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. 2012 Jun 13:4:32.
doi: 10.1186/1758-3284-4-32.

Enhanced patient reported outcome measurement suitable for head and neck cancer follow-up clinics

Naseem Ghazali  1 , Derek Lowe, Simon N Rogers
Affiliations

Enhanced patient reported outcome measurement suitable for head and neck cancer follow-up clinics

Naseem Ghazali et al. Head Neck Oncol. .

Expression of concern in

  • Comment: Head and Neck Oncology.
    BioMed Central. BioMed Central. BMC Med. 2014 Feb 5;12:24. doi: 10.1186/1741-7015-12-24. BMC Med. 2014. PMID: 24499430 Free PMC article. Review.

Abstract

Background: The 'Worse-Stable-Better' (W-S-B) question was introduced to capture patient-perceived change in University of Washington Quality of Life (UW-QOL) domains.

Methods: 202 head and neck cancer patients in remission prospectively completed UW-QOL and Patients Concerns Inventory (PCI). For each UW-QOL domain, patients indicated whether over the last month things had worsened (W), remained stable (S) or were better (B).

Results: 202 patients at 448 attendances selected 1752 PCI items they wanted to discuss in consultation, and 58% (1024/1752) of these were not covered by the UW-QOL. UW-QOL algorithms highlighted another 440 significant problems that the patient did not want to discuss (i.e. the corresponding items on the PCI were not selected).After making allowance for UW-QOL algorithms to identify 'significant problems' and PCI selection of corresponding issues for discussion there remained clear residual and notable variation in W-S-B responses, in particular to identify patients with significant problems that were getting worse, and patients without significant problems that wanted to discuss issues that were getting worse. Changes in mean UW-QOL scores were notably lower for those getting worse on the W-S-B question, typically by 10 or more units a magnitude that suggests clinically important changes in score.

Conclusions: The W-S-B question adds little questionnaire burden and could help to better identify patients who might benefit from intervention. The results of this study suggest that the UW-QOL with the W-S-B modification should be used together with the PCI to allow optimal identification of issues for patient-clinician discussion during routine outpatient clinics.

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