Identifying Patient-Reported Outcome Measures (PROMs) for Routine Surveillance of Physical and Emotional Symptoms in Head and Neck Cancer Populations: A Systematic Review

Abstract

The aims of this review were to identify symptoms experienced by head and neck cancer (HNC) patients and their prevalence, as well as to compare symptom coverage identified in HNC specific patient-reported outcome measures (PROMs). Searches of Ovid Medline, Embase, PsychInfo, and CINAHL were conducted to identify studies. The search revealed 4569 unique articles and identified 115 eligible studies. The prevalence of reported symptoms was highly variable among included studies. Variability in sample size, timing of the assessments, and the use of different measures was noted across studies. Content mapping of commonly used PROMs showed variability and poor capture of prevalent symptoms, even though validation studies confirmed satisfactory reliability and validity. This suggests limitations of some of the tools in providing an accurate and comprehensive picture of the patient’s symptoms and problems.

First Phase Development of a Patient-reported Outcome Measure for Midface Oncology

“…31 A systematic review of PROMs used in patients with head and neck cancer identified dysphagia, saliva function, difficulty chewing and dental problems, dysphagia, oral mucositis, and voice and speech impairment to be the most common functional issues addressed. 48 These PROMs are often developed from patient populations where the majority have undergone surgery involving the aerodigestive tract. 31 For example, the Edmonton-33 instrument, a commonly used PROM in head and neck cancer patients, was designed and tested only in patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx, 49 whereas OncoQuest, a PROM measuring HRQL in head and neck cancer patients, was validated in a patient population where 78% of patients had tumors of the pharynx, larynx, or oral cavity.…”

Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating

“…Since patient eating behaviors are generally superior as an outpatient compared to inpatient, electronic patient-reported outcomes (ePRO) [69][70][71][72][73]130,[137][138][139][140][166][167][168] may help to generate new data and metrics concerning differences between predominantly outpatient versus inpatient chemotherapy delivery and admissions for chemotherapy and amelioration of serious adverse events (SAEs). For example, this approach could ask for (number of hospital days/year) to generate a new ePRO metric of quality and cost of cancer care.…”

Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition

“…The use of patient-reported outcome measures may assist patients with describing, recording and temporally monitoring relevant symptoms within this setting. 173 In the absence of high-quality prospective trial data, follow-up schedules should remain in line with international standards, although current evidence would support additional patient-initiated follow up.…”