Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach
Abstract Background The use of Patient-Reported Outcome Measures (PROMs) in routine clinical care can help ensure symptoms are identified, acknowledged and addressed. In 2007, the provincial cancer agency, Cancer Care Ontario, began to implement routine symptom screening with the Edmonton Symptom As...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-11-01
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| Series: | Journal of Patient-Reported Outcomes |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41687-020-00270-1 |
| _version_ | 1828885593257410560 |
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| author | Nicole Montgomery Doris Howell Zahra Ismail Susan J. Bartlett Michael Brundage Denise Bryant-Lukosius Monika Krzyzanowska Lesley Moody Claire Snyder Lisa Barbera The Cancer Care Ontario Patient Reported Outcome Advisory Committee |
| author_facet | Nicole Montgomery Doris Howell Zahra Ismail Susan J. Bartlett Michael Brundage Denise Bryant-Lukosius Monika Krzyzanowska Lesley Moody Claire Snyder Lisa Barbera The Cancer Care Ontario Patient Reported Outcome Advisory Committee |
| author_sort | Nicole Montgomery |
| collection | DOAJ |
| description | Abstract Background The use of Patient-Reported Outcome Measures (PROMs) in routine clinical care can help ensure symptoms are identified, acknowledged and addressed. In 2007, the provincial cancer agency, Cancer Care Ontario, began to implement routine symptom screening with the Edmonton Symptom Assessment System (ESAS) for ambulatory cancer patients. Having had a decade of experience with ESAS, the program developed a strategic interest in implementing new and/or additional measures. This article describes the development of a streamlined PROM selection and implementation evaluation process with core considerations. Methods Development of the PROM selection and implementation evaluation process involved analysis of quantitative and qualitative data as well as consensus building through a multi-stakeholder workshop. Core PROM selection considerations were developed through a literature scan, review and refinement by a panel of methodological experts and patient advisors, and testing via a test case. Core PROM implementation evaluation considerations were developed through analysis of PROM evaluation frameworks, and review and refinement by a committee of provincial implementation leads. Results Core PROM selection considerations were identified under three overarching themes: symptom coverage, usability and psychometric properties. The symptom coverage category assesses each PROM to determine how well the PROM items address the most prevalent and burdensome symptoms in the target patient population. The usability category aims to assess each measure on characteristics key to successful implementation in the clinical setting. The psychometric properties category assesses each PROM to ensure the data collected is credible, meaningful and interpretable. A scoring system was developed to rate PROM performance by assigning a grade of “weak”, “average” or “good” for each category. The process results in a summary matrix which illustrates the overall assessment of each PROM. Implementation evaluation considerations were identified under three overarching concepts: acceptability, outcomes, and sustainability. A consensus building exercise resulted in the further identification of patient, provider, and clinic specific indicators for each consideration. Conclusion To address the need for a systematic, evidence-based approach to selection, implementation and evaluation of PROMs in the clinical setting, Cancer Care Ontario defined a process with embedded core considerations to facilitate decision-making and encourage standardization. |
| first_indexed | 2024-12-13T11:29:25Z |
| format | Article |
| id | doaj.art-b8dd603f393846828ae000022135a6a4 |
| institution | Directory Open Access Journal |
| issn | 2509-8020 |
| language | English |
| last_indexed | 2024-12-13T11:29:25Z |
| publishDate | 2020-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Patient-Reported Outcomes |
| spelling | doaj.art-b8dd603f393846828ae000022135a6a42022-12-21T23:48:02ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202020-11-01411910.1186/s41687-020-00270-1Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approachNicole Montgomery0Doris Howell1Zahra Ismail2Susan J. Bartlett3Michael Brundage4Denise Bryant-Lukosius5Monika Krzyzanowska6Lesley Moody7Claire Snyder8Lisa Barbera9The Cancer Care Ontario Patient Reported Outcome Advisory CommitteeCancer Care OntarioUniversity Health NetworkWomen’s College HospitalMcGill UniversityCancer Centre of Southeastern OntarioMcMaster UniversityCancer Care OntarioUniversity Health NetworkJohns Hopkins UniversityTom Baker Cancer CentreAbstract Background The use of Patient-Reported Outcome Measures (PROMs) in routine clinical care can help ensure symptoms are identified, acknowledged and addressed. In 2007, the provincial cancer agency, Cancer Care Ontario, began to implement routine symptom screening with the Edmonton Symptom Assessment System (ESAS) for ambulatory cancer patients. Having had a decade of experience with ESAS, the program developed a strategic interest in implementing new and/or additional measures. This article describes the development of a streamlined PROM selection and implementation evaluation process with core considerations. Methods Development of the PROM selection and implementation evaluation process involved analysis of quantitative and qualitative data as well as consensus building through a multi-stakeholder workshop. Core PROM selection considerations were developed through a literature scan, review and refinement by a panel of methodological experts and patient advisors, and testing via a test case. Core PROM implementation evaluation considerations were developed through analysis of PROM evaluation frameworks, and review and refinement by a committee of provincial implementation leads. Results Core PROM selection considerations were identified under three overarching themes: symptom coverage, usability and psychometric properties. The symptom coverage category assesses each PROM to determine how well the PROM items address the most prevalent and burdensome symptoms in the target patient population. The usability category aims to assess each measure on characteristics key to successful implementation in the clinical setting. The psychometric properties category assesses each PROM to ensure the data collected is credible, meaningful and interpretable. A scoring system was developed to rate PROM performance by assigning a grade of “weak”, “average” or “good” for each category. The process results in a summary matrix which illustrates the overall assessment of each PROM. Implementation evaluation considerations were identified under three overarching concepts: acceptability, outcomes, and sustainability. A consensus building exercise resulted in the further identification of patient, provider, and clinic specific indicators for each consideration. Conclusion To address the need for a systematic, evidence-based approach to selection, implementation and evaluation of PROMs in the clinical setting, Cancer Care Ontario defined a process with embedded core considerations to facilitate decision-making and encourage standardization.http://link.springer.com/article/10.1186/s41687-020-00270-1Patient-reported outcome measuresClinical careRoutine careRecommendationsSymptom management |
| spellingShingle | Nicole Montgomery Doris Howell Zahra Ismail Susan J. Bartlett Michael Brundage Denise Bryant-Lukosius Monika Krzyzanowska Lesley Moody Claire Snyder Lisa Barbera The Cancer Care Ontario Patient Reported Outcome Advisory Committee Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach Journal of Patient-Reported Outcomes Patient-reported outcome measures Clinical care Routine care Recommendations Symptom management |
| title | Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach |
| title_full | Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach |
| title_fullStr | Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach |
| title_full_unstemmed | Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach |
| title_short | Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach |
| title_sort | selecting implementing and evaluating patient reported outcome measures for routine clinical use in cancer the cancer care ontario approach |
| topic | Patient-reported outcome measures Clinical care Routine care Recommendations Symptom management |
| url | http://link.springer.com/article/10.1186/s41687-020-00270-1 |
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