Related Experiment Video
Updated: Jul 17, 2025
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Defining Priorities in Value-Based Cancer Care: Insights From the Alliance for Clinical Trials in Oncology National
Casey J Allen1, Rebecca A Snyder2, Danea Marie Horn3
1Division of Surgical Oncology, Institute of Surgery, Allegheny Health Network Cancer, Pittsburgh, PA.
Purpose:
We determine how stakeholders prioritize the importance of oncologic outcomes, patient-reported outcomes (PROs), and cancer-related health care costs.
Methods:
A survey was distributed to the National Clinical Trials Network Alliance for Clinical Trials in Oncology cooperative group membership from May 14 to June 30, 2022. Respondents were asked to rate (5-point Likert scale) and rank (1-9) evidence-based value domains: overall survival, treatment toxicities/complications, quality of life (QOL), financial toxicity, access to care, compliance with evidence-based care, health system performance, scientific discovery and innovation, and cost to the health care system.
Results:
A total of 514 members responded, including researchers (24.7%), nurses (19.5%), medical oncologists (17.9%), administrators (9.3%), surgical and radiation oncologists (9.1%), patient advocates (3.1%), and nonphysician providers (16.4%). Participants represented various practice settings including National Cancer Institute-designated cancer centers (29.8%), university-affiliated academic cancer centers (21%), hospital-owned oncology practices (21.8%), and others (27.4%). There was agreement in how respondents prioritized value domains (W = 0.39, P < .001). Respondents ranked patient QOL (mean rank: 2.6 ± 1.9) as most important above all other metrics including survival (mean rank: 3.5 ± 0.3) and access to care (mean rank: 3.5 ± 2.1; P < .001). Members engaged in direct patient care also ranked access to care of higher importance than nonclinicians (P = .026). Cost to the health care system (mean rank: 7.5 ± 2.1) and health system performance (mean rank: 7 ± 2) were ranked as least important (P < .001). Inclusion of PROs into therapeutic assessment (59.3%) was the most frequently selected priority of future cooperative group initiatives.
Conclusion:
Oncology community stakeholders deemed patient-centered value domains as most important and considered patient QOL the highest priority. Inclusion of PROs into clinical trials was endorsed as an important component of therapeutic assessment. These findings can be taken into consideration when creating a value framework for inclusion in cancer clinical trials.
Insights
Oncology stakeholders prioritize patient quality of life (QOL) and patient-reported outcomes (PROs) over survival and costs. Including PROs in cancer clinical trials is a key future initiative for therapeutic assessment.
Area of Science:
- Oncology
- Health Services Research
- Clinical Trials
Background:
- Stakeholder perspectives are crucial for developing effective value frameworks in cancer care.
- Prioritization of oncologic outcomes, patient-reported outcomes (PROs), and healthcare costs varies among different stakeholder groups.
- Understanding these priorities is essential for designing cancer clinical trials that align with patient and provider values.
Purpose of the Study:
- To determine how various stakeholders prioritize oncologic outcomes, patient-reported outcomes (PROs), and cancer-related healthcare costs.
- To identify the most important value domains for cancer clinical trials from the perspective of cooperative group members.
Main Methods:
- A survey was distributed to members of the National Clinical Trials Network Alliance for Clinical Trials in Oncology cooperative group.
- Respondents rated and ranked nine evidence-based value domains, including overall survival, quality of life (QOL), and financial toxicity.
- Data from 514 respondents representing diverse roles and practice settings were analyzed.
Main Results:
- Respondents overwhelmingly prioritized patient quality of life (QOL) as the most important metric, ranking it higher than survival and access to care.
- Patient advocates and clinicians ranked access to care higher than non-clinicians.
- Cost to the health care system and health system performance were ranked as the least important domains.
Conclusions:
- Oncology community stakeholders consider patient-centered value domains, particularly QOL, as paramount.
- There is strong support for including patient-reported outcomes (PROs) in the assessment of cancer therapies and clinical trials.
- These findings can inform the development of a comprehensive value framework for cancer clinical trials.
More Related Videos
Related Concept Videos
02:56Treatment Resistant Cancers
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
01:11Clinical Trials: Overview
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
01:21Cancer Survival Analysis