Relevant content for a patient-reported outcomes questionnaire for use in oncology clinical practice: Putting doctors and patients on the same page

To investigate relevant patient-reported outcome (PRO) domains for oncology clinical practice. We conducted cross-sectional semi-structured telephone interviews with patients with breast and prostate cancer and clinicians. Using open-ended questions followed by structured prompts of PRO domains, subjects were asked what they currently discuss during visits and which topics are relevant for a clinical practice PRO. For each domain, we calculated the percentage of patients and clinicians who responded positively. A qualitative thematic content analysis identified barriers and benefits of using PROs in clinical practice. A total of 41 patients (21 breast cancer and 20 prostate cancer) and 15 clinicians (7 medical oncologists, 5 radiation oncologists, and 3 surgeons) completed the interviews. In general, clinicians and patients reported that the topics explored were relevant. Barriers to using PROs in clinical practice include (1) time constraints, (2) varying relevance of questions, (3) value of the conversational approach, (4) decreased usefulness in established relationships, and (5) respondent burden. Benefits of PROs in clinical practice include (1) identifying problems, (2) serving as a reminder of topics to discuss, and (3) tracking changes over time. PROs in clinical practice may help triage issues and focus discussions. Computer-adaptive tests should be explored to tailor questionnaires to patients' specific issues.