Identifying Patient-Reported Outcome Measures (PROMs) for Routine Surveillance of Physical and Emotional Symptoms in Head and Neck Cancer Populations: A Systematic Review

Abstract

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.

First Phase Development of a Patient-reported Outcome Measure for Midface Oncology

“…31 A systematic review of PROMs used in patients with head and neck cancer identified dysphagia, saliva function, difficulty chewing and dental problems, dysphagia, oral mucositis, and voice and speech impairment to be the most common functional issues addressed. 48 These PROMs are often developed from patient populations where the majority have undergone surgery involving the aerodigestive tract. 31 For example, the Edmonton-33 instrument, a commonly used PROM in head and neck cancer patients, was designed and tested only in patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx, 49 whereas OncoQuest, a PROM measuring HRQL in head and neck cancer patients, was validated in a patient population where 78% of patients had tumors of the pharynx, larynx, or oral cavity.…”

Patient-Reported Outcome Measures in a Facial Reconstruction Case Series Following the Implementation of an Integrated Craniofacial Multidisciplinary Team Clinic, Three-Dimensional Photography, and Computer Modeling

“…In head and neck cancer, many PROM tools have been used in studies to assess the quality of life of patients, but many of these instruments have not been specific to patients with head and neck cancer and are instead directed to a particular symptom or issue. 14 For example, when evaluating outcomes such as anxiety in patients with head and neck cancer, the Hospital Anxiety and Depression Scale (HADS-A) has often been used, which is a generic questionnaire used by clinicians to measure anxiety and depression in a general patient population. Having said this, some examples of PROM tools have been mentioned in the literature that are specific to patients with head and neck cancer.…”

“… 16 Other PROM tools that have been mentioned in the literature include FACT-HN, a 39-item questionnaire that has been reported to cover a full range of physical and emotional symptoms experienced by patients with head and neck cancer but may need to be supplemented with condition-specific measures depending on the objective of the clinician. 14 , 17 …”

Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating

“…Since patient eating behaviors are generally superior as an outpatient compared to inpatient, electronic patient-reported outcomes (ePRO) [69][70][71][72][73]130,[137][138][139][140][166][167][168] may help to generate new data and metrics concerning differences between predominantly outpatient versus inpatient chemotherapy delivery and admissions for chemotherapy and amelioration of serious adverse events (SAEs). For example, this approach could ask for (number of hospital days/year) to generate a new ePRO metric of quality and cost of cancer care.…”