Enhanced patient reported outcome measurement suitable for head and neck cancer follow-up clinics

Ghazali, N, Lowe, D and Rogers, Simon N (2012) Enhanced patient reported outcome measurement suitable for head and neck cancer follow-up clinics. Head & Neck Oncology, 4 (32). ISSN 1758-3284 DOI https://doi.org/10.1186/1758-3284-4-32

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Background: The ‘Worse-Stable-Better’ (W-S-B) question was introduced to capture patient-perceived change in University of Washington Quality of Life (UW-QOL) domains. Methods: 202 head and neck cancer patients in remission prospectively completed UW-QOL and Patients Concerns Inventory (PCI). For each UW-QOL domain, patients indicated whether over the last month things had worsened (W), remained stable (S) or were better (B). Results: 202 patients at 448 attendances selected 1752 PCI items they wanted to discuss in consultation, and 58% (1024/1752) of these were not covered by the UW-QOL. UW-QOL algorithms highlighted another 440 significant problems that the patient did not want to discuss (i.e. the corresponding items on the PCI were not selected). After making allowance for UW-QOL algorithms to identify 'significant problems' and PCI selection of corresponding issues for discussion there remained clear residual and notable variation in W-S-B responses, in particular to identify patients with significant problems that were getting worse, and patients without significant problems that wanted to discuss issues that were getting worse. Changes in mean UW-QOL scores were notably lower for those getting worse on the W-S-B question, typically by 10 or more units a magnitude that suggests clinically important changes in score. Conclusions: The W-S-B question adds little questionnaire burden and could help to better identify patients who might benefit from intervention. The results of this study suggest that the UW-QOL with the W-S-B modification should be used together with the PCI to allow optimal identification of issues for patient-clinician discussion during routine outpatient clinics.

Item Type: Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RT Nursing
Divisions: Nursing and Midwifery
Date Deposited: 04 Jul 2012 15:54
URI: http://repository.edgehill.ac.uk/id/eprint/3952

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