname: van Hattum
authors.affiliation: Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Efficace
authors.affiliation: Department of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: Creemers
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Ignace H
authors.initials: IH
authors.lastname: de Hingh
authors.affiliation: Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Miriam
authors.initials: M
authors.lastname: Koopman
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: I Quintus
authors.initials: IQ
authors.lastname: Molenaar
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Hanneke W
authors.initials: HW
authors.lastname: Wilmink
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Olivier R
authors.initials: OR
authors.lastname: Busch
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Besselink
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Amsterdam, the Netherlands. Electronic address: h.vanlaarhoven@amc.nl.
authors.forename: Hanneke W
authors.initials: HW
authors.lastname: van Laarhoven
mesh_terms: D000368:Aged; D003697:Delphi Technique; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D010190:Pancreatic Neoplasms / Q000150:complications / Q000628:therapy*; D063868:Patient Outcome Assessment; D057285:Precision Medicine / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires
keywords: Delphi survey; Pancreatic cancer; Patient-reported outcomes; Personalized medicine; Quality of life