Grant Number:	1R03CA292987-01 Interpret this number
Primary Investigator:	Zeng, Chengbo
Organization:	Brigham And Women'S Hospital
Project Title:	Nonresponse of Patient-Reported Outcomes in Routine Cancer Care
Fiscal Year:	2024

PROJECT SUMMARY/ABSTRACT Patient-reported outcome (PRO) measures, or PROMs, are powerful tools in cancer care to enhance clinician- patient communication, identify problematic symptoms and treatment priorities, facilitate shared decision-making, and prolong survival. Nonresponse significantly undermines the representativeness of PRO data that is routinely collected as part of clinical care, thereby compromising its utility for promoting high-value, equitable patient- centered care in cancer clinics. The lack of adequate representativeness also hampers the use of routinely collected PRO data for quality improvement and value-based healthcare. There is an urgent need to delineate the representativeness of PRO data collected in routine cancer care, identify the underlying causes of nonresponse, and develop novel methods to ensure data representativeness. Despite compelling evidence that expanding the reach of PROMs collection to underrepresented patients and improving their PROMs completions are critical to ensure the representativeness of routinely collected PRO data, most of the current research focuses on methods to increase collection instead of methods to enhance PRO data representativeness. The overarching goal of this proposal is to characterize and delineate the causes of nonresponse and devise mitigation strategies to improve the representativeness of PRO data collected in routine cancer care. By examining the data of the Patient-Reported Outcomes Measurement Information System Global-10 measure collected as part of routine care at seven Radiation Oncology clinics within the Mass General Brigham healthcare system, we will (Aim 1) characterize the nonresponse of the Global-10 across clinic, provider, and patient levels; (Aim 2) identify multilevel causes of nonresponse and potential strategies to improve representativeness in PROMs collection; and (Aim 3) develop effective modifications to missing-data methods to enhance the representativeness of pre-existing PRO data. Our expected outcomes are generalizable knowledge and strategies to address nonresponse in PROMs, enhancing PRO data representativeness in routine cancer care. The successful completion of this project will elucidate the characteristics of PROMs nonresponse and its intricate associations with multilevel factors of successful large-scale PROMs collection in diverse patient populations. Insights from this endeavor will also guide the evolution and development of PROMs collection programs to expand their reach to underrepresented cancer patients and improve data representativeness. This will, in turn, enable the utility of PRO data for quality improvement and high-value, equitable patient-centered cancer care.





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