Patient Reported Outcomes

Patient Reported Outcomes

Understanding what happens to patients who are treated with radiotherapy


Patient Reported Outcomes (PRO) are recognized as an essential component to supporting improved quality of life and survivorship for those undergoing cancer treatment. While PRO can be used to assess the impact cancer treatment has on a patient’s quality of life and well-being, they can also be used to help understand how specific treatments, such as radiotherapy, can affect a patient by helping to identify symptoms and toxicity they experience throughout their care. In 2017, CPQR launched an initiative to support the increased use of PRO in routine clinical care across Canada.

From 2017-2019 CPQR supported the translation of BC Cancer’s Prospective Outcomes and Support Initiative (POSI) to other RT programs across the country. POSI was seen as a program to emulate due to its nimble “real time” approach to the collection and review of PRO during patient encounters and adaptability for programs with limited resources. The POSI model is being used at  centres affiliated with Dalhousie University Department of Radiation Oncology and broader PRO implementation is being supported by CAPCA partner the Canadian Partnership Against Cancer.

Organization in Charge

In 2021, patient reported outcomes was divested from CPQR to CARO. CARO’s commitment to high quality patient-centred care is reflected in its new role as steward of the patient-centred programs. CARO’s efforts will further enhance and promote the integration of CPQR’s patient engagement, education and outcome guidance into professional practice across the country.

If you have questions or wish more information about this program, please contact CARO .


Building on the success of prior guidance documents, CPQR developed guidance around the collection and use of PRO for radiation treatment that reflects community best practice. A series of comprehensive guided interviews were conducted aided in development. The results were compiled and published in a document entitled “Guidance on the use of Patient Reported Outcomes for Canadian Radiation Treatment Programs.”

In 2020, a self-audit tool was released allowing radiation treatment programs to evaluate their alignment with PRO guidance. For a full list of all self-audit tools available, please visit our self-audit page.

Endorsed measures for patient reported outcomes

CPQR supports the consistent use of PRO in Canadian radiation treatment programs to improve the clinical encounter for patients. Promoting the use of the same Patient Reported Outcome Measures (PROM) across the country will also help facilitate big data analysis against treatment outcomes which may be used to inform population-based decisions regarding optimal care. The table below provides CPQR-endorsed measure for PROs.

Disease site Endorsed Measure Description
General Symptom Screening Edmonton Symptom Assessment Screening
A paper-based questionnaire used to rate the intensity of nine common symptoms experienced by cancer patients, including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath.
Bone Metastasis Brief Pain Inventory A form to assess the severity of patient’s pain and the impact of pain on daily functions.
Early-stage Prostate cancer Expanded Prostate Cancer Index Composite (EPIC) A self-report scale designed to measure the health-related quality of life among prostate cancer patients.
Head and neck cancer MD Anderson Symptom Inventory for Head and Neck (MDASI-HN)) A multi-symptom PRO measure for clinical and research use to assess the severity of symptoms experienced by patients with cancer and the interference with daily living caused by these symptoms.
Cervical and other gynecological cancers Cervical cancer EORTC QLQ-CX24 Developed by the European Organization for the Research and Treatment of Cancer, the cervical cancer module is an extension of their basic quality of life measure. It consists of 3 multiitem scales and 5 single-item scales and is designed to assess disease and treatment-specific aspects of quality of life in patients with cervical cancer.

If you want more information about the endorsed measures or how they are being used across the country get in touch.

For more information on CPQR’s work around big-data analysis please visit our Canadian Big Radiotherapy Data Initiative (CBRTDI) page.