Elaboration of a Standard Value-based Healthcare Metrics set for Hepatic Carcinoma and Validation by International Delphi Method

Background: Global healthcare system is looking for new models based on value to improve patient outcomes. Therefore, it is necessary to identify standardized outcome measurements allowing monitor-ing and qualityof- care comparison. These outcomes include medical results (CROMs – Clinical Re-ported Outcome Measurements), symptoms and quality-oflife (PROMs – Patient Reported Outcome Measurements). Objective: The aim was to create standardized metrics to be used for outcomes analysis of liver cancers. Methods: A multidisciplinary working group (WG) was assembled. The systematic review conducted collected the most common outcomes in liver cancers’ clinical studies. After 3 workshops, the WG reached a consensus on the definition of the main outcomes, identified existing questionnaires for PROMs collection, set the timeline for data collection. To validate the final set, an international external committee completed a Delphi process. Results: After a systematic literature review, 377 clinical studies were reviewed, 1539 outcomes listed. The WG selected 141 outcomes (121 CROMs and 20 PROMs) to submit to the Delphi vote committee. In total 96 outcomes (86 CROMs and 10 PROMs) were retained. PROMs were added to monitor quali-ty-of-life, functioning, symptoms, through the EORTC QLQ-C30 and QLQ-HCC18 questionnaires. Conclusions: A standardized set of outcome measures validated through an international health out-come comparisons and quality-of-care assessments was built for primary and secondary liver cancers.