title: A controlled study of use of patient-reported outcomes to improve assessment of late effects after treatment for head-and-neck cancer.
abstract: To test the effect of longitudinal feedback on late effects reported by survivors of head-and-neck cancer (HNC) to clinicians during regular follow-up.
  
  
  
  A total of 266 participants were sequentially assigned to either control or intervention group and filled in electronic versions of the EORTC QLQ C-30, H&N35, HADS and a study-specific list of symptoms at up to two consecutive follow-up visits. Participants' symptoms displayed according to severity were provided to the clinician for the intervention group but not for the control group. Linear mixed-effects models were used to examine the number of symptoms assessed by clinicians (primary outcome). Multivariate linear regression models examined participants' long-term symptom control and QoL (secondary outcome).
  
  
  
  More symptoms were assessed by clinicians in the intervention group at all three visits (P<0.001, <0.001, and P=0.04). No effect was observed on most patient outcomes. When prompted by patient-reported outcomes at consultations, clinicians and patients were in better agreement about the occurrence of severe symptoms at all three visits.
  
  
  
  Timely patient-reported outcomes to clinicians in routine follow-up of HNC survivors enhanced clinicians' rates of assessment of late symptoms. Giving reports of patient-reported outcome to clinicians had limited impact on participants' QoL or symptom burden.
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark. Electronic address: trille@cancer.dk.
authors.forename: Trille
authors.initials: T
authors.lastname: Kjaer
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Susanne Oksbjerg
authors.initials: SO
authors.lastname: Dalton
authors.affiliation: Department of Oncology, Herlev Hospital, University of Copenhagen, Denmark.
authors.forename: Elo
authors.initials: E
authors.lastname: Andersen
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Randi
authors.initials: R
authors.lastname: Karlsen
authors.affiliation: Department of Oncology, Herlev Hospital, University of Copenhagen, Denmark.
authors.forename: Anni Linnet
authors.initials: AL
authors.lastname: Nielsen
authors.affiliation: Department of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Merete Kjaer
authors.initials: MK
authors.lastname: Hansen
authors.affiliation: Department of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Frederiksen
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011788:Quality of Life; D012107:Research Design; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data
keywords: Head-and-neck cancer; Late effects; Patient-reported outcomes