What outcomes do studies use to measure the impact of prognostication on people with advanced cancer? Findings from a systematic review of quantitative and qualitative studies

Background:
Studies evaluating the impact of prognostication in advanced cancer patients vary in the outcomes they measure, and there is a lack of consensus about which outcomes are most important.
Aim:
To identify outcomes previously reported in prognostic research with people with advanced cancer, as a first step towards constructing a core outcome set for prognostic impact studies.

Design: A systematic review was conducted and analysed in two subsets: one qualitative and one quantitative. (PROSPERO ID: CRD42022320117; 29/03/2022). Data sources: Six databases were searched from inception to September 2022. We extracted data describing (1) outcomes used to measure the impact of prognostication and (2) patients’ and informal caregivers’ experiences and perceptions of prognostication in advanced cancer. We classified findings using the Core Outcome Measures in Effectiveness Trials (COMET) initiative taxonomy, along with a narrative description. We appraised retrieved studies for quality, but quality was not a basis for exclusion.
Results: We identified 42 eligible studies: 32 quantitative, 6 qualitative, 4 mixed methods. We extracted 70 outcomes of prognostication in advanced cancer and organised them into 12 domains: (1) survival; (2) psychiatric outcomes; (3) general outcomes; (4) spiritual/ religious/existential functioning/wellbeing, (5) emotional functioning/wellbeing; (6) cognitive functioning; (7) social functioning; (8) global quality of life; (9) delivery of care; (10) perceived health status; (11) personal circumstances; and (12) hospital/hospice use.
Conclusion: Outcome reporting and measurement varied markedly across the studies. A standardised approach to outcome reporting in studies of prognosis is necessary to enhance data synthesis, improve clinical practice and better align with stakeholders’ priorities.

Aim

To identify outcomes previously reported in prognostic research with people with advanced cancer, as a first step towards constructing a core outcome set for prognostic impact studies.

Contributors

Caitlin Spooner, Bella Vivat, Nicola White, Andrea Bruun, Gudrun Rohde, Pei Xing Kwek and Patrick Stone

Publication

Journal: Palliative Medicine
Volume: 37
Issue: 9
Pages: 1345 - 1364
Year: 2023
DOI: 10.1177/02692163231191148

Further Study Information

Current Stage: Completed
Date:
Funding source(s): The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Economic and Social Research Council and Marie Curie Cancer Care [grant number: ES/P000592/1].

Health Area

Disease Category: Cancer

Disease Name: Advanced cancer

Target Population

Age Range: Unknown

Sex: Either

Nature of Intervention: Palliative

Stakeholders Involved

Study Type

- Systematic review of outcome measures/measurement instruments
- Systematic review of outcomes measured in trials
- Systematic review of qualitative research

Method(s)

- Systematic review

MEDLINE, EMBASE, PsycINFO, CINAHL, the Cochrane Controlled Register of Trials and the Cochrane Central Register were searched from inception to September 2022. Search limits were applied to restrict results to a human, adult population and studies published in English
language only due to limitations in resources. The search included trials registered at ClinicalTrials.gov and The International Clinical Trials Registry Platform Search Portal. Grey literature searches were conducted using OpenGrey and ProQuest-Digital Dissertations and
Theses. Finally, study references of included studies were searched forward and backward.

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