Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Cancer Program, Sunnybrook Research Institute, Evaluative Clinical Sciences Platform, Toronto, Ontario, Canada.
BMJ Open. 2022 Jun 14;12(6):e061309. doi: 10.1136/bmjopen-2022-061309.
Following a cancer diagnosis, patients and their caregivers face crucial decisions regarding goals of care and treatment, which have consequences that can persist throughout their cancer journey. To foster informed and value-driven treatment choices, evidence-based information on outcomes relevant to patients is needed. Traditionally, clinical studies have largely focused on a few concrete and easily measurable outcomes such as survival, disease progression and immediate treatment toxicities. These outcomes do not capture other important factors that patients consider when making treatment decisions. Patient-centred outcomes (PCOs) reflect the patients' individual values, preferences, needs and circumstances that are essential to directing meaningful and informed healthcare discussions. Often, however, these outcomes are not included in research protocols in a standardised and practical fashion. This scoping review will summarise the existing literature on PCOs in gastrointestinal (GI) cancer care as well as the tools used to assess these outcomes. A comprehensive list of these PCOs will be generated for future efforts to develop a core outcome set.
This scoping review will follow Arksey and O'Malley's expanded framework for scoping reviews. We will systematically search Medline, Embase, CINAHL, Cochrane Library and APA PsycINFO databases for studies examining PCOs in the context of GI cancer. We will include studies published in or after the year 2000 up to the date of the final searches, with no language restrictions. Studies involving adult patients with GI cancers and discussion of any PCOs will be included. Opinion pieces, protocols, case reports and abstracts will be excluded. Two authors will independently perform two rounds of screening to select studies for inclusion. The data from full texts will be extracted, charted and summarised both quantitatively and qualitatively.
No ethics approval is required for this scoping review. Results will be disseminated through scientific publication and presentation at relevant conferences.
在癌症诊断后,患者及其护理人员面临着关于治疗目标和治疗方案的关键决策,这些决策的后果可能会持续贯穿整个癌症治疗过程。为了促进知情和基于价值观的治疗选择,需要提供与患者相关的基于证据的结局信息。传统上,临床研究主要集中在少数具体且易于衡量的结局上,如生存、疾病进展和即时治疗毒性。这些结局并不能捕捉到患者在做出治疗决策时考虑的其他重要因素。患者为中心的结局(PCOs)反映了患者的个人价值观、偏好、需求和情况,这些对于指导有意义和知情的医疗保健讨论至关重要。然而,这些结局通常没有以标准化和实用的方式纳入研究方案。本范围综述将总结胃肠道(GI)癌症护理中 PCOs 的现有文献以及用于评估这些结局的工具。将生成这些 PCOs 的综合清单,以便未来努力制定核心结局集。
本范围综述将遵循 Arksey 和 O'Malley 扩展的范围综述框架。我们将系统地检索 Medline、Embase、CINAHL、Cochrane 图书馆和 APA PsycINFO 数据库,以查找研究 GI 癌症背景下 PCOs 的研究。我们将纳入 2000 年及以后发表的研究,检索日期截止到最后一次搜索,不限制语言。纳入研究涉及 GI 癌症的成年患者,以及任何 PCOs 的讨论。将排除观点文章、方案、病例报告和摘要。两位作者将独立进行两轮筛选,以选择纳入的研究。将从全文中提取、图表和总结数据,进行定量和定性分析。
本范围综述不需要伦理批准。结果将通过科学出版物和在相关会议上的演讲进行传播。