Health Outcomes Assessment in Cancer: Current Measurement Strategies and Recommendations for Improvement
William F. Lawrence
Carolyn M. Clancy
Measuring the outcomes of cancer care has become increasingly important both in clinical practice and in health policy. Responsiveness to patient-centered needs, preferences, and outcomes is one of the hallmarks of quality healthcare. Health-related quality of life (HR-QOL) measures can be considered within a framework based upon: (i) whether the measure is a generic instrument applicable across a wide range of health conditions, or whether it is specific to cancer or a specific cancer site; (ii) whether it measures a single domain of health or multiple domains; and (iii) whether or not the measure is preference based. Judicious selection of a set of instruments from within different areas of this framework can provide a detailed description of relevant aspects of a patient Current health outcomes research is focused not only on the development of improved measures of health, but also on how to expand the use of these measures from research settings into clinical practice and health policy in ways to improve the process and outcomes of cancer care. Shared decision-making tools incorporating HR-QOL data can assist patients in clarifying decision alternatives for difficult cancer treatment decisions. Observational studies of HR-QOL of cancer patients can help patients better understand potential outcomes of their choices. HR-QOL measures are being used in quality of care initiatives. Cancer care is composed of a spectrum of services, ranging from prevention and early detection, through to diagnosis and treatment, as well as end-of-life care. As the importance of the patient
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