Clinical Outcome Assessment in Cancer Rehabilitation and the Central Role of Patient-Reported Outcomes

Abstract

The aim of cancer rehabilitation is to help patients regain functioning and social participation. In order to evaluate and optimize rehabilitation, it is important to measure its outcomes in a structured way. In this article, we review the different types of clinical outcome assessments (COAs), including Clinician-Reported Outcomes (ClinROs), Observer-Reported Outcomes (ObsROs), Performance Outcomes (PerfOs), and Patient-Reported Outcomes (PROs). A special focus is placed on PROs, which are commonly defined as any direct report from the patient about their health condition without any interpretation by a third party. We provide a narrative review of available PRO measures (PROMs) for relevant outcomes, discuss the current state of PRO implementation in cancer rehabilitation, and highlight trends that use PROs to benchmark value-based care. Furthermore, we provide examples of PRO usage, highlight the benefits of electronic PRO (ePRO) collection, and offer advice on how to select, implement, and integrate PROs into the cancer rehabilitation setting to maximize efficiency.

Mentalizing and epistemic trust as critical success factors in psychosomatic rehabilitation: results of a single center longitudinal observational study

“…In model B, mean change in mentalizing as measured by the MZQ total score was added to the model as a mediator for this relationship, and changes in the epistemic trust subscales were added as predictors for mentalizing. Due to baseline differences, the calculation of change scores may lead to misleading effects (e.g., floor or ceiling effects) and thus may distort the interpretation of therapy effectiveness across groups with differences A simple solution might be the use of the "performance score (T2D), " based on the formula T2 + (T2-T1), which reflects the individual performance and considers the functional status at the beginning of rehabilitation (changes from T1 to T2; Δ) without problems of mathematical coupling or regression effects, as seen in ANCOVA (41)(42)(43). We therefore used the T2D mentalizing and epistemic trust scores in the models as moderator and predictor variables.…”

Development of a Cancer Rehabilitation Dashboard to Collect Data on Physical Function in Cancer Patients and Survivors

“…The patient-reported instruments chosen were the PROMIS-Physical Function short form (PROMIS-PF) and PROMIS-Fatigue short form (PROMIS-F), both of which are well accepted in both oncology and rehabilitation medicine. 18,19 Grip strength (GS) was chosen because it is one of the original frailty criteria and more recently was found to be especially useful when assessing older (>80 yrs old) or nonambulatory patients. [20][21][22] Timed Up and Go Test (TUG) has been in clinical use for more than 30 yrs and, in addition to being a marker of gait speed, also provides some insight into balance and motor planning.…”

Associations of Age and Sex with the Efficacy of Inpatient Cancer Rehabilitation: Results from a Longitudinal Observational Study Using Electronic Patient-Reported Outcomes

“…There are different ways to assess whether or not cancer rehabilitation is effective in supporting patients in recovering physically and psychologically. Clinician-reported outcomes, observer-reported outcomes, performance outcomes, and patient-reported outcomes (PROs) can be used (as reviewed in Lehmann et al [ 39 ]). PROs allow us to assess a patient’s own perception of their health status, independently from a third party’s interpretation.…”