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La valeur en sante, consistant a produire de meilleurs resultats tout en maitrisant les couts, necessite d’etablir des mesures normees des resultats, prenant en compte ce qui importe aux patients. Le but etait de construire ce type de questionnaire pour le parcours de soins des patients atteint d’un cancer du pancreas. Methodologie Un groupe de travail multidisciplinaire (GTM), associant des patients a fait une revue systematique des resultats utilises dans les essais cliniques a partir de clinicaltrials.gov., et a selectionne les plus pertinents. Un comite international multidisciplinaire associant des patients a valide par methode Delphi le questionnaire. Resultats 570 etudes cliniques ont ete selectionnees et 3370 parametres ont ete repertories (cliniques = CROM, et de qualite de vie = PROM). De janvier 2018 a juin 2018, parmi ces parametres, le GTM a propose une liste de 102 parametres (92 CROM et 10 PROM) au comite international. Un ensemble de 78 variables a ete retenu apres les 4 etapes du vote Delphi pour constituer le questionnaire final incluant des PROM par l’utilisation de « Fact-Hep ». Conclusions Pour la premiere fois, un questionnaire standardise concernant le cancer du pancreas, axes sur le patient, a ete mis etabli, permettant desormais son deploiement.

Summary Objective Reducing the time required for diagnosis is one of the major challenges to improving and accelerating the management of patients. The aim of this work is to describe an organizational innovation in the management of patients with hepatobiliary or pancreatic diseases, and to report the initial results. Materials and methods A multidisciplinary and multi-professional working group designed and instituted a patient-centered organizational system that optimizes the investigation of liver and pancreatic diseases, in order to achieve diagnosis in one day. From January 2017 to June 2017, all patients referred for consultation for hepatobiliary or pancreatic pathology were included in this new management pathway. Data were collected prospectively in a standardized form. Results Fifty-six patients with hepatobiliary or pancreatic disease were evaluated in the program during dedicated slots over a total of 20 days. Of these, four patients underwent evaluation in the program twice. The average number of patient slots in the program was three per day (range: 1–5). An additional computed tomography (CT) and/or magnetic resonance imaging (MRI) was required in 23 (41.7%) of the visits. These imaging studies were performed the same day, including nine patients who required both types of imaging (16.7% of cases). “One-day diagnosis” established an accurate diagnosis by the end of the day in 49 patient encounters (81.7%). Overall assessment of this organization was considered excellent by 46 (83%) of patients. Conclusion An organizational innovation has made it possible to effectively diagnose hepatobiliary or pancreatic pathology within one day in the majority of cases, with good patient satisfaction. It is now necessary to evaluate the medico-economic aspect of this organization, and more generally to develop a methodology for multidimensional evaluation of organizational innovations.