Use of Patient-Reported Outcomes to Improve the Predictive Accuracy of Clinician-Reported Adverse Events

Abundant research has now demonstrated that patient and clinician reports of symptoms—and particularly symptomatic toxicities (ie, adverse events) during cancer treatment—provide discrepant yet complementary data (1–3). How can this be? Can’t only the patient or the clinician be “right”? The more patient-centered among us might state that the patient is always right by definition because nobody (not even the most sensitive clinician) can truly know another person’s subjective experience. But the more traditional among us might assert that clinicians should be considered right because they have an “objective” perspective based on experience and training, which prevents them from exaggerating or understating what they observe. In fact, it appears that both the patient and clinician provide information of value, which when combined provides a more accurate understanding of the patient’s symptoms. This finding is good news for those of us who are interested in improving the measurement of symptoms in clinical trials and practice. The optimistic among us might state that all we need to do now is figure out how to operationalize this approach.