Table 1 A comparison of three baseline reviews

Luckett et al. 2009 [26]

To identify future strategies for (1) interventions to impact patient outcomes; and (2) trials to identify treatment effects.

MEDLINE and PsycINFO were systematically searched to identify reports of relevant randomised controlled trials. The time span was between 2006 and 1 August 2008. Four cancer trials were cited in a previous review (Valderas et al. 2008)[27].

1. Examined the citations of the four trials 2. Adopted the strategy used by Valderas et al. [27] and Espallargues et al. [29] which involved searching for the terms ‘health status’, ‘functional status’ or ‘quality of life’ and ‘clinical practice’, ‘clinical setting’, ‘practice setting’, ‘medical practice’ or ‘medical consultation’ anywhere in the title, abstract or keywords. Results were limited by publication date (2006–2008) and the MeSH or keyword neoplasm.

6 RCTs

Future interventions should motivate and equip health professionals to use PROs data in managing patients, training patients in self-efficacy, using more specific PROs in clinics, improving the interpretability of feedback for both medical staff and patients, and monitoring the use of PROs to intervene when problems arise. Future trials should use a cluster randomised design to control for contamination and enable systems-based interventions.

Valderas et al. 2008 [27]

To summarize the best evidence regarding the impact of providing patient reported outcomes (PRO) information to health care professionals in daily clinical practice.

Systematic review of randomised clinical trials (Medline, Cochrane Library); reference lists of previous systematic reviews; and requests to authors and experts in the field. Time span: Articles published between 1978 and 2007.

No exact search terms provided but indicated available from the author upon request.

34 articles corresponding to 28 original studies; only 2 (not 4) as mentioned in the above review, are in an oncologic setting.

Methodological concerns limit the strength of inference regarding the impact of providing PROs information to clinicians. Results suggest great heterogeneity of impact; contexts and interventions that will yield important benefits remain to be clearly defined.

Marshall et al. 2006 [28]

To synthesize the evidence for using publically reported performance data to improve quality. Only articles that provided empirical evidence on the impact of public reporting on outcomes (effectiveness, patient safety, and patient-centeredness) and unintended consequences, as well as selection and quality improvement activity were included.

Webspirs Medline was searched for the years from January 1976 to November 2004. Reference lists of included studies and appropriate reviews (Greenhalgh & Meadows 1999[30]; Espallargues et al. 2000 [29]; Gilbody et al. 2003 [31]) were also searched for relevant articles. Finally, PubMed’s ‘related articles’ feature was used with several background and included articles (Drury et al. 2000 [32]; Velikova et al. 2004 [13]) to identify publications with a high proportion of similar text in the title and abstract.

Terms used in relation to patient-reported outcome measures (for example, ‘self report* near2 measure*’) joined with an ‘and’ command to terms related to routine practice outcomes (for example, ‘improve* near detect*’) or patient involvement in the health care process (such as ‘patient* near provider* near interaction*’).

40 articles included in the review including 5 publications from an oncologic setting.

The pattern of results suggests a general lack of clarity in the field, especially regarding appropriate goals for PROs and the mechanisms by which they might achieve them. To fully evaluate their role in routine practice, studies need to use PROs that capture issues of importance to patients and to measure impacts relating to the patient–provider relationship and patient contributions to their well-being. Until studies evaluate PROs as a means to facilitate patient-centred care, their full potential in clinical practice will remain unknown.