title: Communicating Value in Health Care Using Radar Charts: A Case Study of Prostate Cancer.
abstract: The transformation from volume to value will require communication of outcomes and costs of therapies; however, outcomes are usually nonstandardized, and cost of therapy differs among stakeholders. We developed a standardized value framework by using radar charts to visualize and communicate a wide range of patient outcomes and cost for three forms of prostate cancer treatment.
  
  
  
  We retrospectively reviewed data from men with low-risk prostate cancer who were treated with low-dose rate brachytherapy (LDR-BT), proton beam therapy, or robotic-assisted prostatectomy. Patient-reported outcomes comprised the Expanded Prostate Cancer Index Composite-50 domains for sexual function, urinary incontinence and/or bother, bowel bother, and vitality 12 months after treatment. Costs were measured by time-driven activity-based costing for the first 12 months of the care cycle. Outcome and cost data were plotted on a single radar chart for each treatment modality.
  
  
  
  Outcome and cost data from patients who were treated with robotic-assisted prostatectomy (n = 381), proton beam therapy (n = 165), and LDR-BT (n = 238) were incorporated into the radar chart. LDR-BT seemed to deliver the highest overall value of the three treatment modalities; however, incorporation of patient preferences regarding outcomes may allow other modalities to be considered high-value treatment options.
  
  
  
  Standardization and visualization of outcome and cost metrics may allow more comprehensive and collaborative discussions about the value of health care services. Communicating the value framework by using radar charts may be an effective method to present total value and the value of all outcomes and costs in a manner that is accessible to all stakeholders. Variations in plotting of costs and outcomes will require future focus group initiatives.
authors: The University of Texas MD Anderson Cancer Center, Houston, TX; Arizona Oncology, The US Oncology Network, Tucson, AZ; The Hospital of the University of Pennsylvania, Philadelphia, PA; and Harvard Business School, Boston, MA.
authors: Nikhil G
authors: NG
authors: Thaker
authors: The University of Texas MD Anderson Cancer Center, Houston, TX; Arizona Oncology, The US Oncology Network, Tucson, AZ; The Hospital of the University of Pennsylvania, Philadelphia, PA; and Harvard Business School, Boston, MA.
authors: Tariq N
authors: TN
authors: Ali
authors: The University of Texas MD Anderson Cancer Center, Houston, TX; Arizona Oncology, The US Oncology Network, Tucson, AZ; The Hospital of the University of Pennsylvania, Philadelphia, PA; and Harvard Business School, Boston, MA.
authors: Michael E
authors: ME
authors: Porter
authors: The University of Texas MD Anderson Cancer Center, Houston, TX; Arizona Oncology, The US Oncology Network, Tucson, AZ; The Hospital of the University of Pennsylvania, Philadelphia, PA; and Harvard Business School, Boston, MA.
authors: Thomas W
authors: TW
authors: Feeley
authors: The University of Texas MD Anderson Cancer Center, Houston, TX; Arizona Oncology, The US Oncology Network, Tucson, AZ; The Hospital of the University of Pennsylvania, Philadelphia, PA; and Harvard Business School, Boston, MA.
authors: Robert S
authors: RS
authors: Kaplan
authors: The University of Texas MD Anderson Cancer Center, Houston, TX; Arizona Oncology, The US Oncology Network, Tucson, AZ; The Hospital of the University of Pennsylvania, Philadelphia, PA; and Harvard Business School, Boston, MA sjfrank@mdanderson.org.
authors: Steven J
authors: SJ
authors: Frank
mesh_terms: D001918:Brachytherapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006801:Humans; D008297:Male; D000071066:Patient Reported Outcome Measures; D011468:Prostatectomy / Q000191:economics*; D011471:Prostatic Neoplasms / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D061766:Proton Therapy / Q000191:economics*; D011788:Quality of Life; D012107:Research Design; D016896:Treatment Outcome