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Su X, Huang Y, Gong R, Xu W, Dai W, Pu Y, Yu J, Yu Q, Zhang L, Zhang J, Shi Q. Undergoing Lung Surgery (PSA-Lung) was appropriate for symptom assessment after discharge. Qual Life Res 2024; 33:1807-1818. [PMID: 38735915 DOI: 10.1007/s11136-024-03636-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE To examine whether a 7-day or 24-h recall period of Perioperative Symptom Assessment for Patients Undergoing Lung Surgery (PSA-Lung) was appropriate for symptom assessment after discharge. METHODS A total of 377 patients were recruited in a cohort study of patients who underwent lung surgery. We measured patient symptoms daily and weekly using the two recall period versions of the PSA-Lung scale, respectively. The psychometric properties of both versions were calculated. Spearman rank correlation coefficients and kappa (k) coefficients were used to measure the association between items score measured by the two version scales each week. Cohen's d effect size and mixed linear model were used to measure responsiveness to change over time. RESULTS Spearman rank correlation coefficients between the symptom scores generated by the 7-day and 24-h versions (range 0.48-0.77; all P < 0.05). The correlations increased in patients in stable condition (weekly symptom change < 2). Cronbach's α coefficients for both ratings were > 0.87 and both had good test-retest reliability. The longitudinal analysis and Cohen's d effect sizes showed that both ratings had good ability to detect changes in all items. CONCLUSION The 7-day retrospective scale was as effective as the 24-h retrospective scale in terms of psychometric performance. In the stage where the patient's symptoms change rapidly, it is recommended to use the 24-h retrospective scale for symptom monitoring. On the contrary, in a stable state, it can be considered to use the 7-day retrospective scale for monitoring to reduce the patient's burden.
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Affiliation(s)
- Xueyao Su
- School of Public Health, Chongqing Medical University, No.1, Medical School Road, Yuzhong District, Chongqing, 400016, China
| | - Yanyan Huang
- School of Public Health, Chongqing Medical University, No.1, Medical School Road, Yuzhong District, Chongqing, 400016, China
| | - Ruoyan Gong
- School of Public Health, Chongqing Medical University, No.1, Medical School Road, Yuzhong District, Chongqing, 400016, China
| | - Wei Xu
- School of Public Health, Chongqing Medical University, No.1, Medical School Road, Yuzhong District, Chongqing, 400016, China
| | - Wei Dai
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine,, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Yang Pu
- School of Public Health, Chongqing Medical University, No.1, Medical School Road, Yuzhong District, Chongqing, 400016, China
| | - Jingwen Yu
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Qingsong Yu
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Lijun Zhang
- School of Public Health, Chongqing Medical University, No.1, Medical School Road, Yuzhong District, Chongqing, 400016, China
| | - Jiayuan Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Qiuling Shi
- School of Public Health, Chongqing Medical University, No.1, Medical School Road, Yuzhong District, Chongqing, 400016, China.
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine,, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
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Su X, Huang Y, Dai W, Zhang Y, Zhang L, Zhang J, Gong R, Yu J, Kang D, Xiang R, Chen J, Shi Q. Recall Bias in the Assessment of Cough for Patients Discharged from Lung Surgery. Patient Prefer Adherence 2023; 17:1561-1572. [PMID: 37426047 PMCID: PMC10327912 DOI: 10.2147/ppa.s399635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/24/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose This study aimed to evaluate the presence of recall bias when patients retrospectively report cough scores. Patients and Methods Patients who underwent lung surgery between July 2021 and November 2021 were recruited for this study. We retrospectively assessed the severity of cough within the past 24 hours and the past 7 days using a 0-10 numerical rating scale. Recall bias was defined as the difference between the scores reported on the two assessments. Patients were grouped based on the longitudinal change in cough scores from pre-operation to 4 weeks after discharge using group-based trajectory models. Using generalized estimating equation to explore the factors influencing recall bias. Results Overall, 199 patients were analyzed and demonstrated the three distinct trajectories of post-discharge cough: high (21.1%), medium (58.3%), and low (20.6%). Significant recall bias was found in week 2 for the high-trajectory patients (6.26 vs 5.10, P<0.01) and in week 3 for the medium-trajectory patients (2.88 vs 2.60, P=0.01). Among all recall bias, 41.8% were of underestimation, and 21.7% of overestimation. The high trajectory group (β=1.14, P<0.01) and measurement interval (β=0.36, P<0.01) were risk factors for underestimation, while post-discharge time (β=-0.57, P<0.01) and measurement interval (β=-0.13, P=0.02) were protective factors for overestimation. Conclusion Retrospective assessment of post-discharge cough in patients who underwent lung surgery will introduce recall bias, with a tendency of underestimation. The high-trajectory group, interval time and post-discharge time are influencing factors of recall bias. For patients with severe cough at discharge, a shorter recall periods should be employed for monitoring, due to the large bias that results from a longer recall period.
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Affiliation(s)
- Xueyao Su
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yanyan Huang
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Wei Dai
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China
| | - Yubo Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lijun Zhang
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jiayuan Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Ruoyan Gong
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jingwen Yu
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dan Kang
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Rumei Xiang
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jiaojiao Chen
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qiuling Shi
- School of Public Health, Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China
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Gao X, Dai W, Zhang Q, Liu W, Liu Y, Yang L, Wei X, Shi Q, Pompili C, Pu Y, Xie S, Xiang R, Tian B, Hu B, Yang X, Wang X, Yang X, Xie T, Tang Y, Qiao G, Sun N, Gao S, Zhang G, Chen D, Cui Y, Chen X, He Y, Zhang R, Li Q, Zhuang X. Longitudinal patient-reported outcomes 1 year after thoracoscopic segmentectomy versus lobectomy for early-stage lung cancer: a multicentre, prospective cohort study protocol. BMJ Open 2023; 13:e067841. [PMID: 36657755 PMCID: PMC9853240 DOI: 10.1136/bmjopen-2022-067841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Segmentectomy and lobectomy are the main surgical procedures for early-stage lung cancer. However, few studies have analysed patient-reported outcomes after segmentectomy versus lobectomy. This study aims to compare patient-reported outcomes-such as symptoms, daily functioning and quality of life-between thoracoscopic segmentectomy and lobectomy for early-stage lung cancer during the 1 year after surgery. METHODS AND ANALYSIS Overall, 788 newly diagnosed patients with early-stage lung cancer (tumour size ≤2 cm), who are scheduled to undergo thoracoscopic segmentectomy or lobectomy, will be recruited in this multicentre, prospective cohort study. The patients will receive standardised care after surgery. The Perioperative Symptom Assessment for Lung Surgery-a validated lung cancer surgery-specific scale-will be used to assess the symptoms and functions at baseline, at discharge and monthly after discharge for 1 year. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Lung Cancer module 29 will be used to assess the patients' quality of life at the same time points. The primary outcome will be the shortness of breath scores during the first year after thoracoscopic segmentectomy and lobectomy and will be compared using mixed-effects models. The secondary outcomes will include other symptoms, indicators of daily functioning, quality of life scores and traditional clinical outcomes. These will be compared using mixed-effects models and the Student's t-test, non-parametric test or Χ2 test. Propensity score matching will be used to ensure an even distribution of known confounders between the groups. ETHICS AND DISSEMINATION The Ethics Committee for Medical Research and New Medical Technology of Sichuan Cancer Hospital approved this study (approval number: SCCHEC-02-2022-002). All participants will be instructed to provide informed consent. The manuscript is based on protocol version 3.0. The study results will be presented at medical conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2200060753.
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Affiliation(s)
- Xin Gao
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Wei Dai
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qi Zhang
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Graduate School, Chengdu Medical College, Chengdu, Sichuan, China
| | - Wenwu Liu
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Yangjun Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lingjia Yang
- College of Medical and Dental Science, University of Birmingham, Birmingham, UK
| | - Xing Wei
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qiuling Shi
- Center for Cancer Prevention Research, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Cecilia Pompili
- Thoracic Surgery Unit, University and Hospital Trust - Ospedale Borgo Trento, Verona, Italy
- Section of Patient Centered Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Yang Pu
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Shaohua Xie
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Run Xiang
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Bo Tian
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Bin Hu
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiaozun Yang
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiang Wang
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiaojun Yang
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Tianpeng Xie
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Yong Tang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
| | - Guibin Qiao
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
| | - Nan Sun
- Department of Thoracic Surgery, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, China
| | - Shan Gao
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Guangjian Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Dan Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Chongqing, China
| | - Yue Cui
- Department of Thoracic Surgery, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xiaobo Chen
- Department of Thoracic Surgery, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yu He
- Department of Thoracic Surgery, Ya'an People's Hospital, Ya'an, Sichuan, China
| | - Rong Zhang
- Department of Thoracic Surgery, Ya'an People's Hospital, Ya'an, Sichuan, China
| | - Qiang Li
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiang Zhuang
- Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
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Xu W, Dai W, Xing W, Shi Q. ASO Author Reflections: Using Minimal Clinically Important Improvement for Patient-Reported Symptoms to Define Recovery. Ann Surg Oncol 2022; 29:5605-5606. [PMID: 35727460 DOI: 10.1245/s10434-022-11982-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Wei Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Wei Dai
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Xing
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiuling Shi
- School of Public Health and Management, Chongqing Medical University, Chongqing, China. .,State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China. .,Center for Cancer Prevention Research, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
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