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Feasibility of patient-reported outcomes collection in clinical routine at a radiotherapy department
Ingrid Fagerström Kristensen1, Anton Linnér2, Martin Nilsson3
1Oncology, Lund University, SE-221 85 Lund, Sweden; Radiation physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Sweden, SE-221 85 Lund, Sweden.
Background And Purpose:
Routine collection of patient-reported outcome measures (PROMs) may provide valuable real-world data on quality of life (QoL) and treatment tolerability, complementing clinical outcomes. This study evaluated the feasibility of launching a semi-automated, department-wide PROM collection program at a large tertiary radiotherapy centre.
Patients And Methods:
Patients ≥ 18 years referred for radiotherapy were invited to participate. Exclusion criteria were inability to provide informed consent, severe cognitive conditions, or language barriers. PROMs were collected using a web-based application ("Blå Appen") at baseline, end-of-treatment, and follow-up intervals, using the EORTC QLQ-C30 questionnaire (Version 3).
Results:
During the study period (January 2022 to April 2025), 12,472 patients underwent treatment in the department. A total of 4,764 provided informed consent for study participation, where 3,699 (77.6%) remained after exclusion due to data loss or data inconsistency. Among these, 3,056 patients (82.6%) provided at least one usable PROM questionnaire at baseline. Participants were younger (median age 69 years vs. 71 years). Overall, global health status was relatively high at baseline and remained stable or slightly improved at one-year follow-up. To further investigate clinically significant changes in QoL over time, we evaluated the proportion of patients in each diagnostic category who experienced a change of > 10 points in selected QLQ-C30 scales between baseline and follow-up. Breast cancer patients had the highest rates of meaningful improvement and the lowest rates of major deterioration. In contrast, prostate cancer patients were more prone to significant declines in QoL scales over time.
Interpretation:
This prospective study demonstrates that department-wide collection of PROM is feasible. Using a digital platform, we achieved a high initial response rate and successfully engaged patients across a broad range of cancers. The routine PROM collection provided valuable insights into patients' quality of life and symptom burden during and after treatment.
