The "Medicine PRO-Cision" approach helps personalize care for cancer patients

Patient Reported Outcomes (PRs) are an important target of efforts to improve health care, focusing on the most important issues and outcomes identified by patients themselves. A special supplement to Medical care presents a toolkit of methods to help personalize care for cancer patients using a "medicine PRO-cision" approach. The paper is published in Lippincott's portfolio by Wolters Kluwer.

"Patients are increasingly being asked to fill out standardized, validated questionnaires about their symptoms, functioning, and well-being as part of routine care," writes Claire Snyder, PhD, of the Johns Hopkins School of Medicine. Kimmel Cancer Center, Baltimore. "These PROs can be used to inform care and management of patients, what we call" PRO-decision medicine "." Dr. Snyder's co-authors are Albert Wu, MD, MPH and Yonaira Rivera, MPH, also of Johns Hopkins; and Michael Brundage, MD, MSc, of the Queen's Cancer Research Institute, Kingston, Ontario, Canada.

Methods to interpret and act on PRO to improve cancer care

For example, in cancer patients, PRO questionnaires can provide useful information about the patient's feelings and the management of their daily activities. This is an important and potentially more significant addition for patients than traditional results evaluated by clinicians, such as tumor response and markers. "The guest editors stated that the use of PRO in clinical practice could promote personalized and patient-centered care."

However, health care providers struggle to translate PR responses into significant improvements in care. Guest editors invited experienced experts to develop effective approaches to PRO-cision medicine. "Together, the 14 articles in this supplement provide a range of options or" tools "that clinicians and researchers can apply to the use of PRO in clinical practice," write Dr. Snyder and his coauthors.

Six papers focus on approaches to interpretation Advantages. Some experts point to tools for determining how PRO badessments reflect changes in symptoms or functional status, and how this information can be used to monitor clinical progress and inform decision-making. Articles include discussions of "feedback" approaches applying PRO data to patient groups or populations, as well as "feedback" approaches providing the patient with the patient's perspective.

Eight communications describe methods of acting PRO to guide clinical care. Several articles describe emerging technologies that enable patients and professionals to access and view PRO results. In the treatment of cancer, PRO-cision Medicine is a valuable approach to monitor the patient's illness and response to treatment, including modifying symptoms or other scores for which action is needed.

Researchers are also exploring ways to engage patients and clinicians in symptom reporting to promote the use of PR in clinical practice. "Patients place more importance on routine PRO data collection when their clinicians use it to inform their care," write the guest editors.

Dr. Snyder and his colleagues hope that the expertise and experience shared in this special issue will help encourage and improve the use of PRO-cision medicine approaches for cancer and other conditions. They conclude "[T]This "toolkit for methods" can inform clinicians and researchers who want to implement routine PRO reports into clinical practice by providing methodological fundamentals and concrete examples to promote personalized patient care. "