Allen Casey J, Danea Horn M, Smieliauskas Fabrice, Edge Stephen, Greenup Rachel A
Division of Surgical Oncology, Institute of Surgery, Allegheny Health Network, Pittsburgh, PA, United States.
School of Pharmacy, University of California, San Francisco, San Francisco, CA, United States.
Front Oncol. 2025 May 15;15:1580575. doi: 10.3389/fonc.2025.1580575. eCollection 2025.
This article argues for incorporating a broader definition of "value" into cancer clinical trials. Current trials primarily focus on efficacy and safety, neglecting patient-reported outcomes (PROs) such as quality of life, financial toxicity, and time burden, as well as cost-effectiveness. We propose a novel framework integrating oncologic outcomes, PROs, and cost analyses. We also propose a multidimensional visual tool, such as a radar chart, to facilitate better-informed, value-based shared decision-making. This requires a collaborative approach, involving stakeholders in defining value metrics. While acknowledging challenges such as increased administrative burden and data interpretation complexities, a comprehensive framework can substantially improve patient-centered cancer care. The ultimate goal is to standardize value assessment in cancer research, leading to more equitable and effective care.
本文主张将更广泛的“价值”定义纳入癌症临床试验。当前的试验主要关注疗效和安全性，忽视了患者报告的结局（PROs），如生活质量、经济毒性和时间负担，以及成本效益。我们提出了一个整合肿瘤学结局、PROs和成本分析的新框架。我们还提出了一种多维可视化工具，如雷达图，以促进基于价值的更明智的共同决策。这需要一种协作方法，让利益相关者参与定义价值指标。虽然承认存在行政负担增加和数据解释复杂性等挑战，但一个全面的框架可以大幅改善以患者为中心的癌症护理。最终目标是使癌症研究中的价值评估标准化，从而实现更公平、有效的护理。
