Mission of the Outcomes Research Branch

The mission of the Outcomes Research Branch (ORB), one of three branches in the Applied Research Program (ARP) (see the attached organization chart), is to coordinate and sponsor research to measure, evaluate, and improve patient-centered outcomes of cancer care delivery across the cancer care continuum. ORB is particularly interested in morbidity and mortality outcomes, patient symptoms and health-related quality of life (HRQOL), patient experience of and satisfaction with health care, and social and economic consequences of cancer care.

ORB supports both methodological and applied research directed toward a variety of aims:

• enhancing the state of the science of outcomes measurement;
• assessing, monitoring, and enhancing the quality of cancer care at all levels -- the provider-patient interaction, the health care organization, and the health care system;
• translating research findings into care delivery products and strategies for use by public and private decision makers, who provide, pay for, regulate, set standards for, and make personal decisions about cancer care; and
• evaluating innovative programs designed to improve the effectiveness and efficiency of providing evidence-based practice throughout the cancer care continuum.

The Emerging Field of Outcomes Research

Cancer outcomes research is a relatively new field, and Outcomes Research staff have worked on a number of ways to help define the field and assist researchers to come to a common understanding of its parameters and conceptual underpinnings. These efforts include:

• In 2004, the Journal of the National Cancer Institute released a monograph, Cancer Outcomes Research: The Arenas of Application, analyzing recent literature in cancer outcomes research. The volume highlights and illustrates a wide range of applications of cancer outcome measures, and provides a significant boost to efforts to delineate this field.
• In 2005, Cambridge University Press published a book, Outcomes Assessment in Cancer: Measures, Methods, and Applications. The book is a compendium of outcomes assessment in cancer, covering applications throughout the continuum of care, methods development, and research and policy implications.
• In 2007, the Journal of Clinical Oncology released an issue dedicated to Patient-Reported Outcomes Assessment in Clinical Trials, assessing the NCI clinical research infrastructure, issues and opportunities for improving the planning, design, methods, and implementation of PROs in cancer clinical trials at all phases of development.
• In 2007, the NCI published a monograph, Patient-Centered Communication in Cancer Care – Promoting Healing and Reducing Suffering to lay out the foundation for future research that would help facilitate the delivery of patient centered communication between cancer patients/family and the health care delivery team across the cancer continuum.
• In 2007, NCI sponsored a supplement in the Quality of Life Research Journal focused on Applying Item Response Theory to Enhance Health Outcomes Assessment. This journal provides guidance for the effective application of modern measurement theory methods to develop valid, precise, and efficient measures of patient symptoms and health-related quality of life.

Through a variety of initiatives and mechanisms, ORB supports the continued development of outcomes research in all aspects of cancer care, ranging from cancer clinical trials, observational research and surveillance studies of cancer prevention, early detection, treatment, survivorship care, and end-of-life care.