Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA.
Ann Surg Oncol. 2018 Oct;25(10):2839-2845. doi: 10.1245/s10434-018-6616-1. Epub 2018 Jul 3.
Patient-reported outcomes (PROs) provide insight into how patients perceive health and treatment effects, how treatments impact outcomes, and are helpful in determining how disease and surgical interventions impact many aspects of a patients' life. Commonly utilized metrics include survival and disease control, degree of recovery and functional status, access to treatment, treatment-related complications, health-related quality of life, and long-term consequences of therapy. The key to value-based, patient-centered health care is systematically incorporating patient input into the measures that they consider to be the most important outcomes for a particular medical condition while minimizing costs of care. This manuscript reviews the development and validation of multiple available PROs in breast surgical oncology and reconstruction, their impact in improving patient-physician communication and treatment outcome, and potential for impacting reimbursement. The implementation of PROs can be complex and challenging and care must be taken to minimize the potential for survey fatigue by patients and the potential financial burden for implementation, maintenance, and analyses of collected data. Because there is an increased emphasis in providing high-value care for cancer patients, the widespread incorporation of transparent breast-specific PROs stratified by treatments received and disease stage will be essential in delivering exceptional quality care.
患者报告的结果(PROs)提供了患者如何感知健康和治疗效果的深入了解,以及治疗如何影响结果的信息,有助于确定疾病和手术干预如何影响患者生活的许多方面。常用的指标包括生存率和疾病控制率、恢复程度和功能状态、治疗的可及性、治疗相关并发症、健康相关生活质量以及治疗的长期后果。基于价值的、以患者为中心的医疗保健的关键是系统地将患者的意见纳入他们认为对特定医疗状况最重要的结果的衡量标准中,同时最大限度地降低医疗成本。本文回顾了在乳房外科肿瘤学和重建中多种可用的 PRO 的开发和验证,它们在改善患者-医生沟通和治疗结果方面的影响,以及在影响报销方面的潜力。PRO 的实施可能很复杂和具有挑战性,必须注意尽量减少患者调查疲劳的可能性,以及实施、维护和分析收集数据的潜在财务负担。由于对为癌症患者提供高价值护理的重视程度不断提高,因此,按所接受的治疗和疾病阶段分层的透明的特定于乳房的 PRO 的广泛纳入将是提供卓越护理质量的关键。