Performance Measures Based on How Adults With Cancer Feel and Function: Stakeholder Recommendations and Feasibility Testing in Six Cancer Centers

PURPOSE Patient-reported outcome measures (PROMs) that assess how patients feel and function have potential for evaluating quality of care. Stakeholder recommendations for PRO-based performance measures (PMs) were elicited, and feasibility testing was conducted at six cancer centers. METHODS Interviews were conducted with 124 stakeholders to determine priority symptoms and risk adjustment variables for PRO-PMs and perceived acceptability. Stakeholders included patients and advocates, caregivers, clinicians, administrators, and thought leaders. Feasibility testing was conducted in six cancer centers. Patients completed PROMs at home 5-15 days into a chemotherapy cycle. Feasibility was operationalized as $75$ 75% patient acceptability. RESULTS Stakeholder priority PRO-PMs for systemic therapy were GI symptoms (diarrhea, constipation, nausea, vomiting), depression/anxiety, pain, insomnia, fatigue, dyspnea, physical function, and neuropathy. Recommended risk adjusters included demographics, insurance type, cancer type, comorbidities, emetic risk, and difficulty paying bills. In feasibility testing, 653 patients enrolled (approximately 110 per site), and 607 (93%) completed PROMs, which indicated high feasibility for home collection. The majority of patients (470 of 607; 77%) completed PROMs without a reminder call, and 137 (23%) of 607 completed them after a reminder call. Most patients (72%) completed PROMs through web, 17% paper, or 2% interactive voice response (automated call that verbally asked patient questions). For acceptability, . 95% of patients found PROM items to be easy to understand and complete. CONCLUSION Clinicians, patients, and other stakeholders agree that PMs that are based on how patients feel and function would be an important addition to quality measurement. This study also shows that PRO-PMs can be feasibly captured at home during systemic therapy and are acceptable to patients. PRO-PMs may add value to the portfolio of PMs as oncology transitions from fee-for-service payment models to performance-based care that emphasizes outcome measures

Innovative research methods in health social sciences : an introduction

Innovative, or creative research, methods have become increasingly popular in the last few decades. In this chapter, I will include several salient issues on which chapters in the section on “Innovative Research Methods in Health Social Sciences” can be situated. First, I discuss some ideas about innovative and creative methods. This is followed with the notion of those who practice innovative methods: the innovative researcher. I will then bring readers through a number of innovative and creative methods that researchers have adopted in their research. These include the theoretical lens, arts-based and visual research methods, the body and embodiment research, digital methods, and textual (plus visual) methods of inquiry. As an innovative researcher, our choice of innovative methods primarily depends on the questions we pose; the people who are involved; our moral, ethical, and methodological competence as researchers; and the sociocultural environment of the research. As we are living in the world that continue to change, it is likely that health and social science researchers will continue to experiment with their creative methods in order to ensure the success of their research. I anticipate that in the future, we will see even more creative methods that researchers will bring forth