The Effects of Patient-Reported Outcome Screening on the Survival of People with Cancer: A Systematic Review and Meta-Analysis

Abstract

This study examined the effects of the routine assessment of patient-reported outcomes (PROs) on the overall survival of adult patients with cancer. We included clinical trials and observational studies with a control group that compared PRO monitoring interventions in cancer clinical practice to usual care. The Cochrane risk-of-bias tools were used. In total, six studies were included in the systematic review: two randomized trials, one population-based retrospectively matched cohort study, two pre–post with historical control studies and one non-randomized controlled trial. Half were multicenter, two were conducted in Europe, three were conducted in the USA and was conducted in Canada. Two studies considered any type of cancer, two were restricted to lung cancer and two were restricted to advanced forms of cancer. PRO screening was electronic in four of the six studies. The meta-analysis included all six studies (intervention = 130.094; control = 129.903). The pooled mortality outcome at 1 year was RR = 0.77 (95%CI 0.76–0.78) as determined by the common effect model and RR = 0.82 (95%CI 0.60–1.12; p = 0.16) as determined by the random-effects model. Heterogeneity was statistically significant (I2 = 73%; p < 0.01). The overall risk of bias was rated as moderate in five studies and serious in one study. This meta-analysis seemed to indicate the survival benefits of PRO screening. As routine PRO monitoring is often challenging, more robust evidence regarding the effects of PROs on mortality would support systematic applications.

Using Implementation Science Frameworks to Guide the Use of Electronic Patient-Reported Outcome Symptom Monitoring in Routine Cancer Care

“…Electronic patient-reported outcomes (ePROs) are an evidence-based means of detecting cancer symptoms and treatment side effects earlier and improving patient outcomes. Studies have demonstrated the benefits of ePRO symptom monitoring between clinic visits, including improved symptom control, 1-5 physical function, 6-8 treatment adherence, 5-10 patient satisfaction, 4,8,10 patient self-efficacy, 3,7 cost-effectiveness, 11,12 and overall survival, 13-16 as well as reductions in emergency department presentations 5,6,10,15,17-19 and hospital admissions. 15,19 ePRO symptom monitoring is recommended by the European Society of Medical Oncology Clinical Practice Guidelines 20 and as part of value-based health care initiatives in the United States.…”

Synbiotics in Oncology: A Scoping Review Protocol on Their Impact and Outcomes in Cancer Care

“…PRO-based symptom management interventions typically consist of collecting patient symptom reports using ePRO tools and responding to these reports, which serve as measurement methods and digital interventions to monitor, detect, and manage patients’ symptoms, thereby improving their outcomes [ 16 ]. Recent evidence suggests that, compared to standard care, symptom management strategies based on ePRO could enhance the symptom burden, quality of life and overall survival of patients with cancer [ 17 ].…”

The use of patient reported outcome measures in oncology clinical practice across Australia and New Zealand

“…Over the past decade there has been growing interest in the use of PROMS in oncology clinical care as their routine collection has been associated with improved survival, reduced hospitalisations and emergency department presentations [ 6 – 9 ]. Further, with improved cancer treatments, the number of cancer survivors has increased [ 10 , 11 ]. Positive findings from a systematic review by Graupner and colleagues recommend the use of PROMs in daily cancer care combined with feedback to the patients and relevant stakeholders [ 10 ] which may provide an important opportunity for a standardised approach to personalised cancer care [ 12 ].…”