Improving the Evidence Base for Delivery of High-Quality Cancer Care

In delivering care to patients with cancer, the oncology community is dependent on the availability of accurate, evidence-based treatment information, largely gleaned from the outcomes of clinical trials or high-quality observational studies. At a time when clinicians are encouraged to provide more tailored and patient-centered care, including the patient's voice as a component of evidence generation is critical. Patient values and preferences can influence treatment choice. In addition, physician knowledge of comorbid conditions, preexisting patient symptoms, and adverse effects of treatment are essential. During the past 2 decades, we have seen increased incorporation of patient-reported outcomes (PROs) as part of clinical trial assessments to bridge the gap between patient preferences and physician practice, in the form of multidimensional health-related quality of life and symptom assessment. Regulatory bodies now endorse inclusion of such measures as part of regulatory approvals of drugs. However, delivering high-quality patient-centered care is complex, especially as the health care system undergoes dramatic changes, as noted in the Institute of Medicine's (IOM) recent report. The IOM recommended that additional efforts be made to collect more detailed information on patient experiences with treatments, as well as more comprehensive information about patient characteristics and behaviors. In this issue of JAMA Oncology, the studies by Basch et al and Ye et al take important first steps in showing us that it is feasible to obtain expanded information about patient experiences, comorbid conditions, and toxic effects that occur among patients with cancer.

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