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Cancers
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Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer
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Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Systematic Review or Meta-Analysis in Cancer Research".

Deadline for manuscript submissions: closed (31 May 2021) | Viewed by 23241

Special Issue Editor

Prof. Dr. Massimo Di Maio

E-Mail Website
Guest Editor
Department of Oncology, University of Turin, at SCDU Medical Oncology, Ordine Mauriziano Hospital, 10128 Turin, Italy
Interests: methodology of clinical trials; systematic reviews; meta-analyses; patient-reported outcomes.

Special Issue Information

Dear Colleagues,

In recent years, the relevance of patient-reported outcomes in cancer research, as well as in other fields of medicine, has been better recognized. In fact, the definition of the real value of a treatment for patients with cancer should necessarily include the evaluation of their subjective experience.

Unfortunately, while health-related quality of life (QoL) is universally considered to be a measure of clinical benefit, its inclusion in clinical trials and in related publications remains suboptimal. Consequently, systematic reviews and meta-analyses are rarely focused on QoL and patient-reported outcomes. However, even when the experimental treatment shows a benefit in terms of overall survival, QoL results can be helpful to define the trade-off between benefits and harms, especially if the survival benefit is modest and the potential treatment-related toxicity is not negligible. In addition, QoL analysis is even more important when the interpretation of the trial is based on a surrogate endpoint (such as progression-free survival); in this case, a patient-focused assessment is crucial to define the value of a radiologically defined result.

With the aim of improving the scientific discussion about these issues and their visibility, this Special Issue will welcome contributions in the field of systematic reviews and meta-analyses focused on patient-reported outcomes and QoL in cancer research.

Prof. Dr. Massimo Di Maio
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • systematic review
  • patient-reported outcomes
  • cancer
  • clinical trials

Published Papers (7 papers)

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13 pages, 2625 KiB  
Article
Meta-Analysis of Gastrointestinal Adverse Events from Tyrosine Kinase Inhibitors for Chronic Myeloid Leukemia
by Prahathishree Mohanavelu, Mira Mutnick, Nidhi Mehra, Brandon White, Sparsh Kudrimoti, Kaci Hernandez Kluesner, Xinyu Chen, Tim Nguyen, Elaina Horlander, Helena Thenot, Vamsi Kota and Cassie S. Mitchell
Cancers 2021, 13(7), 1643; https://doi.org/10.3390/cancers13071643 - 01 Apr 2021
Cited by 14 | Viewed by 3396
Abstract
Tyrosine kinase inhibitors (TKIs) are the frontline therapy for BCR-ABL (Ph+) chronic myeloid leukemia (CML). A systematic meta-analysis of 43 peer-reviewed studies with 10,769 CML patients compared the incidence of gastrointestinal adverse events (GI AEs) in a large heterogeneous CML population as a [...] Read more.
Tyrosine kinase inhibitors (TKIs) are the frontline therapy for BCR-ABL (Ph+) chronic myeloid leukemia (CML). A systematic meta-analysis of 43 peer-reviewed studies with 10,769 CML patients compared the incidence of gastrointestinal adverse events (GI AEs) in a large heterogeneous CML population as a function of TKI type. Incidence and severity of nausea, vomiting, and diarrhea were assessed for imatinib, dasatinib, bosutinib, and nilotinib. Examination of combined TKI average GI AE incidence found diarrhea most prevalent (22.5%), followed by nausea (20.6%), and vomiting (12.9%). Other TKI GI AEs included constipation (9.2%), abdominal pain (7.6%), gastrointestinal hemorrhage (3.5%), and pancreatitis (2.2%). Mean GI AE incidence was significantly different between TKIs (p < 0.001): bosutinib (52.9%), imatinib (24.2%), dasatinib (20.4%), and nilotinib (9.1%). Diarrhea was the most prevalent GI AE with bosutinib (79.2%) and dasatinib (28.1%), whereas nausea was most prevalent with imatinib (33.0%) and nilotinib (13.2%). Incidence of grade 3 or 4 severe GI AEs was ≤3% except severe diarrhea with bosutinib (9.5%). Unsupervised clustering revealed treatment efficacy measured by the complete cytogenetic response, major molecular response, and overall survival is driven most by disease severity, not TKI type. For patients with chronic phase CML without resistance, optimal TKI selection should consider TKI AE profile, comorbidities, and lifestyle. Full article
(This article belongs to the Special Issue Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer)
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19 pages, 1200 KiB  
Systematic Review
Patient-Reported Financial Distress in Cancer: A Systematic Review of Risk Factors in Universal Healthcare Systems
by Sophie Pauge, Bastian Surmann, Katja Mehlis, Andrea Zueger, Luise Richter, Natalja Menold, Wolfgang Greiner and Eva C. Winkler
Cancers 2021, 13(19), 5015; https://doi.org/10.3390/cancers13195015 - 07 Oct 2021
Cited by 18 | Viewed by 4287
Abstract
Financial toxicity is a side effect of cancer that results from the perceived financial distress an individual may experience in the course of the disease. The purpose of this paper is to analyse underlying factors related to subjective financial distress in high-income countries [...] Read more.
Financial toxicity is a side effect of cancer that results from the perceived financial distress an individual may experience in the course of the disease. The purpose of this paper is to analyse underlying factors related to subjective financial distress in high-income countries with universal healthcare coverage. A systematic literature review was conducted to identify qualitative and quantitative studies of cancer patient-reported subjective financial distress by performing a search in the databases of PubMed, PsycINFO and CINAHL up to December 2020. A qualitative synthesis was performed linking the time-dependent occurrence of risk factors to derived categories of risk factors. Out of 4321 identified records, 30 quantitative and 16 qualitative studies were eligible. Classification of risk factors resulted in eight categories with a total of 34 subcategories. Subjective financial distress is primarily determined by pre-diagnosis sociodemographic- factors as well as financial and work factors that might change during the course of the disease. The design of healthcare and social security systems shapes the country-specific degree of subjective financial distress. Further research should focus on evolving multidisciplinary intervention schemes and multidimensional instruments for subjective financial distress to account for identified risk factors in universal healthcare systems more precisely. Full article
(This article belongs to the Special Issue Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer)
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22 pages, 1055 KiB  
Systematic Review
Additional Value of Patient-Reported Symptom Monitoring in Cancer Care: A Systematic Review of the Literature
by Luís Lizán, Lucía Pérez-Carbonell and Marta Comellas
Cancers 2021, 13(18), 4615; https://doi.org/10.3390/cancers13184615 - 15 Sep 2021
Cited by 16 | Viewed by 2932
Abstract
Background: To describe the benefit of patient-reported symptom monitoring on clinical, other patient-reported, and economic outcomes. Methods: We conducted a systematic literature review using Medline/PubMed, limited to original articles published between 2011 and 2021 in English and Spanish, and focused on the benefit [...] Read more.
Background: To describe the benefit of patient-reported symptom monitoring on clinical, other patient-reported, and economic outcomes. Methods: We conducted a systematic literature review using Medline/PubMed, limited to original articles published between 2011 and 2021 in English and Spanish, and focused on the benefit of patient-reported symptom monitoring on cancer patients. Results: We identified 16 reports that deal with the benefit of patient-reported symptom monitoring (collected mostly electronically) on different outcomes. Five studies showed that patient-reported symptom surveillance led to significantly improved survival compared with usual care—mainly through better symptom control, early detection of tumor recurrence, and extended chemotherapy use. Additionally, three evaluations demonstrated an improvement in Health-Related Quality of Life (HRQoL) associated with this monitoring strategy, specifically by reducing symptom severity. Additionally, six studies observed that this monitoring approach prevented unplanned emergency room visits and hospital readmissions, leading to a substantial decrease in healthcare usage. Conclusions: There is consistent evidence across the studies that patient-reported symptom monitoring might entail a substantial survival benefit for cancer patients, better HRQoL, and a considerable decrease in healthcare usage. Nonetheless, more studies should be conducted to demonstrate their effectiveness in addition to their cost-effectiveness in clinical practice. Full article
(This article belongs to the Special Issue Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer)
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20 pages, 2801 KiB  
Systematic Review
Different Approaches for Case-Mix Adjustment of Patient-Reported Outcomes to Compare Healthcare Providers—Methodological Results of a Systematic Review
by Nora Tabea Sibert, Holger Pfaff, Clara Breidenbach, Simone Wesselmann and Christoph Kowalski
Cancers 2021, 13(16), 3964; https://doi.org/10.3390/cancers13163964 - 05 Aug 2021
Cited by 11 | Viewed by 2145
Abstract
Patient-reported outcomes (PROs) are increasingly being used to compare the quality of outcomes between different healthcare providers (medical practices, hospitals, rehabilitation facilities). However, such comparisons can only be fair if differences in the case-mix between different types of provider are taken into account. [...] Read more.
Patient-reported outcomes (PROs) are increasingly being used to compare the quality of outcomes between different healthcare providers (medical practices, hospitals, rehabilitation facilities). However, such comparisons can only be fair if differences in the case-mix between different types of provider are taken into account. This can be achieved with adequate statistical case-mix adjustment (CMA). To date, there is a lack of overview studies on current CMA methods for PROs. The aim of this study was to investigate which approaches are currently used to report and examine PROs for case-mix-adjusted comparison between providers. A systematic MEDLINE literature search was conducted (February 2021). The results were examined by two reviewers. Articles were included if they compared (a) different healthcare providers using (b) case-mix-adjusted (c) patient-reported outcomes (all AND conditions). From 640 hits obtained, 11 articles were included in the analysis. A wide variety of patient characteristics were used as adjustors, and baseline PRO scores and basic sociodemographic and clinical information were included in all models. Overall, the adjustment models used vary considerably. This evaluation is an initial attempt to systematically investigate different CMA approaches for PROs. As a standardized approach has not yet been established, we suggest creating a consensus-based methodological guideline for case-mix adjustment of PROs. Full article
(This article belongs to the Special Issue Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer)
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22 pages, 1673 KiB  
Systematic Review
Stakeholder Perceptions of Key Aspects of High-Quality Cancer Care to Assess with Patient Reported Outcome Measures: A Systematic Review
by Angela M. Stover, Rachel Kurtzman, Jennifer Walker Bissram, Jennifer Jansen, Philip Carr, Thomas Atkinson, C. Tyler Ellis, Ashley T. Freeman, Kea Turner and Ethan M. Basch
Cancers 2021, 13(14), 3628; https://doi.org/10.3390/cancers13143628 - 20 Jul 2021
Cited by 6 | Viewed by 2535
Abstract
Performance measurement is the process of collecting, analyzing, and reporting standardized measures of clinical performance that can be compared across practices to evaluate how well care was provided. We conducted a systematic review to identify stakeholder perceptions of key symptoms and health domains [...] Read more.
Performance measurement is the process of collecting, analyzing, and reporting standardized measures of clinical performance that can be compared across practices to evaluate how well care was provided. We conducted a systematic review to identify stakeholder perceptions of key symptoms and health domains to test as patient-reported performance measures in oncology. Stakeholders included cancer patients, caregivers, clinicians, and healthcare administrators. Standard review methodology was used, consistent with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). MEDLINE/PubMed, EMBASE, and the Cochrane Library were searched to identify relevant studies through August 2020. Four coders independently reviewed entries and conflicts were resolved by a fifth coder. Efficacy and effectiveness studies, and studies focused exclusively on patient experiences of care (e.g., communication skills of providers) were excluded. Searches generated 1813 articles and 1779 were coded as not relevant, leaving 34 international articles for extraction. Patients, caregivers, clinicians, and healthcare administrators prioritize psychosocial care (e.g., distress) and symptom management for patient-reported performance measures. Patients and caregivers also perceive that maintaining physical function and daily activities are critical. Clinicians and administrators perceive control of specific symptoms to be critical (gastrointestinal symptoms, pain, poor sleep). Results were used to inform testing at six US cancer centers. Full article
(This article belongs to the Special Issue Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer)
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16 pages, 666 KiB  
Systematic Review
Text Messaging in Cancer-Supportive Care: A Systematic Review
by Don Thiwanka Wijeratne, Meghan Bowman, Isobel Sharpe, Siddhartha Srivastava, Matthew Jalink and Bishal Gyawali
Cancers 2021, 13(14), 3542; https://doi.org/10.3390/cancers13143542 - 15 Jul 2021
Cited by 6 | Viewed by 2932
Abstract
The global cancer disease burden is substantial, resulting in increased economic and clinical strain on our healthcare systems. A proposed solution is text-based communication, which can be used for cancer-supportive care. We conducted a systematic review to synthesize and describe the use of [...] Read more.
The global cancer disease burden is substantial, resulting in increased economic and clinical strain on our healthcare systems. A proposed solution is text-based communication, which can be used for cancer-supportive care. We conducted a systematic review to synthesize and describe the use of text-based communications for cancer-supportive care. Our population of interest included adult patients with cancer. A total of 18 studies were included in the review: 9 RCTs and 9 non-randomized interventional/observational studies. Patients were largely satisfied with text-based communication during their cancer care. Compared to controls, results for other outcomes including symptoms and quality of life were largely mixed; however, no harms were observed. Furthermore, positive outcomes were seen for specific interventions, such as text message medication reminders. These findings should be considered with caution due to the considerable heterogeneity observed between studies regarding their design and reported outcomes and the high risk of bias associated with 6/18 studies. Overall, this review suggests that text-based communication may be a complementary tool for cancer-supportive care; however, more research is needed to examine the feasibility of implementation and use. Full article
(This article belongs to the Special Issue Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer)
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22 pages, 850 KiB  
Systematic Review
Potentially Modifiable Factors Associated with Adherence to Adjuvant Endocrine Therapy among Breast Cancer Survivors: A Systematic Review
by Kirsti I. Toivonen, Tamara M. Williamson, Linda E. Carlson, Lauren M. Walker and Tavis S. Campbell
Cancers 2021, 13(1), 107; https://doi.org/10.3390/cancers13010107 - 31 Dec 2020
Cited by 31 | Viewed by 3837
Abstract
Adjuvant endocrine therapy (AET) reduces risk of breast cancer recurrence. However, suboptimal adherence and persistence to AET remain important clinical issues. Understanding factors associated with adherence may help inform efforts to improve use of AET as prescribed. The present systematic review examined potentially [...] Read more.
Adjuvant endocrine therapy (AET) reduces risk of breast cancer recurrence. However, suboptimal adherence and persistence to AET remain important clinical issues. Understanding factors associated with adherence may help inform efforts to improve use of AET as prescribed. The present systematic review examined potentially modifiable factors associated with adherence to AET in accordance with PRISMA guidelines (PROSPERO registration ID: CRD42019124200). All studies were included, whether factors were significantly associated with adherence or results were null. This review also accounted for the frequency with which a potentially modifiable factor was examined and whether univariate or multivariate models were used. This review also examined whether methodological or sample characteristics were associated with the likelihood of a factor being associated with AET adherence. A total of 68 articles were included. Potentially modifiable factors were grouped into six categories: side effects, attitudes toward AET, psychological factors, healthcare provider-related factors, sociocultural factors, and general/quality of life factors. Side effects were less likely to be associated with adherence in studies with retrospective or cross-sectional than prospective designs. Self-efficacy (psychological factor) and positive decisional balance (attitude toward AET) were the only potentially modifiable factors examined ≥10 times and associated with adherence or persistence ≥75% of the time in both univariate and multivariate models. Self-efficacy and decisional balance (i.e., weight of pros vs. cons) were the potentially modifiable factors most consistently associated with adherence, and hence may be worth focusing on as targets for interventions to improve AET adherence among breast cancer survivors. Full article
(This article belongs to the Special Issue Systematic Reviews of Patient-Reported Outcomes in Patients with Cancer)
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