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Patient reported outcomes (PROs) are reports of health conditions that come directly from patients. Use of PROs has been associated with improved patient outcomes, enhanced quality of life, and reduced end-of-life spending. Yet there are still outstanding questions regarding the process of implementing PRO collection in routine practice. In this article, we describe the experience of selecting and implementing PROs in a multisite, multidisease academic medical center-based radiation oncology practice and demonstrate that such large-scale rollout is feasible. We establish that PROs can be implemented with minimal to no workflow delays, are generally seen as valuable by clinicians, and can enhance patient-doctor communication. We additionally detail the challenges involved in selecting clinically relevant PRO questionnaires and the centrality of physician buy-in, easy data access, and clear workflows to successful implementation.

We examined the epidemiology and phenomenology of major depressive disorder (MDD) and minor depression among a community sample of 496 female adolescents. Diagnostic interviews were conducted annually for 7 years, allowing us to examine onset, course, and symptom presentation among participants 12 through 20 years old. Approximately 1 of 6 girls experienced MDD. MDD episodes had a mean duration of 5.3 months (SD = 4.2). One-year prevalence for MDD peaked at age 16 (5.3%). White racial status and younger age were associated with greater worthlessness and suicidality during an MDD episode. One of 5 girls met criteria for minor depression. Adolescents from racial/ethnic minority groups were at especially high risk for minor depression. Adolescence is a high-risk period for depression in young women, although its prevalence and phenomenology vary as a function of age and race/ethnicity.

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