Patient Preferences: More Complex Than Maximizing Survival Time

 August 11, 2016

Discrepancies Among Patient-oriented Variables

As new PRO (Patient Reported Outcomes) endpoints become more widely employed in research, even in the measurement of quality of care in clinical settings, it is important to clearly distinguish PROs from patient preferences and quality of life, emphasized Richard Schilsky, MD, FASCO, FACP, chief medical officer of the American Society of Clinical Oncology (ASCO) in Alexandria, Virginia.
“They're not all the same thing,” Dr Schilsky cautioned. “Patient preferences are typically just that: I prefer to receive this treatment every week than that 1 every 3 weeks. That's a patient preference. Treatments may produce similar outcomes except that 1 is associated with neuropathy—nerve damage—and another is associated more commonly with diarrhea. If I'm a professional violinist, my preference is to avoid nerve damage at all costs, because that will affect my career.”
PROs, in contrast, are measurements of a patient's own experience, usually regarding adverse events associated with treatment, such as pain, nausea, or fatigue, Dr Schilsky said. “Quality of life is typically a more global assessment of how a patient is going through her life experiences. It has many domains, many scales—such as social support, physical functioning, psychological—and they all roll up into an overall ‘Quality of Life' assessment.”......