The aims of this review were to identify symptoms experienced by head and neck cancer (HNC) patients and their prevalence, as well as to compare symptom coverage identified in HNC specific patient-reported outcome measures (PROMs). Searches of Ovid Medline, Embase, PsychInfo, and CINAHL were conducted to identify studies. The search revealed 4569 unique articles and identified 115 eligible studies. The prevalence of reported symptoms was highly variable among included studies. Variability in sample size, timing of the assessments, and the use of different measures was noted across studies. Content mapping of commonly used PROMs showed variability and poor capture of prevalent symptoms, even though validation studies confirmed satisfactory reliability and validity. This suggests limitations of some of the tools in providing an accurate and comprehensive picture of the patient’s symptoms and problems.

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Background: Respiratory tract infection (RTI) is the leading reason for avoidable antimicrobial use in primary care, yet provider-level feedback on its use is only available in some provinces. The aim of this study was to validate case definitions for RTI across the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) and determine baseline provider-level variability in antimicrobial prescribing in 2019. Methods: The RTI case definitions were developed using demographic, diagnostic coding and keywords in electronic medical record. Manual chart abstraction was performed to identify cases of acute otitis media. Remaining RTI definitions were validated using a random sample of 5,164 patients with encounters in 2019. The proportion of patients with an RTI treated with antibiotics was determined by provider, per patient, per episode and per patient encounter. Results: Negative predictive value, positive predictive value and prevalence were as follows: 1.00 (0.99–1.00), 0.99 (0.96–0.99) and 4.14% (4.10–4.19) for common cold; 1.00 (0.99–1.00), 0.94 (0.88–0.98) and 1.09% (1.07–1.12) for acute otitis media; 0.98 (0.96–1.00), 0.93 (0.87–0.97) and 1.2% (1.18–1.22) for acute pharyngitis; 0.99 (0.99–1.00), 0.88 (0.81–0.93) and 1.99% (1.96–2.02) for sinusitis; 0.99 (0.97–0.99), 0.95 (0.89–0.98) and 4.01% (3.97–4.05) for acute bronchitis/asthma. By provider, median (interquartile range [IQR]) proportion treated with antibiotics (per patient) was 6.72 (14.92) for common cold, 64.29 (40.00) for acute otitis media, 20.00 (38.89) for pharyngitis, 54.17 (38.09) for sinusitis, 8.33 (20.00) for acute bronchitis/asthma and 21.10 (20.56) for overall RTI. Conclusion: The CPCSSN can provide national surveillance of antimicrobial prescribing practices for RTI across primary care. Baseline variability underscores the need for provider feedback and quality improvement.

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Patient-reported experience measures (PREMs) capture the patient’s view about his or her experience while receiving care across the continuum of care. Your Voice Matters (YVM), a real-time electronic PREM tool, was developed to measure the patient experience in the outpatient cancer setting and to drive quality improvements in the cancer system. This study describes the development and validation of YVM, a real-time electronic PREM tool in cancer services. Cognitive interviewing was conducted with patient and family advisors for both the French (n = 3) and English (n = 5) versions of the YVM tool. YVM was administered through five Regional Cancer Centers (RCCs) between April and August 2015. Shapley value regression used overall experience-dependent variables to determine core items and items eligible for removal from YVM. Exploratory factor analysis was used to determine the underlying factor structure.Internal consistency reliabilities were calculated using Cronbach’s alpha. A total of 557 YVM tools were completed by cancer patients in the treatment phase. Shapley value regression identified five lower scoring items for removal. Exploratory factor analysis showed that a 27-item, five-factor structure reflected the underlying patient experience dimensions in the cancer treatment visit. Cronbach’s alpha of 0.827 for all items suggested good internal consistency. YVM is a validated tool for measuring the experience of cancer patients during the treatment phase through the visit trajectory in real time. YVM will help drive improvements based on patients’ preferences and needs, and will provide robust patient experience data for cancer care delivery.