Patient Reported Outcomes

Patient Reported Outcomes

Understanding what happens to patients who are treated with radiotherapy

Patient Reported Outcomes (PRO) are recognized as an essential component to supporting improved quality of life and survivorship for those undergoing cancer treatment. While PRO can be used to assess the impact cancer treatment has on a patient’s quality of life and well-being, they can also be used to help understand how specific treatments, such as radiotherapy, can affect a patient by helping to identify symptoms and toxicity they experience throughout their care. In 2017 CPQR launched an initiative to support the increased use of PRO in routine clinical care across Canada.

What has been done

From 2017-2019 CPQR supported the translation of BC Cancer’s Prospective Outcomes and Support Initiative (POSI) to other RT programs across the country.  POSI was seen as a program to emulate due to its nimble “real time” approach to the collection and review of PRO during patient encounters and adaptability for programs with limited resources.  Today a POSI model is being integrated into centres affiliated with Dalhousie University Department of Radiation Oncology and being considered by centres across the country.  This piloting will continue to be undertaken through centre leadership and monitored by CPQR.

Building on the success of its prior guidance documents, CPQR has developed guidance around the collection and use of PRO for radiation treatment that reflects community best practice. A series of comprehensive guided interviews were conducted aided in development. The resulting document entitled “Guidance on the use of Patient Reported Outcomes for Canadian Radiation Treatment Programs,” is now available!

Determine your radiation treatment programs alignment with CPQR PRO guidance using the self-audit tool, part of the suite of self-audit tools launched in 2020!

CPQR-endorsed measures for patient reported outcomes

CPQR supports the consistent use of PRO in Canadian radiation treatment programs to improve the clinical encounter for patients. Promoting the use of the same Patient Reported Outcome Measures (PROM) across the country will also help facilitate big data analysis against treatment outcomes which may be used to inform population-based decisions regarding optimal care. The table below provides CPQR-endorsed measure for PROs.

Disease site Endorsed Measure Description
General Symptom Screening Edmonton Symptom Assessment Screening
A paper-based questionnaire used to rate the intensity of nine common symptoms experienced by cancer patients, including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath.
Bone Metastasis Brief Pain Inventory A form to assess the severity of patient’s pain and the impact of pain on daily functions.
Early-stage Prostate cancer Expanded Prostate Cancer Index Composite (EPIC) A self-report scale designed to measure the health-related quality of life among prostate cancer patients.
Head and neck cancer MD Anderson Symptom Inventory for Head and Neck (MDASI-HN)) A multi-symptom PRO measure for clinical and research use to assess the severity of symptoms experienced by patients with cancer and the interference with daily living caused by these symptoms.
Cervical and other gynecological cancers Cervical cancer EORTC QLQ-CX24 Developed by the European Organization for the Research and Treatment of Cancer, the cervical cancer module is an extension of their basic quality of life measure. It consists of 3 multiitem scales and 5 single-item scales and is designed to assess disease and treatment-specific aspects of quality of life in patients with cervical cancer.
Lung cancer Coming soon!

If you want more information about the endorsed measures or how they are being used across the country get in touch.

For more information on CPQR’s work around big-data analysis please visit our Canadian Big Radiotherapy Data Initiative (CBRTDI) page.