title: Focusing on the "Person" in Personalized Medicine: The Future of Patient-Centered Care in Radiation Oncology.
abstract: Numerous efforts in radiation oncology aim to improve the value of clinical care. To evaluate the success of these efforts, outcome measures must be well defined and incorporate the beliefs of the patients they affect. These outcomes have historically centered on rates of tumor control, overall survival, and adverse events as perceived and reported by providers. However, the future of patient-centered care in radiation oncology is increasingly focusing on the "person" in the population and the individual in the studies to more closely reflect the ideals of personalized medicine. Formally known as patient-centered outcomes, this metric encompasses parameters of patient satisfaction, engagement, and treatment compliance. Evaluations that investigate the safety and efficacy of treatments are increasingly soliciting participation from patients within a model of shared decision making that improves patients' knowledge, satisfaction, physical and emotional well-being, and trust in providers. Modern clinical trials that embrace this approach may even focus on patient-reported outcomes as the primary end point, as opposed to time-honored physician-reported events. The authors explore the growing role of patient-centered care, the incorporation of shared decision making, and the relevant body of existing and developing literature on this topic in radiation oncology. The authors report recent discoveries from this area of study and describe how they can not only support high-quality, high-value patient care but also enhance recruitment to clinical oncology trials, both of which are challenging to achieve in today's relatively resource-strapped environment.
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: abigail.berman@uphs.upenn.edu.
authors.forename: Abigail T
authors.initials: AT
authors.lastname: Berman
authors.affiliation: Sutter Medical Group and Sutter Cancer Center, Sacramento, California.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Rosenthal
authors.affiliation: Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Drew
authors.initials: D
authors.lastname: Moghanaki
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Kristina D
authors.initials: KD
authors.lastname: Woodhouse
authors.affiliation: Henry Ford Hospital, Detroit, Michigan.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Movsas
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Neha
authors.initials: N
authors.lastname: Vapiwala
mesh_terms: D017146:Models, Organizational; D009937:Organizational Objectives; D010348:Patient Care Team / Q000458:organization & administration*; D010358:Patient Participation / Q000379:methods*; D018802:Patient-Centered Care / Q000458:organization & administration*; D010817:Physician-Patient Relations; D058996:Quality Improvement / Q000458:organization & administration*; D018787:Radiation Oncology / Q000458:organization & administration*; D014481:United States
keywords: Radiation oncology; decision aid; patient-reported outcomes; personalized care; quality of life; shared decision making