Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers.

<h4>Background</h4>Evidence suggests there are inconsistencies in patient-reported outcome (PRO) assessment and reporting in clinical trials, which may limit the use of these data to inform patient care. For trials with a PRO endpoint, routine inclusion of key PRO information in the prot...

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Main Authors: Melanie Calvert, Derek Kyte, Helen Duffy, Adrian Gheorghe, Rebecca Mercieca-Bebber, Jonathan Ives, Heather Draper, Michael Brundage, Jane Blazeby, Madeleine King
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0110216
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author Melanie Calvert
Derek Kyte
Helen Duffy
Adrian Gheorghe
Rebecca Mercieca-Bebber
Jonathan Ives
Heather Draper
Michael Brundage
Jane Blazeby
Madeleine King
author_facet Melanie Calvert
Derek Kyte
Helen Duffy
Adrian Gheorghe
Rebecca Mercieca-Bebber
Jonathan Ives
Heather Draper
Michael Brundage
Jane Blazeby
Madeleine King
author_sort Melanie Calvert
collection DOAJ
description <h4>Background</h4>Evidence suggests there are inconsistencies in patient-reported outcome (PRO) assessment and reporting in clinical trials, which may limit the use of these data to inform patient care. For trials with a PRO endpoint, routine inclusion of key PRO information in the protocol may help improve trial conduct and the reporting and appraisal of PRO results; however, it is currently unclear exactly what PRO-specific information should be included. The aim of this review was to summarize the current PRO-specific guidance for clinical trial protocol developers.<h4>Methods and findings</h4>We searched the MEDLINE, EMBASE, CINHAL and Cochrane Library databases (inception to February 2013) for PRO-specific guidance regarding trial protocol development. Further guidance documents were identified via Google, Google scholar, requests to members of the UK Clinical Research Collaboration registered clinical trials units and international experts. Two independent investigators undertook title/abstract screening, full text review and data extraction, with a third involved in the event of disagreement. 21,175 citations were screened and 54 met the inclusion criteria. Guidance documents were difficult to access: electronic database searches identified just 8 documents, with the remaining 46 sourced elsewhere (5 from citation tracking, 27 from hand searching, 7 from the grey literature review and 7 from experts). 162 unique PRO-specific protocol recommendations were extracted from included documents. A further 10 PRO recommendations were identified relating to supporting trial documentation. Only 5/162 (3%) recommendations appeared in ≥50% of guidance documents reviewed, indicating a lack of consistency.<h4>Conclusions</h4>PRO-specific protocol guidelines were difficult to access, lacked consistency and may be challenging to implement in practice. There is a need to develop easily accessible consensus-driven PRO protocol guidance. Guidance should be aimed at ensuring key PRO information is routinely included in appropriate trial protocols, in order to facilitate rigorous collection/reporting of PRO data, to effectively inform patient care.
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spelling doaj-art-5de183d937d248fba457a8d4b2e022412025-08-20T03:10:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01910e11021610.1371/journal.pone.0110216Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers.Melanie CalvertDerek KyteHelen DuffyAdrian GheorgheRebecca Mercieca-BebberJonathan IvesHeather DraperMichael BrundageJane BlazebyMadeleine King<h4>Background</h4>Evidence suggests there are inconsistencies in patient-reported outcome (PRO) assessment and reporting in clinical trials, which may limit the use of these data to inform patient care. For trials with a PRO endpoint, routine inclusion of key PRO information in the protocol may help improve trial conduct and the reporting and appraisal of PRO results; however, it is currently unclear exactly what PRO-specific information should be included. The aim of this review was to summarize the current PRO-specific guidance for clinical trial protocol developers.<h4>Methods and findings</h4>We searched the MEDLINE, EMBASE, CINHAL and Cochrane Library databases (inception to February 2013) for PRO-specific guidance regarding trial protocol development. Further guidance documents were identified via Google, Google scholar, requests to members of the UK Clinical Research Collaboration registered clinical trials units and international experts. Two independent investigators undertook title/abstract screening, full text review and data extraction, with a third involved in the event of disagreement. 21,175 citations were screened and 54 met the inclusion criteria. Guidance documents were difficult to access: electronic database searches identified just 8 documents, with the remaining 46 sourced elsewhere (5 from citation tracking, 27 from hand searching, 7 from the grey literature review and 7 from experts). 162 unique PRO-specific protocol recommendations were extracted from included documents. A further 10 PRO recommendations were identified relating to supporting trial documentation. Only 5/162 (3%) recommendations appeared in ≥50% of guidance documents reviewed, indicating a lack of consistency.<h4>Conclusions</h4>PRO-specific protocol guidelines were difficult to access, lacked consistency and may be challenging to implement in practice. There is a need to develop easily accessible consensus-driven PRO protocol guidance. Guidance should be aimed at ensuring key PRO information is routinely included in appropriate trial protocols, in order to facilitate rigorous collection/reporting of PRO data, to effectively inform patient care.https://doi.org/10.1371/journal.pone.0110216
spellingShingle Melanie Calvert
Derek Kyte
Helen Duffy
Adrian Gheorghe
Rebecca Mercieca-Bebber
Jonathan Ives
Heather Draper
Michael Brundage
Jane Blazeby
Madeleine King
Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers.
PLoS ONE
title Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers.
title_full Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers.
title_fullStr Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers.
title_full_unstemmed Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers.
title_short Patient-reported outcome (PRO) assessment in clinical trials: a systematic review of guidance for trial protocol writers.
title_sort patient reported outcome pro assessment in clinical trials a systematic review of guidance for trial protocol writers
url https://doi.org/10.1371/journal.pone.0110216
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