将患者报告结局纳入儿童癌症幸存者临床护理的十点考量
Ten Considerations for Integrating Patient-Reported Outcomes into Clinical Care for Childhood Cancer Survivors.
作者信息
Horan Madeline R, Sim Jin-Ah, Krull Kevin R, Ness Kirsten K, Yasui Yutaka, Robison Leslie L, Hudson Melissa M, Baker Justin N, Huang I-Chan
机构信息
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
School of AI Convergence, Hallym University, Chuncheon 24252, Republic of Korea.
出版信息
Cancers (Basel). 2023 Feb 6;15(4):1024. doi: 10.3390/cancers15041024.
Patient-reported outcome measures (PROMs) are subjective assessments of health status or health-related quality of life. In childhood cancer survivors, PROMs can be used to evaluate the adverse effects of cancer treatment and guide cancer survivorship care. However, there are barriers to integrating PROMs into clinical practice, such as constraints in clinical validity, meaningful interpretation, and technology-enabled administration of the measures. This article discusses these barriers and proposes 10 important considerations for appropriate PROM integration into clinical care for choosing the right measure (considering the purpose of using a PROM, health profile vs. health preference approaches, measurement properties), ensuring survivors complete the PROMs (data collection method, data collection frequency, survivor capacity, self- vs. proxy reports), interpreting the results (scoring methods, clinical meaning and interpretability), and selecting a strategy for clinical response (integration into the clinical workflow). An example framework for integrating novel patient-reported outcome (PRO) data collection into the clinical workflow for childhood cancer survivorship care is also discussed. As we continuously improve the clinical validity of PROMs and address implementation barriers, routine PRO assessment and monitoring in pediatric cancer survivorship offer opportunities to facilitate clinical decision making and improve the quality of survivorship care.
患者报告结局测量(PROMs)是对健康状况或与健康相关的生活质量的主观评估。在儿童癌症幸存者中,PROMs可用于评估癌症治疗的不良反应并指导癌症生存护理。然而,将PROMs纳入临床实践存在障碍,例如临床有效性、有意义的解释以及这些测量的技术支持管理方面的限制。本文讨论了这些障碍,并提出了将PROMs适当地纳入临床护理的10项重要考虑因素,包括选择正确的测量方法(考虑使用PROM的目的、健康概况与健康偏好方法、测量属性),确保幸存者完成PROMs(数据收集方法、数据收集频率、幸存者能力、自我报告与代理报告),解释结果(评分方法、临床意义和可解释性),以及选择临床应对策略(纳入临床工作流程)。还讨论了一个将新的患者报告结局(PRO)数据收集纳入儿童癌症生存护理临床工作流程的示例框架。随着我们不断提高PROMs的临床有效性并解决实施障碍,儿科癌症幸存者的常规PRO评估和监测为促进临床决策和提高生存护理质量提供了机会。