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癌症患者报告结局监测的基本原理及一种可重现的实现方法。

The rationale for patient-reported outcomes surveillance in cancer and a reproducible method for achieving it.

机构信息

Behavioral Research Center, Intramural Research Department, American Cancer Society, Atlanta, Georgia.

Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.

出版信息

Cancer. 2016 Feb 1;122(3):344-51. doi: 10.1002/cncr.29767. Epub 2015 Nov 30.

Abstract

Patient-reported outcomes (PROs) measure quality of life, symptoms, patient functioning, and patient perceptions of care; they are essential for gaining a full understanding of cancer care and the impact of cancer on people's lives. Repeatedly captured facility-level and/or population-level PROs (PRO surveillance) could play an important role in quality monitoring and improvement, benchmarking, advocacy, policy making, and research. This article describes the rationale for PRO surveillance and the methods of the Patient Reported Outcomes Symptoms and Side Effects Study (PROSSES), which is the first PRO study to use the American College of Surgeons Commission on Cancer's Rapid Quality Reporting System to identify patients and manage study data flow. The American Cancer Society, the National Cancer Institute, the Commission on Cancer, and RTI International collaborated on PROSSES. PROSSES was conducted at 17 cancer programs that participated in the National Cancer Institute Community Cancer Centers Program among patients diagnosed with locoregional breast or colon cancer. The methods piloted in PROSSES were successful as demonstrated by high eligibility (93%) and response (61%) rates. Differences in clinical and demographic characteristics between respondents and nonrespondents were mostly negligible, with the exception that non-white individuals were somewhat less likely to respond. These methods were consistent across cancer centers and reproducible over time. If repeated and expanded, they could provide PRO surveillance data from patients with cancer on a national scale.

摘要

患者报告的结局(PROs)衡量生活质量、症状、患者功能和患者对治疗的看法;它们对于全面了解癌症护理以及癌症对人们生活的影响至关重要。反复采集医疗机构层面和/或人群层面的 PROs(PRO 监测),可能在质量监测和改进、基准比较、宣传、政策制定和研究方面发挥重要作用。本文描述了 PRO 监测的基本原理和方法,以及患者报告的结局症状和副作用研究(PROSSES)的方法,这是第一个使用美国外科医师学院癌症委员会快速质量报告系统来识别患者并管理研究数据流的 PRO 研究。美国癌症协会、美国国立卫生研究院、癌症委员会和 RTI 国际合作开展了 PROSSES 研究。在参与美国国立卫生研究院社区癌症中心计划的 17 个癌症项目中,对诊断为局部区域性乳腺癌或结肠癌的患者进行了 PROSSES 研究。PROSSES 中试点的方法取得了成功,证明了高合格率(93%)和高应答率(61%)。应答者和未应答者之间的临床和人口统计学特征差异大多可以忽略不计,但除了非白人应答者的比例略低之外。这些方法在癌症中心之间是一致的,且具有可重复性。如果重复和扩展,它们可以在全国范围内为癌症患者提供 PRO 监测数据。

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