Importance of patient reported outcome measures versus clinical outcomes for breast cancer patients evaluation on quality of care |
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| Affiliation: | 1. Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands;2. Department of Surgery, Medical Center Haaglanden, The Hague, The Netherlands;3. Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands;4. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands;5. Department of Surgery, Haga Hospital, The Hague, The Netherlands;6. Department of Surgery, Bronovo Hospital, The Hague, The Netherlands;7. Department of Surgery, Diaconessenhuis, Leiden, The Netherlands;1. Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio;2. Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio;1. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia;2. William Buckland Radiation Oncology Department, The Alfred, Melbourne, VIC, Australia;1. Radiology Inc. Mishawaka, Indiana;2. Elkhart General Hospital, Elkhart, Indiana;1. Duke University School of Medicine, Durham, NC;2. Fuqua School of Business, Duke University, Durham, NC;3. Division of Thoracic and Cardiovascular Surgery, Duke University Medical Center, Durham, NC;4. Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Medical Center, Durham, NC;1. Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, UK;2. Department of Oncology, Colchester Hospital University NHS Foundation Trust, Essex, UK;3. Cambridge Cancer Trials Centre, Cambridge Clinical Trials Unit – Cancer Theme, Cambridge University Hospitals NHS Foundation Trust, Medical Research Council, Biostatistics Unit Hub for Trials Methodology, UK;4. Cancer Research-UK Centre for Genetic Epidemiology & Dept of Oncology, University of Cambridge, Strangeways Research Laboratory, UK;5. University of Cambridge, Department of Oncology, Oncology Centre, Addenbrooke’s Hospital, UK;6. Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge, UK |
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| Abstract: | IntroductionGiven increasing numbers of breast cancer survivors, there is an increased focus on quality of life and quality of care. This study aims to investigate whether clinical or patient reported outcomes are most important for perceived quality of care by breast cancer patients.MethodsOverall, 606 patients aged 18 years or older, who underwent breast cancer surgery 9–18 months ago in five hospitals in the Netherlands, were invited to complete an internet-based questionnaire. Patients were asked to judge a random selection of 24 patient profiles and choose which of 2 presented patients had received the best quality of care, using conjoint analysis. The individual relative importance (RI) for each outcome was estimated using Hierarchical Bayes Estimation, and averaged over all patients to assess which outcomes were most important.ResultsComplete data were available for 350 patients (58%). Avoiding severe breast symptoms was most important for good quality of care according to patients (RI 23.22 [95% Confidence Interval (95% CI) 22.32–24.12]), followed by a 2 year longer disease free survival (18.30 [17.38–19.22]). However, the importance differed by age: younger patients (<50 years) assigned higher importance to longer disease free survival (21.99 [19.52–24.46]) than older patients (65 + years) (15.03 [13.88–16.18]).ConclusionAvoiding severe breast symptoms rather than 2 year longer disease free survival is considered most important in our population of breast cancer patients for evaluation of quality of care. These data should thus be included in both information provision prior to treatment choices and post treatment quality of care evaluation. |
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| Keywords: | Breast cancer Patient reported outcome measures (PROMs) Quality of care |
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