Comparative effectiveness needs patient perspective

The patient perspective is vital to evaluating the effectiveness, benefits and harms of various cancer treatments, according to research published online in the Journal of Clinical Oncology this week.

Therefore, patients' assessments of symptoms and health-related quality of life should be included in comparative-effectiveness studies.

"There is no way to adequately assess a treatment's impact on the patient without including their point of view, gleaned directly from asking about their experience in a consistent and scientifically validated manner," lead researcher Ethan Basch, M.D., director of the Cancer Outcomes Research Program at UNC Lineberger Comprehensive Cancer Center, said yesterday in a statement.

Adding patient-reported outcomes to comparative effectiveness research provides a complete picture of how treatments perform, which can help patients, providers, payers and regulators make more informed decisions about a particular treatment option, researchers noted.

Researchers also recommended patient-reported information adhere to selection, implementation and validation standards to ensure such data is relevant.

To help make comparative-effectiveness research more patient centered, the Patient-Centered Outcomes Research Institute (PCORI) in June awarded $30 million to 50 pilot projects that will focus on engaging patients in the health research and dissemination process.

Meanwhile, articles in this month's Health Affairs found that comparative-effectiveness studies fail to change patient care or clinical practice. The authors cited several problems, including fee-for-service models, intrinsic biases in interpreting results and limited use of clinical decision-support tools better aligned with outcomes, that prevent scientific evidence from affecting clinical practice.

To learn more:
- check out the study abstract
- here's the research announcement
- read the MedPage Today article