Supportive Care in Cancer

, Volume 24, Issue 6, pp 2503–2512 | Cite as

PRO-ONKO—selection of patient-reported outcome assessments for the clinical use in cancer patients—a mixed-method multicenter cross-sectional exploratory study

  • Heike Schmidt
  • Daniela Merkel
  • Michael Koehler
  • Hans-Henning Flechtner
  • Jörg Sigle
  • Bernd Klinge
  • Karin Jordan
  • Dirk Vordermark
  • Margarete Landenberger
  • Patrick Jahn
Original Article



Cancer patients frequently suffer from multiple symptoms often impairing functional status and health-related quality of life (HRQOL). A comprehensive assessment including patient-reported outcomes (PROs) is recommended to enable individualized supportive care. However, PRO assessments are still not part of routine clinical practice. Therefore, this project aimed to compile an item pool from validated assessment instruments to facilitate the use of PROs for clinical decision-making in oncology clinics.


This qualitative dominant mixed-method cross-sectional exploratory study was carried out in four centers and comprised two stages. Stage I: Six interdisciplinary focus groups were conducted to choose questionnaires meeting particular clinical requirements. Stage II: Adult patients with heterogeneous cancer diagnoses, receiving in- or out-patient treatment were asked to participate and complete the chosen questionnaires (participation 71/74). Resulting PROs were compared with clinical records. Health care professionals (HCPs) and patients rated the usefulness for routine clinical practice.


The European Organisation of Research and Treatment of Cancer (EORTC) QLQ-C30 and Distress Thermometer were chosen for screening and M.D. Anderson Symptom Inventory (MDASI) and EORTC single items for monitoring. Comparison of n = 88 PRO assessments with clinical records showed consistent documentation of side effects like fever and emesis. Symptoms like fatigue, sadness, or sleep disturbance were not documented regularly in the medical records but captured by PRO assessments. Patients and HCPs judged the chosen questionnaires and electronic data collection as useful.


Future studies should examine how PROs can complement or substitute routine documentation in order to achieve standardized assessment and documentation during the treatment process in different settings and examine possible benefits for patients.


Patient-reported outcomes Cancer Quality of life Screening Monitoring Supportive therapy 


Compliance with ethical standards

Conflict of interest

The work was funded by a grant of the Wilhelm-Roux program of the medical faculty of the Martin Luther University Halle-Wittenberg. The authors state no conflicts of interest related to the work of this study. The authors have full control of all primary data that can be reviewed if requested.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Heike Schmidt
    • 1
  • Daniela Merkel
    • 1
  • Michael Koehler
    • 2
  • Hans-Henning Flechtner
    • 3
  • Jörg Sigle
    • 4
    • 5
  • Bernd Klinge
    • 6
  • Karin Jordan
    • 7
  • Dirk Vordermark
    • 8
  • Margarete Landenberger
    • 1
  • Patrick Jahn
    • 1
    • 9
  1. 1.Medical Faculty, Institute of Health and Nursing SciencesMartin Luther University Halle-WittenbergHalle (Saale)Germany
  2. 2.Department of Hematology and OncologyUniversity Hospital, Otto-von-Guericke-University MagdeburgMagdeburgGermany
  3. 3.Department of Child and Adolescent PsychiatryOtto-von-Guericke-University MagdeburgMagdeburgGermany
  4. 4.Scientific IT ConsultingBettingenSwitzerland
  5. 5.Reha ChrischonaBettingenSwitzerland
  6. 6.Surgical DepartmentHelios KlinikSangerhausenGermany
  7. 7.Department of Internal Medicine IV, Hematology and OncologyUniversity Hospital Halle, Martin Luther University Halle-WittenbergHalle (Saale)Germany
  8. 8.Department of Radiation OncologyUniversity Hospital Halle, Martin Luther University Halle-WittenbergHalle (Saale)Germany
  9. 9.Nursing Research UnitUniversity Hospital Halle, Martin Luther University Halle-WittenbergHalle (Saale)Germany

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