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Wong CKH, Lang BHH, Lam CLK. A systematic review of quality of thyroid-specific health-related quality-of-life instruments recommends ThyPRO for patients with benign thyroid diseases. J Clin Epidemiol 2016; 78:63-72. [PMID: 27020087 DOI: 10.1016/j.jclinepi.2016.03.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/03/2016] [Accepted: 03/15/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To appraise the measurement properties of thyroid-specific health-related quality-of-life (HRQOL) instruments and to provide recommendations on the choice of HRQOL instruments. STUDY DESIGN AND SETTING Systematic review of English-language literature published between 1993 and 2015 identified psychometric studies involving patients with thyroid disease through a search of Pubmed, Web of Science, Embase, and OVID MEDLINE. HRQOL instruments were graded on methodological quality and overall levels of evidence using a COSMIN checklist. RESULTS After a review of 742 original studies, 23 studies reporting 14 standardized HRQOL instruments targeted for Graves' ophthalmopathy (n = 4), hypothyroidism (n = 3), thyroid cancer (n = 2), other thyroid disease (n = 3), and nonthyroid tumor sites (n = 2) were identified. Hypothesis testing was evaluated most frequently. The 84-item thyroid-specific patient-reported outcome measure (ThyPRO) and 16-item Graves' ophthalmopathy-specific Quality-of-Life (GO-QOL) instruments were the most extensively evaluated instrument. The highest number of positive ratings in overall level of psychometric evidence was found in ThyPRO, GO-QOL, and 11-item Thyroid Treatment Satisfaction Questionnaire (ThyTSQ) instruments. CONCLUSION The ThyPRO is recommended for the assessment of HRQOL in patients with benign thyroid diseases while measurement properties of GO-QOL and ThyTSQ are satisfactory in measuring HRQOL of patients with Graves' ophthalmopathy and hypothyroidism, respectively.
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Affiliation(s)
- Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong.
| | - Brian H H Lang
- Division of Endocrine Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Pok Fu Lam, Hong Kong
| | - Cindy L K Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong
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Winters ZE, Afzal M, Balta V, Freeman J, Llewellyn-Bennett R, Rayter Z, Cook J, Greenwood R, King MT. Patient-reported outcomes and their predictors at 2- and 3-year follow-up after immediate latissimus dorsi breast reconstruction and adjuvant treatment. Br J Surg 2016; 103:524-36. [PMID: 26924354 DOI: 10.1002/bjs.10102] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/25/2015] [Accepted: 12/02/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim of this study was to estimate the impact 2 and 3 years after surgery of implant-assisted latissimus dorsi (LDI) and autologous latissimus dorsi (ALD) flap breast reconstructions on patient-reported outcomes (PROs), and, secondarily, to determine whether baseline characteristics can predict PROs. METHODS This was a multicentre prospective cohort study. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) and breast cancer module (QLQ-BR23), Functional Assessment of Cancer Therapy - Breast (FACT-B), and Hospital Anxiety and Depression Scale (HADS) PROs were completed before surgery and at 2 and 3 years after breast reconstruction. The effects of LDI and ALD, adjusted for baseline clinicodemographic characteristics, were estimated with multiple linear regressions. Effect sizes above 0·5 were considered clinically important. RESULTS Some 206 patients (LDI 93, ALD 113) were recruited in 2007-2013; 66·5 per cent were node-negative and 34·6 per cent received radiotherapy. Women with adverse clinicopathological factors were more likely to have received radiotherapy and to undergo ALD. Patients in both surgical groups showed clinically important effects at 2 and 3 years, including improvements in emotional scales, but worse physical functioning, social well-being, body image and anxiety. Radiotherapy adversely affected social functioning at 2 years (P = 0·002). Women undergoing ALD reconstruction had significantly improved sexual functioning at 3 years (P = 0·003) relative to those who had LDI procedures, even after adjusting for case mix (P = 0·007). At 3 years, younger women experienced worse physical well-being than older women (P = 0·006), and chemotherapy was associated with worse arm symptoms (P = 0·005). CONCLUSION Clinically important changes occurred in physical functioning, breast symptoms, body image and psychological distress. These results will guide selections of key PRO domains and sample-size calculation of future studies.
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Affiliation(s)
- Z E Winters
- Breast Cancer Surgery Patient Reported and Clinical Outcomes Research Group, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK
| | - M Afzal
- Breast Cancer Surgery Patient Reported and Clinical Outcomes Research Group, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK
| | - V Balta
- Breast Cancer Surgery Patient Reported and Clinical Outcomes Research Group, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK
| | - J Freeman
- Breast Cancer Surgery Patient Reported and Clinical Outcomes Research Group, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK
| | - R Llewellyn-Bennett
- Breast Cancer Surgery Patient Reported and Clinical Outcomes Research Group, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK
| | - Z Rayter
- Bristol Breast Care Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - J Cook
- Bristol Breast Care Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - R Greenwood
- Research Design Service - South West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - M T King
- Quality of Life Office, School of Psychology and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Acceptance and commitment therapy for adults with advanced cancer (CanACT): study protocol for a feasibility randomised controlled trial. Trials 2016; 17:77. [PMID: 26865162 PMCID: PMC4750179 DOI: 10.1186/s13063-016-1169-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/12/2016] [Indexed: 12/26/2022] Open
Abstract
Background One-third of people with cancer experience psychological distress and may suppress distressing thoughts, emotions, and concerns, leading to further problems. Conventional psychological treatments reduce distress by problem solving, but in advanced cancer, when ill health is progressive and death may be approaching, physical and psychological difficulties are complex and have no simple solutions. Acceptance and Commitment Therapy encourages acknowledgement and acceptance of mental experiences, increasing people’s ability to work with problems that cannot be solved. Previous pilot work in advanced cancer confirms that distress can be associated with an avoidance of experiencing uncomfortable thoughts and emotions. Methods/Design This feasibility randomised controlled trial of Acceptance Commitment Therapy aims to establish parameters for a larger trial. Fifty-four participants with advanced cancer will be randomly allocated to up to eight sessions (each 1 hour) of Acceptance Commitment Therapy or a talking control. Participants will be recruited from those attending outpatient services and hospice day care at three specialist palliative care units in North and East London, United Kingdom. The primary outcome is a measure of functioning in four areas of life (physical, social/family, emotional, and general activity) using the Functional Assessment of Cancer Therapies - General questionnaire at 3 months after randomisation. Secondary outcomes are (i) acceptance using the Acceptance and Action Questionnaire; (ii) psychological distress using the Kessler Psychological Distress Scale; (iii) physical functioning using a timed walk and sit-to-stand test; and (iv) quality of life measures including the Euroqol-5 Dimensions and ICECAP Supportive Care measures. Qualitative data will be collected at 3 months to explore the participants’ experiences of the trial and therapy. Data will be collected on the costs of care. Discussion Data generated on the recruitment, retention, and experience of the interventions and the usefulness of the outcome measures will inform the adaptations required and whether changes in function are consistent with existing data when planning for a sufficiently powered randomised controlled trial. Trial registration ISRCTN13841211 (registered 22 July 2015). Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1169-8) contains supplementary material, which is available to authorized users.
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154
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Tho PC, Ang E. The effectiveness of patient navigation programs for adult cancer patients undergoing treatment: a systematic review. ACTA ACUST UNITED AC 2016; 14:295-321. [DOI: 10.11124/jbisrir-2016-2324] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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155
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Magaji BA, Moy FM, Roslani AC, Law CW, Sagap I. Psychometric Validation of the Malaysian Chinese Version of the EORTC QLQ-C30 in Colorectal Cancer Patients. Asian Pac J Cancer Prev 2016; 16:8107-12. [DOI: 10.7314/apjcp.2015.16.18.8107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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157
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Zikos E, Coens C, Quinten C, Ediebah DE, Martinelli F, Ghislain I, King MT, Gotay C, Ringash J, Velikova G, Reeve BB, Greimel E, Cleeland CS, Flechtner H, Taphoorn MJB, Weis J, Schmucker-von Koch J, Sprangers MAG, Bottomley A. The Added Value of Analyzing Pooled Health-Related Quality of Life Data: A Review of the EORTC PROBE Initiative. J Natl Cancer Inst 2015; 108:djv391. [DOI: 10.1093/jnci/djv391] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/20/2015] [Indexed: 11/15/2022] Open
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158
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Faithfull S, Lemanska A, Chen T. Patient-reported Outcome Measures in Radiotherapy: Clinical Advances and Research Opportunities in Measurement for Survivorship. Clin Oncol (R Coll Radiol) 2015; 27:679-85. [DOI: 10.1016/j.clon.2015.07.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 07/20/2015] [Indexed: 12/23/2022]
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159
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Gillanders DT, Sinclair AK, MacLean M, Jardine K. Illness cognitions, cognitive fusion, avoidance and self-compassion as predictors of distress and quality of life in a heterogeneous sample of adults, after cancer. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2015. [DOI: 10.1016/j.jcbs.2015.07.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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160
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Hyde MK, Chambers SK, Shum D, Ip D, Dunn J. Psycho-oncology assessment in Chinese populations: a systematic review of quality of life and psychosocial measures. Eur J Cancer Care (Engl) 2015; 25:691-718. [PMID: 26292029 DOI: 10.1111/ecc.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2015] [Indexed: 11/26/2022]
Abstract
This systematic review describes psychosocial and quality of life (QOL) measures used in psycho-oncology research with cancer patients and caregivers in China. Medline and PsycINFO databases were searched (1980-2014). Studies reviewed met the following criteria: English language; peer-reviewed; sampled Chinese cancer patients/caregivers; developed, validated or assessed psychometric properties of psychosocial or QOL outcome measures; and reported validation data. The review examined characteristics of measures and participants, translation and cultural adaptation processes and psychometric properties of the measures. Ninety five studies met review criteria. Common characteristics of studies reviewed were they: assessed primarily QOL measures, sampled patients with breast, colorectal, or head and neck cancer, and validated existing measures (>80%) originating in North America or Europe. Few studies reported difficulties translating measures. Regarding psychometric properties of the measures >50% of studies reported subscale reliabilities <α = 0.70, <50% reported test-retest reliability, and <30% reported divergent validity. Few reported sensitivity, specificity or responsiveness. Improved accuracy and transparency of reporting for translation, cultural adaptation and psychometric testing of psychosocial measures is needed. Developing support structures for translating and validating psychosocial measures would enable this and ensure Chinese psycho-oncology clinical practice and research keeps pace with international focus on patient reported outcome measures and data management.
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Affiliation(s)
- M K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, WA, Australia.,Centre for Clinical Research, The University of Queensland, Herston, Qld, Australia.,Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - D Shum
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - D Ip
- The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - J Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,School of Social Science, The University of Queensland, St Lucia, Qld, Australia
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161
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Cheung K, de Mol M, Visser S, Den Oudsten BL, Stricker BH, Aerts JGJV. Reliability and validity of the Cancer Therapy Satisfaction Questionnaire in lung cancer. Qual Life Res 2015. [PMID: 26195317 PMCID: PMC4706586 DOI: 10.1007/s11136-015-1062-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE To test the reliability and validity of the Cancer Treatment Satisfaction Questionnaire (CTSQ), to assess its relation with quality of life (QoL), and to assess the interpretability of the domain scores in lung cancer patients receiving intravenous chemotherapy. METHODS Patients with stage IIIB and IV non-squamous non-small cell lung carcinoma treated with pemetrexed were enrolled in our study. They completed the 16-item CTSQ and two other (health-related) QoL questionnaires. Information about sociodemographic characteristics, cancer stage, and the experience of adverse events was collected. Internal consistency, construct validity, and clinical interpretability were calculated. RESULTS Fifty-five patients completed the CTSQ. Correlations of the CTSQ items with its domain were all above 0.40. A high correlation between item 8 and the expectations of therapy and satisfaction with therapy domain was observed (0.50 and 0.48, respectively). The CTSQ domains demonstrated good internal consistency and low to moderate correlations of the CTSQ with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and World Health Organization Quality of Life-BREF. No significant differences in mean domain scores were observed in relation to the number and severity of different adverse events and chemotherapy-related adverse events. CONCLUSIONS The Dutch version of the CTSQ was found to be a reliable and valid instrument to assess satisfaction and expectations of treatment in lung cancer patients receiving intravenous chemotherapy. Furthermore, the CTSQ proved to be of additional informative value as not all of its domains correlated with the various domains of the existing HRQoL instruments.
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Affiliation(s)
- K Cheung
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Inspectorate of Health Care, The Hague, The Netherlands.
| | - M de Mol
- Department of Pulmonary Diseases, Amphia Hospital Breda, Breda, The Netherlands
- Department of Pulmonary Diseases, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - S Visser
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Pulmonary Diseases, Amphia Hospital Breda, Breda, The Netherlands
- Department of Pulmonary Diseases, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - B L Den Oudsten
- Department of Medical and Clinical Psychology, Centre of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - B H Stricker
- Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Inspectorate of Health Care, The Hague, The Netherlands.
| | - J G J V Aerts
- Department of Pulmonary Diseases, Amphia Hospital Breda, Breda, The Netherlands
- Department of Pulmonary Diseases, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Schandelmaier S, Conen K, von Elm E, You JJ, Blümle A, Tomonaga Y, Amstutz A, Briel M, Kasenda B. Planning and reporting of quality-of-life outcomes in cancer trials. Ann Oncol 2015; 26:1966-1973. [PMID: 26133966 DOI: 10.1093/annonc/mdv283] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/24/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Information about the impact of cancer treatments on patients' quality of life (QoL) is of paramount importance to patients and treating oncologists. Cancer trials that do not specify QoL as an outcome or fail to report collected QoL data, omit crucial information for decision making. To estimate the magnitude of these problems, we investigated how frequently QoL outcomes were specified in protocols of cancer trials and subsequently reported. DESIGN Retrospective cohort study of RCT protocols approved by six research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003. We compared protocols to corresponding publications, which were identified through literature searches and investigator surveys. RESULTS Of the 173 cancer trials, 90 (52%) specified QoL outcomes in their protocol, 2 (1%) as primary and 88 (51%) as secondary outcome. Of the 173 trials, 35 (20%) reported QoL outcomes in a corresponding publication (4 modified from the protocol), 18 (10%) were published but failed to report QoL outcomes in the primary or a secondary publication, and 37 (21%) were not published at all. Of the 83 (48%) trials that did not specify QoL outcomes in their protocol, none subsequently reported QoL outcomes. Failure to report pre-specified QoL outcomes was not associated with industry sponsorship (versus non-industry), sample size, and multicentre (versus single centre) status but possibly with trial discontinuation. CONCLUSIONS About half of cancer trials specified QoL outcomes in their protocols. However, only 20% reported any QoL data in associated publications. Highly relevant information for decision making is often unavailable to patients, oncologists, and health policymakers.
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Affiliation(s)
- S Schandelmaier
- Basel Institute for Clinical Epidemiology and Biostatistics; Academy of Swiss Insurance Medicine
| | - K Conen
- Department of Oncology, University Hospital of Basel, Basel
| | - E von Elm
- Cochrane Switzerland, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - J J You
- Department of Clinical Epidemiology and Biostatistics; Department of Medicine, McMaster University, Hamilton, Canada
| | - A Blümle
- German Cochrane Centre, Medical Center-University of Freiburg, Freiburg, Germany
| | - Y Tomonaga
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich
| | - A Amstutz
- Basel Institute for Clinical Epidemiology and Biostatistics
| | - M Briel
- Basel Institute for Clinical Epidemiology and Biostatistics; Department of Clinical Epidemiology and Biostatistics; Department of Clinical Research, University of Basel, Basel, Switzerland
| | - B Kasenda
- Basel Institute for Clinical Epidemiology and Biostatistics; Department of Oncology, University Hospital of Basel, Basel; Department of Medical Oncology, Royal Marsden Hospital, London, UK.
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163
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Miyashita M, Wada M, Morita T, Ishida M, Onishi H, Sasaki Y, Narabayashi M, Wada T, Matsubara M, Takigawa C, Shinjo T, Suga A, Inoue S, Ikenaga M, Kohara H, Tsuneto S, Shima Y. Independent Validation of the Japanese Version of the EORTC QLQ-C15-PAL for Patients With Advanced Cancer. J Pain Symptom Manage 2015; 49:953-9. [PMID: 25593101 DOI: 10.1016/j.jpainsymman.2014.11.299] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 11/11/2014] [Accepted: 11/13/2014] [Indexed: 11/12/2022]
Abstract
CONTEXT Although the psychometric properties of the Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL) have been examined previously, that study had several limitations, for example, small sample size. OBJECTIVES To examine the validity and reliability, including test-retest reliability, of the Japanese version of EORTC QLQ-C15-PAL for cancer patients with metastasis or recurrence. METHODS A cross-sectional anonymous questionnaire was administered to cancer patients who were being treated on an oncology inpatient ward, in an oncology outpatient clinic, and in seven inpatient palliative units in Japan, from August 2007 to March 2008. RESULTS Data from a total of 312 cancer patients were analyzed. The proportion of missing values was less than 4% for all items. The factor structure was reproduced identically with the original EORTC QLQ-C15-PAL, English version. The correlation of subscales showed a reasonable matrix. Cronbach's alpha coefficients were 0.76 to 0.86, and intraclass correlation coefficients, which indicate test-retest reliability, ranged from 0.52 to 0.77. All subscales, especially physical functioning, fatigue, and pain, were significantly correlated with self-reported Eastern Cooperative Oncology Group performance status. CONCLUSION The Japanese version of EORTC QLQ-C15-PAL has sufficient validity, acceptable reliability, and feasibility for patients with advanced cancer.
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Affiliation(s)
- Mitsunori Miyashita
- Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| | - Makoto Wada
- Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Shizuoka, Japan
| | - Mayumi Ishida
- Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hideki Onishi
- Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasutsuna Sasaki
- Department of Medical Oncology, Saitama Medical University International Medical Center, Saitama, Japan; Division of Medical Oncology, Department of Medicine, Showa University, School of Medicine, Tokyo, Japan
| | - Masaru Narabayashi
- Department of Palliative Medicine, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomomi Wada
- Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan; Department of Psychiatry, Osaka National Hospital, Osaka, Japan
| | - Mei Matsubara
- Department of Psycho-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Chizuko Takigawa
- KKR Department of Palliative Medicine, Sapporo Medical Center, Hokkaido, Japan
| | | | - Akihiko Suga
- Department of Palliative Medicine, Shizuoka General Hospital, Shizuoka, Japan; Department of Palliative Medicine, Shizuoka Saiseikai General Hospital, Shizuoka, Japan
| | - Satoshi Inoue
- Department of Palliative Care, Seirei Hospice, Seirei Mikatahara Hospital, Shizuoka, Japan
| | - Masayuki Ikenaga
- Hospice & Children's Hospice Hospital, Yodogawa Christian Hospital, Osaka, Japan
| | - Hiroyuki Kohara
- Department of Palliative Care, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Satoru Tsuneto
- Department of Palliative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Ibaraki, Japan
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164
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Koutoukidis DA, Knobf MT, Lanceley A. Obesity, diet, physical activity, and health-related quality of life in endometrial cancer survivors. Nutr Rev 2015; 73:399-408. [PMID: 26011914 PMCID: PMC4477700 DOI: 10.1093/nutrit/nuu063] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Obesity, low-quality diet, and inactivity are all prevalent among survivors of endometrial cancer. The present review was conducted to assess whether these characteristics are associated with health-related quality of life (HRQoL). Electronic databases, conference abstracts, and reference lists were searched, and researchers were contacted for preliminary results of ongoing studies. The quality of the methodology and reporting was evaluated using appropriate checklists. Standardized mean differences were calculated, and data were synthesized narratively. Eight of the 4385 reports retrieved from the literature were included in the analysis. Four of the 8 studies were cross-sectional, 1 was retrospective, 1 was prospective, and 2 were randomized controlled trials. Obesity was negatively associated with overall HRQoL in 4 of 4 studies and with physical well-being in 6 of 6 studies, while it was positively associated with fatigue in 2 of 4 studies. Meeting the recommendations for being physically active, eating a diet high in fruit and vegetables, and abstaining from smoking were positively associated with overall HRQoL in 2 of 2 studies, with physical well-being in 2 of 3 studies, and with fatigue in 1 of 3 studies. Improvements in fatigue and physical well-being were evident after lifestyle interventions. The findings indicate a healthy lifestyle is positively associated with HRQoL in this population, but the number of studies is limited. Additional randomized controlled trials to test effective and practical interventions promoting a healthy lifestyle in survivors of endometrial cancer are warranted.
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Affiliation(s)
- Dimitrios A Koutoukidis
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA.
| | - M Tish Knobf
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA
| | - Anne Lanceley
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA
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165
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Costa DSJ. Reflective, causal, and composite indicators of quality of life: A conceptual or an empirical distinction? Qual Life Res 2015; 24:2057-65. [PMID: 25725599 DOI: 10.1007/s11136-015-0954-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2015] [Indexed: 11/12/2022]
Abstract
Items (or indicators) that constitute "quality of life" instruments can be classified as either reflective (manifestations of some underlying construct), causal (the construct is an effect of the indicators), or composite (the construct is an exact linear combination of the indicators). Psychometric methods based on inter-item associations are only appropriate for reflective indicators, whereas other statistical and non-statistical validation methods can be used for composite or causal indicators. Thus, the distinction has important practical, as well as theoretical, implications. Attempts have been made to empirically identify which items of the EORTC QLQ-C30, a cancer-specific instrument, are causal and which are reflective. Such attempts, however, first require commitment to a particular definition of quality of life, of which there are many. Whether an indicator forms a composite, is causal or reflective of quality of life will depend on the definition adopted, and therefore, the reflective-composite-causal distinction is, arguably, best established on conceptual rather empirical grounds, guided by the "mental experiments" suggested by Bollen (Structural equations with latent variables, Wiley, New York, 1989). Conceptual models of health status and quality of life, as well as a cognitive-linguistic approach to quality of life assessment, may make some contribution to this practice. Theoretical consideration of indicator content can guide not only instrument development and validation, but also the selection of an appropriate instrument.
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Affiliation(s)
- Daniel S J Costa
- Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Level 6, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia,
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Palma CGL, Lera AT, Lerner T, de Oliveira MM, de Borta TM, Barbosa RP, Brito GM, Guazzelli CA, Cruz FJM, del Giglio A. Guarana (Paullinia cupana) Improves Anorexia in Patients with Advanced Cancer. J Diet Suppl 2015; 13:221-31. [DOI: 10.3109/19390211.2015.1008612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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167
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Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Health Related Quality of Life. REHABILITATION ONCOLOGY 2015. [DOI: 10.1097/01893697-201533010-00003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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168
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Wong CKH, Chen J, Yu CLY, Sham M, Lam CLK. Systematic review recommends the European Organization for Research and Treatment of Cancer colorectal cancer-specific module for measuring quality of life in colorectal cancer patients. J Clin Epidemiol 2014; 68:266-78. [PMID: 25455838 DOI: 10.1016/j.jclinepi.2014.09.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 09/11/2014] [Accepted: 09/24/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To critically appraise the measurement properties of standardized health-related quality of life (HRQOL) instruments for colorectal cancer (CRC) patients and to provide recommendations on the choice of HRQOL instruments. STUDY DESIGN AND SETTING Systematic review of English language literature published between January 1985 and May 2014 identified through a database search of PubMed, Web of Science, Embase, and Ovid MEDLINE. HRQOL instruments were rated on methodological quality and overall levels of evidence using a Consensus-based Standards for the selection of health Measurement Instrument checklist. RESULTS Internal consistency and hypothesis testing were evaluated most frequently in 63 studies identified. The Functional Assessment of Cancer Therapy-Colorectal (FACT-C) was the most extensively evaluated. The highest number of positive ratings in the overall level of evidence was found in the CRC-specific quality of life questionnaire module (QLQ-CR38) in European Organization for Research and Treatment of Cancer (EORTC) module, followed by the Memorial Sloan Kettering Cancer Center Bowel instrument, FACT-C, and Quick-FLIC. The EORTC QLQ-CR38 had the most positive ratings on measurement property and was recommended. CONCLUSION The EORTC QLQ-CR38 was recommended to assess HRQOL in patients with CRC, regardless of disease stage and primary tumor site.
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Affiliation(s)
- Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong.
| | - Jing Chen
- School of Nursing, The University of Hong Kong, Rm 306, Faculty of Medicine Building, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Charlotte L Y Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong
| | - Mansy Sham
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong
| | - Cindy L K Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong
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Carr AC, Vissers MCM, Cook JS. The effect of intravenous vitamin C on cancer- and chemotherapy-related fatigue and quality of life. Front Oncol 2014; 4:283. [PMID: 25360419 PMCID: PMC4199254 DOI: 10.3389/fonc.2014.00283] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 09/29/2014] [Indexed: 12/30/2022] Open
Abstract
Cancer patients commonly experience a number of symptoms of disease progression and the side-effects of radiation therapy and adjuvant chemotherapy, which adversely impact on their quality of life (QOL). Fatigue is one of the most common and debilitating symptom reported by cancer patients and can affect QOL more than pain. Several recent studies have indicated that intravenous (IV) vitamin C alleviates a number of cancer- and chemotherapy-related symptoms, such as fatigue, insomnia, loss of appetite, nausea, and pain. Improvements in physical, role, cognitive, emotional, and social functioning, as well as an improvement in overall health, were also observed. In this mini review, we briefly cover the methods commonly used to assess health-related QOL in cancer patients, and describe the few recent studies examining the effects of IV vitamin C on cancer- and chemotherapy-related QOL. We discuss potential mechanisms that might explain an improvement in QOL and also considerations for future studies.
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Affiliation(s)
- Anitra C Carr
- Department of Pathology, Centre for Free Radical Research, University of Otago , Christchurch , New Zealand
| | - Margreet C M Vissers
- Department of Pathology, Centre for Free Radical Research, University of Otago , Christchurch , New Zealand
| | - John S Cook
- New Brighton Health Care , Christchurch , New Zealand
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Chiu L, Chiu N, Chow E, Cella D, Beaumont JL, Lam H, Popovic M, Bedard G, Poon M, Wong E, Zeng L, Bottomley A. Comparison of Three Shortened Questionnaires for Assessment of Quality of Life in Advanced Cancer. J Palliat Med 2014; 17:918-23. [DOI: 10.1089/jpm.2014.0012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Leonard Chiu
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Nicholas Chiu
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Edward Chow
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Cella
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Henry Lam
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Marko Popovic
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Gillian Bedard
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Michael Poon
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Erin Wong
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Liang Zeng
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Bottomley
- European Organisation for Research and Treatment of Cancer Headquarters, Brussels, Belgium
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171
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Smith AB, Cocks K, Taylor M, Parry D. Most domains of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 are reliable. J Clin Epidemiol 2014; 67:952-7. [DOI: 10.1016/j.jclinepi.2014.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 03/03/2014] [Accepted: 03/18/2014] [Indexed: 11/25/2022]
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Which quality of life instruments are preferred by cancer patients in Japan? Comparison of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and the Functional Assessment of Cancer Therapy-General. Support Care Cancer 2014; 22:3135-41. [PMID: 24865876 DOI: 10.1007/s00520-014-2287-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 05/12/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE We compared two health-related quality of life (HRQOL) instruments used for cancer patients [the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy-General (FACT-G)] to identify which instrument cancer patients most preferred. METHODS Adult cancer patients who had received cancer treatments within the previous 2 years (n = 395) completed both surveys; participants assessed the importance, necessity, and appropriateness of each as an indicator of their quality of life. RESULTS The patients significantly preferred the FACT-G over the EORTC QLQ-C30 as a more important (effect size (ES) = 0.37, P < 0.001), necessary (ES = 0.18, P < 0.001), and appropriate questionnaire (ES = 0.14, P = 0.005). The subgroups of patients with good performance status, and those who reported low levels of work disruption, significantly preferred the FACT-G more than the other. The corresponding correlation coefficients were the following: physical functioning and well-being subscale, r = 0.65; emotional functioning and well-being subscale, r = 0.60; social functioning and social/family well-being subscale, r = 0.00; and role functioning and functional well-being subscale, r = 0.41. CONCLUSIONS We recommend using the FACT-G if the performance status of the subject is good, e.g., in outpatient or cancer survivor surveys, based on the observed patient preferences. When performance status is not good, an instrument should be chosen after considering the differences between their scale structures and social domains and based on the availability of disease-specific modules.
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173
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Abstract
Continuous improvements in the diagnosis and treatment of cancer lead to improved cure rates and longer survival. However, in many patients, the disease becomes chronic. In this context, the patients' quality of life (QOL) becomes a crucial issue. After an introduction about QOL, results from different areas of cancer treatment are presented considering their impact on QOL. Finally, implications are discussed for researchers, clinicians, and patients.
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Affiliation(s)
- Ute Goerling
- Department of Psychooncology, Charité Comprehensive Cancer Center, Berlin, Germany,
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174
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Wagner EH, Ludman EJ, Aiello Bowles EJ, Penfold R, Reid RJ, Rutter CM, Chubak J, McCorkle R. Nurse navigators in early cancer care: a randomized, controlled trial. J Clin Oncol 2014; 32:12-8. [PMID: 24276777 PMCID: PMC3867643 DOI: 10.1200/jco.2013.51.7359] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine whether a nurse navigator intervention improves quality of life and patient experience with care for people recently given a diagnosis of breast, colorectal, or lung cancer. PATIENTS AND METHODS Adults with recently diagnosed primary breast, colorectal, or lung cancer (n = 251) received either enhanced usual care (n = 118) or nurse navigator support for 4 months (n = 133) in a two-group cluster randomized, controlled trial with primary care physicians as the units of randomization. Patient-reported measures included the Functional Assessment of Cancer Therapy-General (FACT-G) Quality of Life scale, three subscales of the Patient Assessment of Chronic Illness Care (PACIC), and selected subscales from a cancer adaptation of the Picker Institute's patient experience survey. Self-report measures were collected at baseline, 4 months, and 12 months. Automated administrative data were used to assess time to treatment and total health care costs. RESULTS There were no significant differences between groups in FACT-G scores. Nurse navigator patients reported significantly higher scores on the PACIC and reported significantly fewer problems with care, especially psychosocial care, care coordination, and information, as measured by the Picker instrument. Cumulative costs after diagnosis did not differ significantly between groups, but lung cancer costs were $6,852 less among nurse navigator patients. CONCLUSION Compared with enhanced usual care, nurse navigator support for patients with cancer early in their course improves patient experience and reduces problems in care, but did not differentially affect quality of life.
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Affiliation(s)
- Edward H. Wagner
- Edward H. Wagner, MacColl Center for Health Care Innovation; Edward H. Wagner, Evette J. Ludman, Erin J. Aiello Bowles, Robert Penfold, Robert J. Reid, Carolyn M. Rutter, and Jessica Chubak, Group Health Research Institute; Robert Penfold and Jessica Chubak, University of Washington; Robert J. Reid, Group Health Permanente, Seattle, WA; and Ruth McCorkle, Yale University, New Haven, CT
| | - Evette J. Ludman
- Edward H. Wagner, MacColl Center for Health Care Innovation; Edward H. Wagner, Evette J. Ludman, Erin J. Aiello Bowles, Robert Penfold, Robert J. Reid, Carolyn M. Rutter, and Jessica Chubak, Group Health Research Institute; Robert Penfold and Jessica Chubak, University of Washington; Robert J. Reid, Group Health Permanente, Seattle, WA; and Ruth McCorkle, Yale University, New Haven, CT
| | - Erin J. Aiello Bowles
- Edward H. Wagner, MacColl Center for Health Care Innovation; Edward H. Wagner, Evette J. Ludman, Erin J. Aiello Bowles, Robert Penfold, Robert J. Reid, Carolyn M. Rutter, and Jessica Chubak, Group Health Research Institute; Robert Penfold and Jessica Chubak, University of Washington; Robert J. Reid, Group Health Permanente, Seattle, WA; and Ruth McCorkle, Yale University, New Haven, CT
| | - Robert Penfold
- Edward H. Wagner, MacColl Center for Health Care Innovation; Edward H. Wagner, Evette J. Ludman, Erin J. Aiello Bowles, Robert Penfold, Robert J. Reid, Carolyn M. Rutter, and Jessica Chubak, Group Health Research Institute; Robert Penfold and Jessica Chubak, University of Washington; Robert J. Reid, Group Health Permanente, Seattle, WA; and Ruth McCorkle, Yale University, New Haven, CT
| | - Robert J. Reid
- Edward H. Wagner, MacColl Center for Health Care Innovation; Edward H. Wagner, Evette J. Ludman, Erin J. Aiello Bowles, Robert Penfold, Robert J. Reid, Carolyn M. Rutter, and Jessica Chubak, Group Health Research Institute; Robert Penfold and Jessica Chubak, University of Washington; Robert J. Reid, Group Health Permanente, Seattle, WA; and Ruth McCorkle, Yale University, New Haven, CT
| | - Carolyn M. Rutter
- Edward H. Wagner, MacColl Center for Health Care Innovation; Edward H. Wagner, Evette J. Ludman, Erin J. Aiello Bowles, Robert Penfold, Robert J. Reid, Carolyn M. Rutter, and Jessica Chubak, Group Health Research Institute; Robert Penfold and Jessica Chubak, University of Washington; Robert J. Reid, Group Health Permanente, Seattle, WA; and Ruth McCorkle, Yale University, New Haven, CT
| | - Jessica Chubak
- Edward H. Wagner, MacColl Center for Health Care Innovation; Edward H. Wagner, Evette J. Ludman, Erin J. Aiello Bowles, Robert Penfold, Robert J. Reid, Carolyn M. Rutter, and Jessica Chubak, Group Health Research Institute; Robert Penfold and Jessica Chubak, University of Washington; Robert J. Reid, Group Health Permanente, Seattle, WA; and Ruth McCorkle, Yale University, New Haven, CT
| | - Ruth McCorkle
- Edward H. Wagner, MacColl Center for Health Care Innovation; Edward H. Wagner, Evette J. Ludman, Erin J. Aiello Bowles, Robert Penfold, Robert J. Reid, Carolyn M. Rutter, and Jessica Chubak, Group Health Research Institute; Robert Penfold and Jessica Chubak, University of Washington; Robert J. Reid, Group Health Permanente, Seattle, WA; and Ruth McCorkle, Yale University, New Haven, CT
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175
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King MT, Bell ML, Costa D, Butow P, Oh B. The Quality of Life Questionnaire Core 30 (QLQ-C30) and Functional Assessment of Cancer-General (FACT-G) differ in responsiveness, relative efficiency, and therefore required sample size. J Clin Epidemiol 2014; 67:100-7. [DOI: 10.1016/j.jclinepi.2013.02.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 02/04/2013] [Accepted: 02/18/2013] [Indexed: 12/01/2022]
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176
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Friedlander M, King M. Patient-reported outcomes in ovarian cancer clinical trials. Ann Oncol 2013; 24 Suppl 10:x64-x68. [DOI: 10.1093/annonc/mdt474] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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177
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Alberti P, Rossi E, Cornblath DR, Merkies ISJ, Postma TJ, Frigeni B, Bruna J, Velasco R, Argyriou AA, Kalofonos HP, Psimaras D, Ricard D, Pace A, Galiè E, Briani C, Dalla Torre C, Faber CG, Lalisang RI, Boogerd W, Brandsma D, Koeppen S, Hense J, Storey D, Kerrigan S, Schenone A, Fabbri S, Valsecchi MG, Cavaletti G. Physician-assessed and patient-reported outcome measures in chemotherapy-induced sensory peripheral neurotoxicity: two sides of the same coin. Ann Oncol 2013; 25:257-64. [PMID: 24256846 DOI: 10.1093/annonc/mdt409] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The different perception and assessment of chemotherapy-induced peripheral neurotoxicity (CIPN) between healthcare providers and patients has not yet been fully addressed, although these two approaches might eventually lead to inconsistent, possibly conflicting interpretation, especially regarding sensory impairment. PATIENTS AND METHODS A cohort of 281 subjects with stable CIPN was evaluated with the National Cancer Institute-Common Toxicity Criteria (NCI-CTC v. 2.0) sensory scale, the clinical Total Neuropathy Score (TNSc©), the modified Inflammatory Neuropathy Cause and Treatment (INCAT) sensory sumscore (mISS) and the European Organization for Research and Treatment of Cancer CIPN specific self-report questionnaire (EORTC QOL-CIPN20). RESULTS Patients' probability estimates showed that the EORTC QLQ-CIPN20 sensory score was overall more highly related to the NCI-CTC sensory score. However, the vibration perception item of the TNSc had a higher probability to be scored 0 for EORTC QLQ-CIPN20 scores lower than 35, as vibration score 2 for EORTC QLQ-CIPN20 scores between 35 and 50 and as grade 3 or 4 for EORTC QLQ-CIPN20 scores higher than 50. The linear models showed a significant trend between each mISS item and increasing EORTC QLQ-CIPN20 sensory scores. CONCLUSION None of the clinical items had a perfect relationship with patients' perception, and most of the discrepancies stood in the intermediate levels of CIPN severity. Our data indicate that to achieve a comprehensive knowledge of CIPN including a reliable assessment of both the severity and the quality of CIPN-related sensory impairment, clinical and PRO measures should be always combined.
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Affiliation(s)
- P Alberti
- Department of Surgery and Translational Medicine
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178
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Ringash J, Au HJ, Siu LL, Shapiro JD, Jonker DJ, Zalcberg JR, Moore MJ, Strickland A, Kotb R, Jeffery M, Alcindor T, Ng S, Salim M, Sabesan S, Easaw JC, Shannon J, El-Tahche F, Walters I, Tu D, O'Callaghan CJ. Quality of life in patients with K-RAS wild-type colorectal cancer: the CO.20 phase 3 randomized trial. Cancer 2013; 120:181-9. [PMID: 24127364 DOI: 10.1002/cncr.28410] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 08/20/2013] [Accepted: 08/28/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND The CO.20 trial randomized patients with K-RAS wild-type, chemotherapy-refractory, metastatic colorectal cancer to receive cetuximab (CET) plus brivanib alaninate (BRIV) or CET plus placebo (CET/placebo). METHODS Quality of life (QoL) was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 at baseline and at 2, 4, 6, 8, 12, 16, and 24 weeks until disease progression. Predefined coprimary QoL endpoints were time to deterioration (first worsening from baseline of ≥ 10 points) on the Physical Function (PF) and Global (GHS) scales. RESULTS Of 750 randomized patients, 721 (358 of whom received CET/BRIV) were assessable for QoL. QoL compliance and baseline PF and GHS scores did not differ by treatment arm. The median time to deterioration was 1.6 months versus 1.1 months for GHS (P =.02) and 5.6 months versus 1.7 months for PF (P <.0001) favoring CET/placebo. Secondary analysis favored CET/placebo for QOL response on the PF, Cognitive Function, Fatigue, Nausea, Appetite, and Diarrhea scales. A greater percentage of patients on the CET/BRIV arm had PF worsening at 6 weeks (31% vs 17%). Clinical adverse events of ≥ grade 3 were more common with CET/BRIV than with CET/placebo, including fatigue (25% vs 11%), hypertension, rash, diarrhea, abdominal pain, dehydration, and anorexia. CONCLUSIONS Compared with CET/placebo, the combination of CET/BRIV worsened time to QoL deterioration for patients with K-RAS wild-type, chemotherapy-refractory, metastatic colorectal cancer on the PF and GHS scales of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. This result may be due to higher rates of fatigue and gastrointestinal adverse events.
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Affiliation(s)
- Jolie Ringash
- Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada
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Kelley CG, Lipson AR, Daly B, Douglas SL. Using a psychosocial registry as a data source for nurses. Clin J Oncol Nurs 2013; 17:444-6. [PMID: 23899986 DOI: 10.1188/13.cjon.444-446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nurses at the bedside strive to base their practice on the best available information derived from evidence. However, issues related to patient care often arise for which evidence is either difficult to attain or not available. This can be particularly true for nurses who care for patients with diverse diagnoses because most studies focus on patients with a single cancer diagnosis. For example, evidence about quality of life (QOL) as perceived by the patient is a concern for clinicians but is of particular importance to nurses at the bedside. A great deal of study has been performed on the QOL of patients with cancer; however, most of these reports focus on narrow or limited samples, typically one specific cancer type. Having access to a registry that enrolls patients with diverse types of cancer and collects QOL data could be very useful to practicing bedside nurses.
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Affiliation(s)
- Carol G Kelley
- Frances Payne Bolton School of Nursing, Case Western Reserve University in Cleveland, OH, USA.
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180
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Søreide K, Søreide AH. Using patient-reported outcome measures for improved decision-making in patients with gastrointestinal cancer - the last clinical frontier in surgical oncology? Front Oncol 2013; 3:157. [PMID: 23785670 PMCID: PMC3682158 DOI: 10.3389/fonc.2013.00157] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 06/03/2013] [Indexed: 11/18/2022] Open
Abstract
The genomic era has introduced concepts of “personalized medicine” and “targeted therapy” in the field of oncology. Medicine has become increasingly complex with a plethora of potential dilemmas in diagnosis, treatment, and management. The focus on classical outcomes for clinical decision-making is now increasingly being replaced by patient-reported outcome measures (PROMs). PROMs should increasingly now be in the center of patient-centered decision-making, based on valid, reliable, and clinically useful measures delivered directly by the patient to the caregiver. Surgeons’ ability to interpret and apply PROMs and quality of life results must improve by education and further research, and has an unreleased potential to contribute to a better understanding of the patients’ well-being. A number of caveats must be addressed before this can be brought to fruition; standardization for valid items; appropriate use of instruments; correct timing of the application; missing data handling, compliance, and respondent drop-outs are but a few issues to be addressed. Based on the apparent lack of use in both research and clinical work, it should call for an educational effort to address this among surgeons caring for patients with cancer.
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Affiliation(s)
- Kjetil Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital , Stavanger , Norway ; Department of Clinical Medicine, University of Bergen , Bergen , Norway
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181
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Schofield P, Ugalde A, Gough K, Reece J, Krishnasamy M, Carey M, Ball D, Aranda S. A tailored, supportive care intervention using systematic assessment designed for people with inoperable lung cancer: a randomised controlled trial. Psychooncology 2013; 22:2445-53. [PMID: 23733720 DOI: 10.1002/pon.3306] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 03/27/2013] [Accepted: 04/22/2013] [Indexed: 11/12/2022]
Abstract
OBJECTIVE People with inoperable lung cancer experience higher levels of distress, more unmet needs and symptoms than other cancer patients. There is an urgent need to test innovative approaches to improve psychosocial and symptom outcomes in this group. This study tested the hypothesis that a tailored, multidisciplinary supportive care programme based on systematic needs assessment would reduce perceived unmet needs and distress and improve quality of life. METHODS A randomised controlled trial design was used. The tailored intervention comprised two sessions at treatment commencement and completion. Sessions included a self-completed needs assessment, active listening, self-care education and communication of unmet psychosocial and symptom needs to the multidisciplinary team for management and referral. Outcomes were assessed with the Needs Assessment for Advanced Lung Cancer Patients, Hospital Anxiety and Depression Scale, Distress Thermometer and European Organization of Research and Treatment of Cancer Quality of Life Q-C30 V2.0. RESULTS One hundred and eight patients with a diagnosis of inoperable lung or pleural cancer (including mesothelioma) were recruited from a specialist facility before the trial closed prematurely (original target 200). None of the primary contrasts of interest were significant (all p > 0.10), although change score analysis indicated a relative benefit from the intervention for unmet symptom needs at 8 and 12 weeks post-assessment (effect size = 0.55 and 0.40, respectively). CONCLUSION Although a novel approach, the hypothesis that the intervention would benefit perceived unmet needs, psychological morbidity, distress and health-related quality of life was not supported overall.
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Affiliation(s)
- Penelope Schofield
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia; School of Behavioural Science, The University of Melbourne, Parkville, Australia; School of Nursing, The University of Melbourne, Parkville, Australia
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Rowland JH, Kent EE, Forsythe LP, Loge JH, Hjorth L, Glaser A, Mattioli V, Fosså SD. Cancer survivorship research in Europe and the United States: where have we been, where are we going, and what can we learn from each other? Cancer 2013; 119 Suppl 11:2094-108. [PMID: 23695922 PMCID: PMC3690309 DOI: 10.1002/cncr.28060] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 01/16/2013] [Accepted: 01/16/2013] [Indexed: 11/06/2022]
Abstract
The growing number of cancer survivors worldwide has led to of the emergence of diverse survivorship movements in the United States and Europe. Understanding the evolution of cancer survivorship within the context of different political and health care systems is important for identifying the future steps that need to be taken and collaborations needed to promote research among and enhance the care of those living after cancer. The authors first review the history of survivorship internationally and important related events in both the United States and Europe. Lessons learned from survivorship research are then broadly discussed, followed by examination of the infrastructure needed to sustain and advance this work, including platforms for research, assessment tools, and vehicles for the dissemination of findings. Future perspectives concern the identification of collaborative opportunities for investigators in Europe and the United States to accelerate the pace of survivorship science going forward.
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Affiliation(s)
- Julia H Rowland
- Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health/Department of Health and Human Services, Bethesda, Maryland 20892-7397, USA.
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183
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Zeng L, Bedard G, Cella D, Thavarajah N, Chen E, Zhang L, Bennett M, Peckham K, De Costa S, Beaumont JL, Tsao M, Danjoux C, Barnes E, Sahgal A, Chow E. Preliminary Results of the Generation of a Shortened Quality-of-Life Assessment for Patients with Advanced Cancer: The FACIT-Pal-14. J Palliat Med 2013; 16:509-15. [DOI: 10.1089/jpm.2012.0595] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Liang Zeng
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Gillian Bedard
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Nemica Thavarajah
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Emily Chen
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Liying Zhang
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Margaret Bennett
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Kenneth Peckham
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Sandra De Costa
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer L. Beaumont
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - May Tsao
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Cyril Danjoux
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Barnes
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Arjun Sahgal
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Edward Chow
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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184
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Popovic M, Lao N, Bedard G, Zeng L, Zhang L, Cella D, Beaumont JL, Chiu N, Chiu L, Lam H, Poon M, Chow R, Chow E. Quality of Life in Patients with Advanced Cancer Using the Functional Assessment of Cancer Therapy-General Assessment Tool: A Literature Review. World J Oncol 2013; 4:8-17. [PMID: 29147325 PMCID: PMC5649914 DOI: 10.4021/wjon594w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 01/22/2023] Open
Abstract
Quality of life (QOL) has become an increasingly meaningful endpoint in advanced cancer research. Clinicians assess QOL to help them select appropriate treatment options and regimens. The present review aims to compare QOL scores of the Functional Assessment of Cancer Therapy-General Assessment Tool (FACT-G) in relation to clinical and socio-demographic features in patients with advanced cancer. A literature search in MEDLINE and EMBASE was conducted; a total of 33 studies encompassing 39 study arms were identified that reported FACT-G scores. Four statistically significant parameters were identified with respect to FACT-G scores: education, national per capita healthcare expenditures, admittance status and previous radiation therapy. A greater percentage of patients completing higher education programs were correlated to significantly better emotional well-being and global QOL. Cohorts from countries with higher national per capita healthcare expenditures had better physical well-being, social/family well-being and improved relationships with their doctors. Patient samples comprised of purely outpatients had better levels of emotional well-being and global QOL when compared to samples with a mix of outpatients and inpatients. A greater percentage of patients previously receiving radiation therapy were correlated to a better relationship with doctor score. Although limitations of the present review exist, differences in QOL scores based on socio-demographic and clinical factors are observed; certain correlations described in the present work have been described previously in the literature while others have not. Future work aimed at either determining confounding parameters or cause and effect relationships is recommended.
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Affiliation(s)
- Marko Popovic
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Nicholas Lao
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Gillian Bedard
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Liang Zeng
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Liying Zhang
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Jennifer L Beaumont
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Nicholas Chiu
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Leonard Chiu
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Henry Lam
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Michael Poon
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ronald Chow
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Edward Chow
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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185
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Paiva CE, Rugno FC, Paiva BSR. The Barretos short instrument for assessment of quality of life (BSIqol): development and preliminary validation in a cohort of cancer patients undergoing antineoplastic treatment. Health Qual Life Outcomes 2012. [PMID: 23192011 PMCID: PMC3541104 DOI: 10.1186/1477-7525-10-144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To be clinically useful, an instrument assessing health-related quality of life (HRQOL) should be easy to understand and quick to answer. Few instruments have been designed to be short, simple, and easily understandable by patients from all educational levels. The aim of the present study was to evaluate the psychometric properties of a brief general instrument developed to assess HRQOL. METHODS Results from a preliminary study regarding the initial development of the Barretos Short Instrument for Assessment of Quality of Life (BSIqol) with 80 cancer patients are presented. Out of all the patients, 59 completed the BSIqol on two occasions in order to evaluate the reproducibility test-retest. Validity analyses were done comparing scores from BSIqol with EORTC QLQ-C30 and Edmonton Symptom Assessment System (ESAS). In addition, BSIqol scores were analyzed in function of ECOG-PS, work activity, and financial income. RESULTS BSIqol demonstrated good internal consistency (Cronbach's α = 0.79) and adequate test-retest reliability, with intraclass coefficient correlation (ICC) varying from 0.736 to 0.946. There were adequate correlations between scores of BSIqol, EORTC QLQ-C30 and ESAS. The BSIqol was capable of discriminating between clinical subgroups, with different ECOG-PS and work activity. Patients completed the BSIqol in a median time <2 min. Only one patient reported some difficulty to answer the instrument. CONCLUSIONS BSIqol seems to be a straightforward and useful instrument for rapidly assessing HRQOL from cancer patients. Further studies are necessary to evaluate BSIqol in different populations and also to assess its responsiveness and define its minimal clinically important differences.
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Affiliation(s)
- Carlos Eduardo Paiva
- Departamento de Oncologia Clínica, Hospital de Câncer de Barretos, Rua Antenor Duarte Vilela, 1331, Bairro Dr Paulo Prata, CEP: 14784-400, Barretos, São Paulo, Brazil.
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186
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Pitfalls in the interpretation of standardised quality of life instruments for individual patients? A qualitative study in colorectal cancer. Qual Life Res 2012; 22:1879-88. [DOI: 10.1007/s11136-012-0303-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2012] [Indexed: 01/22/2023]
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187
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Abstract
PURPOSE OF REVIEW The aim of this review is to summarize the current state of the science in physical symptoms and other end-of-life care domains and/or illness-specific outcomes in palliative care. The review includes progress in outcome measure development and interpretation, with specific reference to the clinical trial context. RECENT FINDINGS There are validated measures in a wide range of domains, which can measure outcomes specific to palliative care interventions; which are sufficiently validated to ensure the results of the trial are robust and measuring differences which are both clinically meaningful. In several areas, consensus is emerging which will allow consolidation of outcome measurement and the ability to extend measurement from the clinical trial setting into routine clinical practice. Potential exists for composite measures covering areas prioritized by patients to improve comparability and efficiency. Adverse events need to be measured with the same degree of rigor as efficacy outcomes. SUMMARY Clinical trials of palliative care interventions need to consider a range of outcomes, however, the choice and timing of measurement of the primary outcome need to be guided by the domain most likely to be influenced by the intervention.
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188
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Magaji BA, Moy FM, Roslani AC, Sagap I, Zakaria J, Blazeby JM, Law CW. Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol. BMC Cancer 2012; 12:384. [PMID: 22937765 PMCID: PMC3443003 DOI: 10.1186/1471-2407-12-384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 08/27/2012] [Indexed: 12/12/2022] Open
Abstract
Background Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. Methods/design This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil), then administered, scored and analyzed following the developers’ guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. Conclusion The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments at the end of the study.
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Affiliation(s)
- Bello Arkilla Magaji
- Julius Centre University of Malaya, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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189
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Ferriolli E, Skipworth RJE, Hendry P, Scott A, Stensteth J, Dahele M, Wall L, Greig C, Fallon M, Strasser F, Preston T, Fearon KCH. Physical activity monitoring: a responsive and meaningful patient-centered outcome for surgery, chemotherapy, or radiotherapy? J Pain Symptom Manage 2012; 43:1025-35. [PMID: 22269181 DOI: 10.1016/j.jpainsymman.2011.06.013] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 06/25/2011] [Accepted: 06/28/2011] [Indexed: 11/26/2022]
Abstract
CONTEXT In surgical and clinical oncology, there is a growing need for patient-centered outcomes that are responsive, meaningful, and fit for purpose. OBJECTIVES The aim of this study was to validate physical activity (PA) monitoring as a responsive outcome measure at different stages of disease and treatment, by verifying correlations between PA, performance score, and quality of life (QoL). METHODS Daily life PA of 162 cancer patients, monitored by a device that records time sitting/lying, time standing, time walking, number of steps taken, and walking cadence, was compared with 20 healthy volunteers. In a subgroup of patients, functional status and QoL were assessed using the World Health Organization/Eastern Cooperative Oncology Group and the Karnofsky Performance Status scores and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) questionnaire. RESULTS The PA of patients with resectable gastrointestinal cancer did not differ significantly from controls. In contrast, patients with advanced cancer took 45% fewer steps and spent an extra 2.8 hours/day lying/sitting (P=0.001). Patients undergoing neoadjuvant chemotherapy and surgery (5-6 weeks after operation) experienced a similar reduction in PA. There were significant correlations between PA and the physical and role domains as well as fatigue subscale of the EORTC QLQ-C30 scale. CONCLUSION Objective PA scores correlate significantly with disease stage, functional status, and QoL of patients with cancer. Therefore, activity monitoring can make meaningful objective estimates of patient function in response to cancer and its treatment and may provide surrogate outcomes of QoL.
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Affiliation(s)
- Eduardo Ferriolli
- Clinical and Surgical Sciences, University of Edinburgh, Royal Infirmary Edinburgh, Edinburgh, Scotland, UK.
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Shi HY, Uen YH, Yen LC, Culbertson R, Juan CH, Hou MF. Two-year quality of life after breast cancer surgery: a comparison of three surgical procedures. Eur J Surg Oncol 2011; 37:695-702. [PMID: 21664099 DOI: 10.1016/j.ejso.2011.05.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 04/22/2011] [Accepted: 05/16/2011] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To analyze longitudinal changes in each subscale of a quality of life (QOL) measure and to explore their relationships to effective QOL predictors in breast cancer surgery patients. PATIENTS AND METHODS This prospective study analyzed 172 patients at two tertiary academic hospitals. All patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its supplementary breast cancer measure (QLQ-BR23) at baseline and at 1 and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation (GEE) before and after surgery. RESULTS A 2-year follow-up survey of the examined population revealed significant (P < 0.05) improvement in each QOL subscale. In both postoperative surveys, effect size was largest in the QLQ subscales for patients who had received mastectomy with reconstruction and lowest in those who had received modified radical mastectomy. After adjusting for time effects and baseline predictors, GEE approaches revealed the following explanatory variables for QOL: time, type of surgical procedure, age, chemotherapy, radiotherapy, hormone therapy, and preoperative functional status. CONCLUSIONS When evaluating QOL after breast cancer surgery, several factors other than the surgery itself should be considered. Patients should also be advised that their postoperative QOL might depend not only on the success of their operations, but also on their preoperative functional status.
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Affiliation(s)
- H Y Shi
- Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 807 Kaohsiung, Taiwan, ROC
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