title: The use and impact of quality of life assessment tools in clinical care settings for cancer patients, with a particular emphasis on brain cancer: insights from a systematic review and stakeholder consultations.
abstract: Patient-reported data are playing an increasing role in health care. In oncology, data from quality of life (QoL) assessment tools may be particularly important for those with limited survival prospects, where treatments aim to prolong survival while maintaining or improving QoL. This paper examines the use and impact of using QoL measures on health care of cancer patients within a clinical setting, particularly those with brain cancer. It also examines facilitators and challenges, and provides implications for policy and practice.
  
  
  
  We conducted a systematic literature review, 15 expert interviews and a consultation at an international summit.
  
  
  
  The systematic review found no relevant intervention studies specifically in brain cancer patients, and after expanding our search to include other cancers, 15 relevant studies were identified. The evidence on the effectiveness of using QoL tools was inconsistent for patient management, but somewhat more consistent in favour of improving patient-physician communication. Interviews identified unharnessed potential and growing interest in QoL tool use and associated challenges to address.
  
  
  
  Our findings suggest that the use of QoL tools in cancer patients may improve patient-physician communication and have the potential to improve care, but the tools are not currently widely used in clinical practice (in brain cancer nor some other cancer contexts) although they are in clinical trials. There is a need for further research and stakeholder engagement on how QoL tools can achieve most impact across cancer and patient contexts. There is also a need for policy, health professional, research and patient communities to strengthen information exchange and debate, support awareness raising and provide training on tool design, use and interpretation.
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: King
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK.
authors.forename: Josephine
authors.initials: J
authors.lastname: Exley
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Parks
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ball
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK.
authors.forename: Teresa
authors.initials: T
authors.lastname: Bienkowska-Gibbs
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK.
authors.forename: Calum
authors.initials: C
authors.lastname: MacLure
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Harte
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Stewart
authors.affiliation: RAND Corporation, Pittsburgh, PA, USA.
authors.forename: Jody
authors.initials: J
authors.lastname: Larkin
authors.affiliation: European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bottomley
authors.affiliation: RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK. smarjano@rand.org.
authors.forename: Sonja
authors.initials: S
authors.lastname: Marjanovic
mesh_terms: D001932:Brain Neoplasms / Q000523:psychology*; D006296:Health Services / Q000592:standards*; D006801:Humans; D018434:Sickness Impact Profile
keywords: Brain cancer; Oncology; Quality of life