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Description

At least 50% of the more than 14 million cancer survivors in the United States have remediable physical impairments that degrade their function and QOL. Yet referral rates for cancer rehabilitation services have remained as low as 1-2% despite robust evidence that conventional treatments can improve diverse clinical outcomes including utilization. An important contributor to low referral rates is absence of widely accepted instruments to risk stratify patients for impending functional loss, triage for rehabilitation referral, and track functional outcomes over time. This course will present an overview of approaches developed within the AAPM&R and the ACRM to leverage progress in psychometrics and social networking to advance and standardize functional measurement in cancer care, methods also useful in other populations. The AAPM&R Ad Hoc Cancer Rehabilitation Workgroup used a quasi-Delphi process to establish a collection of item response theory-based measures and is currently testing them at multiple institutions. The goal is to establish a diverse and longitudinal observational database that can be queried to quantify rehabilitation's 'value add' to cancer care. The ACRM Cancer Rehabilitation Networking Group developed a screening tool to drive referrals to cancer rehabilitation from oncology. The NCI Grid Enabled Measures (GEM) platform was used to obtain consensus in its development among a number of stakeholders including physiatrists, therapists and oncologists.

Learning Objectives

  • Provide an overview of the epidemiology of disability and degraded QOL in cancer survivors. Review the state of measures for cancer rehabilitation outcomes and tools for triaging patients from oncology to cancer rehabilitation services.
  • De-mystify PROMIS (Patient-Reported Outcomes Medical Information System) and IRT (Item Response Theory). Present pilot data from a multi-center cancer rehabilitation outcome measures project developed through consensus using PROMIS item banks.
  • Introduce the National Cancer Institute's GEM Database and discuss the collaborative multidisciplinary consensus building process that occurred for building a screening tool to drive cancer rehabilitation referrals.
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