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JAMA Oncol. 2017 May 1;3(5):686-694. doi: 10.1001/jamaoncol.2017.0417.

An International Collaborative Standardizing a Comprehensive Patient-Centered Outcomes Measurement Set for Colorectal Cancer.

Author information

1
International Consortium for Health Outcomes Measurement (ICHOM), Cambridge, Massachusetts2Department of Quality and Patient Safety, Dana-Farber Cancer Institute, Boston, Massachusetts3Division of Hematology and Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
2
International Consortium for Health Outcomes Measurement (ICHOM), Cambridge, Massachusetts4Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
3
International Consortium for Health Outcomes Measurement (ICHOM), Cambridge, Massachusetts.
4
Bowel Cancer Australia, North Sydney, Australia.
5
College of Nursing, University of Nebraska Medical Center, Omaha.
6
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston.
7
Department of Clinical Sciences, Institut d'Investigació Biomèdica de Bellvitge, University of Barcelona, Barcelona, Spain.
8
Division of Hematology and Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
9
Department of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota.
10
Department of Digestive Oncology, University Hospitals Leuven and Katholieke Universiteit Leuven, Leuven, Belgium.
11
Department of Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
12
Department of Surgery, University of Utah School of Medicine, Salt Lake City.
13
Department of Radiation Oncology, Koo Foundation Sun Yan-Sen Cancer Center, Taiwan.
14
Department of Surgery, Campus Charité Mitte/Campus Virchow, Universitätsmedizin Berlin, Berlin, Germany.
15
Colon Cancer Alliance, Washington, DC.
16
Department of Surgery, Peter MacCallum Cancer Center, East Melbourne, Australia.
17
Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
18
Fight Colorectal Cancer, Alexandria, Virginia.
19
Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston.
20
Division of Medical Oncology, National Cancer Centre, Singapore.
21
Department of Gastroenterology, Hospital Sultanah Bahiyah, Kedah, Malaysia.
22
Cancer Support Community, Washington, DC.
23
Division of Medical Oncology, Department of Medicine, University of Washington, Seattle.
24
Department of Pathology, University of Washington, Seattle.
25
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
26
Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.

Abstract

Importance:

Global health systems are shifting toward value-based care in an effort to drive better outcomes in the setting of rising health care costs. This shift requires a common definition of value, starting with the outcomes that matter most to patients.

Objective:

The International Consortium for Health Outcomes Measurement (ICHOM), a nonprofit initiative, was formed to define standard sets of outcomes by medical condition. In this article, we report the efforts of ICHOM's working group in colorectal cancer.

Evidence Review:

The working group was composed of multidisciplinary oncology specialists in medicine, surgery, radiation therapy, palliative care, nursing, and pathology, along with patient representatives. Through a modified Delphi process during 8 months (July 8, 2015 to February 29, 2016), ICHOM led the working group to a consensus on a final recommended standard set. The process was supported by a systematic PubMed literature review (1042 randomized clinical trials and guidelines from June 3, 2005, to June 3, 2015), a patient focus group (11 patients with early and metastatic colorectal cancer convened during a teleconference in August 2015), and a patient validation survey (among 276 patients with and survivors of colorectal cancer between October 15, 2015, and November 4, 2015).

Findings:

After consolidating findings of the literature review and focus group meeting, a list of 40 outcomes was presented to the WG and underwent voting. The final recommendation includes outcomes in the following categories: survival and disease control, disutility of care, degree of health, and quality of death. Selected case-mix factors were recommended to be collected at baseline to facilitate comparison of results across treatments and health care professionals.

Conclusions:

A standardized set of patient-centered outcome measures to inform value-based health care in colorectal cancer was developed. Pilot efforts are under way to measure the standard set among members of the working group.

PMID:
28384684
DOI:
10.1001/jamaoncol.2017.0417
[Indexed for MEDLINE]

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