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Robertson EG, Hetherington K, Daly R, Donoghoe MW, Handelsman N, Ziegler DS, Wakefield CE. The feasibility and acceptability of collecting psychosocial outcome measures embedded within a precision medicine trial for childhood cancer. Cancer Med 2024; 13:e7339. [PMID: 38898768 PMCID: PMC11187165 DOI: 10.1002/cam4.7339] [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] [Received: 10/15/2023] [Revised: 05/07/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Patient-reported outcomes measures (PROMs) are increasingly being collected within cancer clinical trials, yet limited literature on the feasibility and acceptability of doing so. METHODS We collected parent-proxy and adolescent (≥12 years old) PROMs through a longitudinal, psychosocial sub-study ('PRISM-Impact') embedded in a precision medicine trial for children with poor prognosis cancer ('PRISM'). We report on feasibility (response, participation, and attrition rates; follow-up and responding to elevated distress) and acceptability (parents' perceived benefit/burden of participation; and impact on decision to participate in PRISM) of PRISM-Impact. RESULTS Over the reporting period, 462 families were eligible for PRISM-Impact. Family and adolescent response rates were 53% and 45%, respectively. Parents whose child had relapsed were more likely to participate in PRISM-Impact than parents whose child had not (p < 0.001). Parent and adolescent attrition rates were 30% and 56% respectively. We conducted 478 calls for intake and to follow-up on missing questionnaires, and 122 calls to respond to elevated distress. Parents reported wanting to participate in PRISM-Impact for altruistic reasons and because they valued psychosocial research. Parents reported little-to-no burden and some benefit from participating in PRISM-Impact, with little change in ratings overtime. Most parents felt that participating in PRISM-Impact did not impact their desire to participate in PRISM (72%), with some feeling more eager to participate (19%). CONCLUSIONS PRISM-Impact response rates were comparable to other psycho-oncology studies, despite the poor prognosis population. Integration of PROMs within a paediatric oncology trial is acceptable to parents, and may provide a more comprehensive assessment of the impact of trial participation.
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Affiliation(s)
- Eden G. Robertson
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & HealthUNSW SydneyKensingtonNew South WalesAustralia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
- Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
| | - Kate Hetherington
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & HealthUNSW SydneyKensingtonNew South WalesAustralia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
- Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
| | - Rebecca Daly
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & HealthUNSW SydneyKensingtonNew South WalesAustralia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
- Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
| | - Mark W. Donoghoe
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & HealthUNSW SydneyKensingtonNew South WalesAustralia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
- Stats Central, Mark Wainwright Analytical CentreUNSW SydneyKensingtonNew South WalesAustralia
| | - Nicholas Handelsman
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & HealthUNSW SydneyKensingtonNew South WalesAustralia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
- Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
| | - David S. Ziegler
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & HealthUNSW SydneyKensingtonNew South WalesAustralia
- Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
- Children's Cancer InstituteUNSW SydneySydneyNew South WalesAustralia
| | - Claire E. Wakefield
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & HealthUNSW SydneyKensingtonNew South WalesAustralia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
- Kids Cancer CentreSydney Children's HospitalSydneyNew South WalesAustralia
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Zupanec S, Herriage T, Landier W. Children's Oncology Group 2023 blueprint: Nursing discipline. Pediatr Blood Cancer 2023; 70 Suppl 6:e30575. [PMID: 37470719 PMCID: PMC10655901 DOI: 10.1002/pbc.30575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
In contrast to other Children's Oncology Group (COG) committees, the COG nursing discipline is unique in that it provides the infrastructure necessary for nurses to support COG clinical trials and implements a research agenda aimed at scientific discovery. This hybrid focus of the discipline reflects the varied roles and expertise within pediatric oncology clinical trials nursing that encompass clinical care, leadership, and research. Nurses are broadly represented across COG disease, domain, and administrative committees, and are assigned to all clinically focused protocols. Equally important is the provision of clinical trials-specific education and training for nurses caring for patients on COG trials. Nurses involved in the discipline's evidence-based practice initiative have published a wide array of systematic reviews on topics of clinical importance to the discipline. Nurses also develop and lead research studies within COG, including stand-alone studies and aims embedded in disease/ treatment trials. Additionally, the nursing discipline is charged with responsibility for developing patient/family educational resources within COG. Looking to the future, the nursing discipline will continue to support COG clinical trials through a multifaceted approach, with a particular focus on patient-reported outcomes and health equity/disparities, and development of interventions to better understand and address illness-related distress in children with cancer.
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Affiliation(s)
- Sue Zupanec
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Wendy Landier
- University of Alabama at Birmingham, Birmingham, Alabama
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Liu YM, Jaing TH, Wen YC, Chen SH, Weng PY, Lin L, Wu CL. Health-related quality of life predicts length of hospital stay and survival rates for pediatric patients receiving allogeneic hematopoietic cell transplantation. Qual Life Res 2021; 30:3421-3430. [PMID: 34018123 DOI: 10.1007/s11136-021-02887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE We examined the association between health-related quality of life (HRQoL) of pediatric patients during hospitalization for allogeneic hematopoietic cell transplantation (HCT) and length of hospital stay, and 1-year survival. METHODS Primary family caregivers were proxy-assessors for the Pediatric Quality of Life (PedsQL) Stem Cell Transplant Module at three time points: 5-days pre-HCT (T0); 14-days post-HCT (engraftment, T1); and 1-week before hospital discharge (T2). Cox regression analyses determined predictors of the overall 1-year survival after allogeneic HCT. RESULTS Thirty-nine eligible caregivers completed all assessments. The mean age of the pediatric patients was 9.07 years (SD = 5.2). PedsQL Stem Cell Transplant Module scores decreased from 71.33 (SD = 13.26) at T0 to 55.41(SD = 13.05) at T1 (p < 0.001) and increased to 68.46 (SD = 13.97) at T2 (p < 0.001). There was no significant difference between scores at T0 and T2. Longer length of hospital stay was associated with children who were younger and had greater relative changes in scores on the caregiver-proxy PedsQL Stem Cell Transplant Module from T0 to T1. PedsQL Stem Cell Transplant Module scores ≥ 58.07 at T2 were associated with higher 1-year survival rates (Hazard Ratio = 0.12, 95% Confidence Interval = 0.02-0.78; p = 0.03). CONCLUSION Our findings suggest that assessment of HRQoL during early HCT can add prognostic value beyond demographic and HCT factors. Understanding the HRQoL status during hospitalization for HCT could help identify pediatric patients with low prospects of 1-year survival in order to provide support interventions to improve HRQoL and survival rates.
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Affiliation(s)
- Ying-Mei Liu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
- Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- , No. 261, Wen-Hwa 1st Road, Guishan District, Taoyuan, Taiwan.
| | - Tang-Her Jaing
- Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Chuan Wen
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Hsiang Chen
- Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Pei-Yin Weng
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Lin Lin
- School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Chia-Ling Wu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Sung L, Miller TP, Phillips R. Improving symptom control and reducing toxicities for pediatric patients with hematological malignancies. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2020; 2020:280-286. [PMID: 33275755 PMCID: PMC7727514 DOI: 10.1182/hematology.2020000114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The continuing improvement in pediatric cancer survival over time is largely attributable to the availability of intensive therapies. Increasing attention has been focused on addressing the physical and psychosocial impacts of cancer and cancer treatments. Evidence from adult oncology suggests that routine symptom screening and feedback to health care providers can improve patient-clinician communication, reduce distress, and improve quality of life and may even increase survival. Many questions remain regarding implementation of routine symptom screening in pediatric cancer care, including the best symptom assessment instrument and the reporter type and feasibility of integration with electronic health records (EHRs). Nonsymptom adverse events are also important, for both routine clinical care and adverse event reporting for patients enrolled in clinical trials. However, traditional mechanisms for reporting adverse events lead to substantial inaccuracies and are labor intensive. An automated approach for abstraction from EHRs is a potential mechanism for improving accuracy and reducing workload. Finally, identification of symptom and nonsymptom toxicities must be paired with prophylactic and therapeutic strategies. These strategies should be based on clinical practice guidelines that synthesize evidence and use multiprofessional, multidisciplinary expertise to place this evidence in clinical context and create recommendations. How best to implement clinical practice guidelines remains a challenge, but EHR order sets and alerts may be useful. In summary, although survival is excellent for pediatric patients receiving cancer therapies, more focus is needed on identification of symptoms and nonsymptom toxicities and their management. The EHR may be useful for promoting better supportive care through these mechanisms.
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Affiliation(s)
| | - Tamara P. Miller
- Children’s Healthcare of Atlanta, Emory University, Atlanta, GA; and
| | - Robert Phillips
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
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Sato I, Sakka M, Soejima T, Kita S, Kamibeppu K. Randomized comparative study of child and caregiver responses to three software functions added to the Japanese version of the electronic Pediatric Quality of Life Inventory (ePedsQL) questionnaire. J Patient Rep Outcomes 2020; 4:49. [PMID: 32577921 PMCID: PMC7311606 DOI: 10.1186/s41687-020-00213-w] [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] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 06/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) refer to any report of the status of a patient's health condition, health behavior, or experience with healthcare directly from the patient, without interpretation of the patient's response by a clinician or any other external party. While many PROs, such as the Pediatric Quality of Life Inventory (PedsQL), were originally administered in paper-and-pencil format, these are now available as electronic versions (ePROs). Although ePROs might well have used the same structure as their paper versions, we developed an alternate ePedsQL incorporating three software functions: 1) a non-forcing non-response alert, 2) a conditional question branch of the School Functioning Scale that only displays for (pre) school children, and 3) a vertical item-by-item display for small-screen devices. This report evaluated the effect of these functions on item non-response rate, survey completion time, and user experience. METHODS All surveys were conducted via the online/computer mode. We compared the dynamic format containing the three functions with the basic format in a randomized comparative study in 2803 children and 6289 caregivers in Japan. RESULTS We found that the non-response alert lowered the item non-response rate (0.338% to 0.046%, t = - 4.411, p < 0.001 by generalized linear mixed model analysis). The conditional question branch had mixed effects on survey completion time depending on the respondents' age. Surprisingly, respondents rated the vertical question display for handheld devices less legible than the matrix format. Further, multigroup structural equation modelling revealed that the same configuration for both formats showed an acceptable fit (CFI 0.933, RMSEA 0.060, SRMR 0.038) but the errors of observed variables were larger for the dynamic format than the basic format. CONCLUSIONS We confirmed the robustness of the ePedsQL in different formats. The non-response rate of ePedsQL was very low even in the absence of an alert. The branch and item-by-item display were effective but unnecessary for all populations. Our findings further understanding of how humans respond to special software functions and different digital survey formats and provide new insight on how the three tested functions might be most successfully implemented.
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Affiliation(s)
- Iori Sato
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
| | - Mariko Sakka
- Department of Health Quality and Outcome Research, Division of Nursing System, Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan
- Department of Gerontological Home Care and Long-term Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takafumi Soejima
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Sachiko Kita
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
- Department of Health Quality and Outcome Research, Division of Nursing System, Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan
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Sato I, Soejima T, Ishida Y, Maeda M, Koh K, Kamibeppu K. Simple change in logistic procedure improves response rate to QOL assessment: a report from the Japan Children's Cancer Group. J Patient Rep Outcomes 2020; 4:48. [PMID: 32556617 PMCID: PMC7300165 DOI: 10.1186/s41687-020-00214-9] [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] [Received: 01/31/2020] [Accepted: 06/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background Reducing non-completion of quality-of-life assessment in clinical trials is an important challenge in obtaining accurate data and unbiased interpretation of patients’ quality-of-life for each regimen. We evaluated the effect of changing our questionnaire distribution procedure in a multicenter phase II/III trial on the response rate to a quality-of-life questionnaire. Methods In the trial, we distributed 1767 questionnaires and 1045 were returned. We adopted a regression discontinuing design and estimated the change in response rate between pre-intervention (quality-of-life questionnaires were sent to each center soon after patient registration) and post-intervention (a set of tailored questionnaires was sent just before the first quality-of-life assessment). Results The post-intervention response rate was higher (odds ratio = 1.62) than the pre-intervention response rate. Conclusions A simple logistic intervention reduced the non-completion of QOL assessment in this case, suggesting that a simple change can contribute to improving clinical trial accomplishment.
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Affiliation(s)
- Iori Sato
- Center for Quality of Life Research, The University of Tokyo, Bunkyo-ku, Tokyo, Japan. .,Department of Family Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
| | - Takafumi Soejima
- Center for Quality of Life Research, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Family Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yasushi Ishida
- Committee on Long-term Follow-up, Japan Children's Cancer Group, Nagoya, Aichi, Japan.,Pediatric Medical Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan
| | - Miho Maeda
- Committee on Long-term Follow-up, Japan Children's Cancer Group, Nagoya, Aichi, Japan.,Department of Pediatrics, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Katsuyoshi Koh
- Committee on Acute Lymphoblastic Leukemia, Japan Children's Cancer Group, Nagoya, Aichi, Japan.,Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Kiyoko Kamibeppu
- Center for Quality of Life Research, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Family Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Committee on Long-term Follow-up, Japan Children's Cancer Group, Nagoya, Aichi, Japan
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Calaminus G, Jenney M, Hjorth L, Baust K, Bernstein M, Bielack S, Vos PD, Hogendoorn PCW, Jovic G, Krailo M, Kreitz K, Marina N, Popoola BO, Sauerland C, Smeland S, Teske C, Schweinitz CV, Whelan J, Wiener A, Sydes MR, Nagarajan R. Quality of Life of Patients With Osteosarcoma in the European American Osteosarcoma Study-1 (EURAMOS-1): Development and Implementation of a Questionnaire Substudy. JMIR Res Protoc 2019; 8:e14406. [PMID: 31573951 PMCID: PMC6819132 DOI: 10.2196/14406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/19/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The quality of life (QoL) of patients with osteosarcoma (OS) may be adversely affected by the disease or its treatment. Therefore, it is important to understand the QoL of patients undergoing treatment for OS to improve the QoL. We report on the first prospective international QoL study that was embedded within a large randomized clinical trial from 4 national study groups. OBJECTIVE This paper aimed to describe the QoL study development, methodology, accrual details, and characteristics of the QoL cohort. METHODS A total of 2260 patients registered in the EURopean AMerican Osteosarcoma Study-1 (EURAMOS-1), of whom 97.92% (2213/2260) were eligible for the optional QoL assessment and could participate in terms of questionnaire availability. Overall, 61.86% (1369/2213) of patients and/or proxies completed the QoL evaluation at the first assessment time point (E1) after the start of preoperative treatment. The QoL measures used (self- and/or proxy reports) depending on the patient's age and national study group. Participants and nonparticipants in the ancillary QoL study were compared regarding relevant demographic and disease-related characteristics at registration in the trial. RESULTS The participation rate at time point E1 did not differ with regard to age, gender, the occurrence of pathological fracture, or the presence of any metastases at diagnosis. No differences were found regarding the primary tumor site. Only the national study group affiliation had an influence on participation. Participation decreased linearly with trial progress up to 20% at the final time point of QoL assessment. CONCLUSIONS This study demonstrates the feasibility of international cooperation for the purpose of assessing and understanding the QoL of pediatric and adolescent/young adult patients with cancer. Future outcomes of this QoL substudy will help to adapt interventions to improve QoL.
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Affiliation(s)
- Gabriele Calaminus
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Meriel Jenney
- Children & Women's Services Clinical Board, University Hospital of Wales, Cardiff, United Kingdom
| | - Lars Hjorth
- Pediatrics, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Katja Baust
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Mark Bernstein
- IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - Stefan Bielack
- Cooperative Osteosarcoma Study Group, Klinikum Stuttgart - Olgahospital, Stuttgart, Germany
| | - Patricia De Vos
- Department of Pediatric Hematology and Oncology, Gent University Hospital, Gent, Belgium
| | | | - Gordana Jovic
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Mark Krailo
- Department of Preventive Medicine, Keck Medical Center at the University of Southern California, Los Angeles, CA, United States.,Children's Oncolgy Group, Arcadia, CA, United States
| | - Kiana Kreitz
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Neyssa Marina
- Five Prime Therapeutics Inc, South San Francisco, CA, United States
| | - Babasola O Popoola
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Cristina Sauerland
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Sigbjørn Smeland
- Division of Cancer Medicine and Scandinavian Sarcoma Group, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Teske
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Clara V Schweinitz
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany
| | - Jeremy Whelan
- Department of Oncology, University College Hospital, London, United Kingdom
| | | | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, United Kingdom
| | - Rajaram Nagarajan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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Nagarajan R, Gerbing R, Alonzo T, Johnston DL, Aplenc R, Kolb EA, Meshinchi S, Barakat LP, Sung L. Quality of life in pediatric acute myeloid leukemia: Report from the Children's Oncology Group. Cancer Med 2019; 8:4454-4464. [PMID: 31190442 PMCID: PMC6675729 DOI: 10.1002/cam4.2337] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Objectives were used to describe guardian proxy-report and child self-report quality of life (QoL) during chemotherapy for pediatric acute myeloid leukemia (AML) patients. METHODS Patients enrolled on the phase 3 AML trial AAML1031 who were 2-18 years of age with English-speaking guardians were eligible. Instruments used were the PedsQL Generic Core Scales, Acute Cancer Module, and Multidimensional Fatigue Scale. Assessments were obtained at the beginning of Induction 1 and following completion of cycles 2-4. Potential predictors of QoL included the total number of nonhematological grade 3-4 Common Terminology Criteria for Adverse Event (CTCAE) submissions. RESULTS There were 505 eligible guardians who consented to participate and 348 of their children provided at least one self-report assessment. The number of submitted CTCAE toxicities was significantly associated with worse physical health summary scores (β ± standard error (SE) -3.00 ± 0.69; P < 0.001) and general fatigue (β ± SE -2.50 ± 0.66; P < 0.001). Older age was significantly associated with more fatigue (β ± SE -0.58 ± 0.25; P = 0.022). Gender, white race, Hispanic ethnicity, private insurance status, risk status, bortezomib assignment, and duration of neutropenia were not significantly associated with QoL. DISCUSSION The number of CTCAE toxicities was the primary factor influencing QoL among children with AML. Reducing toxicities should improve QoL; identifying approaches to ameliorate them should be a priority.
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Affiliation(s)
- Rajaram Nagarajan
- Division of OncologyCincinnati Children's Hospital Medical CenterCincinnatiOhio
| | | | - Todd Alonzo
- The Children's Oncology GroupMonroviaCalifornia
- Division of BiostatisticsUniversity of Southern CaliforniaLos AngelesCalifornia
| | - Donna L. Johnston
- Division of OncologyChildren's Hospital of Eastern OntarioOttawaOntario
| | - Richard Aplenc
- Division of OncologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvania
| | | | - Soheil Meshinchi
- Division of OncologySeattle Children's HospitalSeattleWashington
| | - Lamia P. Barakat
- Division of OncologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvania
| | - Lillian Sung
- Division of Haematology/OncologyThe Hospital for Sick ChildrenTorontoOntario
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Singer S, Jordan S, Locati LD, Pinto M, Tomaszewska IM, Araújo C, Hammerlid E, Vidhubala E, Husson O, Kiyota N, Brannan C, Salem D, Gamper EM, Arraras JI, Ioannidis G, Andry G, Inhestern J, Grégoire V, Licitra L. The EORTC module for quality of life in patients with thyroid cancer: phase III. Endocr Relat Cancer 2017; 24:197-207. [PMID: 28223365 DOI: 10.1530/erc-16-0530] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 02/21/2017] [Indexed: 12/23/2022]
Abstract
The purpose of the study was to pilot-test a questionnaire measuring health-related quality of life (QoL) in thyroid cancer patients to be used with the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire EORTC QLQ-C30. A provisional questionnaire with 47 items was administered to patients treated for thyroid cancer within the last 2 years. Patients were interviewed about time and help needed to complete the questionnaire, and whether they found the items understandable, confusing or annoying. Items were kept in the questionnaire if they fulfilled pre-defined criteria: relevant to the patients, easy to understand, not confusing, few missing values, neither floor nor ceiling effects, and high variance. A total of 182 thyroid cancer patients in 15 countries participated (n = 115 with papillary, n = 31 with follicular, n = 22 with medullary, n = 6 with anaplastic, and n = 8 with other types of thyroid cancer). Sixty-six percent of the patients needed 15 min or less to complete the questionnaire. Of the 47 items, 31 fulfilled the predefined criteria and were kept unchanged, 14 were removed, and 2 were changed. Shoulder dysfunction was mentioned by 5 patients as missing and an item covering this issue was added. To conclude, the EORTC quality of life module for thyroid cancer (EORTC QLQ-THY34) is ready for the final validation phase IV.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics Epidemiology and Informatics (IMBEI)University Medical Center Mainz, Mainz, Germany
- University Cancer CentreMainz, Germany
| | - Susan Jordan
- QIMR Berghofer Medical Research InstituteHerston, Australia
| | - Laura D Locati
- Head & Neck Medical Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Pinto
- Rehabilitation UnitDepartment of Quality of Life, Istituto Nazionale per lo Studio e la Cura dei Tumori 'Fondazione Giovanni Pascale' - IRCCS, Naples, Italy
| | - Iwona M Tomaszewska
- Department of Medical EducationJagiellonian University Medical College, Krakow, Poland
| | - Cláudia Araújo
- Service of Surgical OncologyInstituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - Eva Hammerlid
- Department of Otolaryngology and Head and Neck SurgerySahlgrenska University Hospital, Gothenburg, Sweden
| | - E Vidhubala
- Department of Psycho-OncologyResource Centre for Tobacco Control, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - Olga Husson
- Department of Medical PsychologyRadboud University Medical Center, Nijmegen, The Netherlands
| | - Naomi Kiyota
- Department of Medical Oncology and HematologyKobe University Hospital, Kobe, Japan
| | - Christine Brannan
- Mount Vernon Cancer CentreEast & North Herts NHS Trust, Northwood, London, UK
| | - Dina Salem
- Clinical OncologyFaculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eva M Gamper
- Department of Nuclear MedicineMedical University of Innsbruck, Innsbruck Institute of Patient-Centred Outcome Research, Innsbruck, Austria
| | | | | | - Guy Andry
- Surgery DepartmentJules Bordet Institute, Brussels, Belgium
| | - Johanna Inhestern
- Clinic of OtorhinolaryngologyJena University Hospital, Jena, Germany
| | - Vincent Grégoire
- Department of Radiation OncologyInstitut de Recherche Experimentale et Clinique, Université Catholique de Louvain, St-Luc University Hospital, Brussels, Belgium
| | - Lisa Licitra
- Head & Neck Medical Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Participation in psychosocial oncology and quality-of-life research: a systematic review. Lancet Oncol 2017; 18:e153-e165. [DOI: 10.1016/s1470-2045(17)30100-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 11/20/2022]
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O'Sullivan C, Lee Dupuis L, Gibson P, Johnston DL, Baggott C, Portwine C, Spiegler B, Kuczynski S, Tomlinson D, Tomlinson GA, Sung L. Evaluation of the electronic self-report Symptom Screening in Pediatrics Tool (SSPedi). BMJ Support Palliat Care 2016; 8:110-116. [DOI: 10.1136/bmjspcare-2015-001084] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 08/18/2016] [Accepted: 10/17/2016] [Indexed: 11/04/2022]
Abstract
ObjectiveWe previously developed the paper-based Symptom Screening in Pediatrics Tool (SSPedi) designed for paediatric cancer symptom screening. Objectives were to evaluate and refine the electronic mobile application (app) of SSPedi using the opinions of children with cancer.MethodsParticipants were children 8–18 years of age with cancer. Participants completed electronic SSPedi on their own and then responded to semistructured questions to determine whether they found electronic SSPedi easy or difficult to complete and understand, understood and liked the app features (audio and animation), and understood previously difficult to understand concepts with the introduction of a help menu. After each group of 10 children, responses were reviewed to determine whether modifications were required.Results20 children evaluated electronic SSPedi. None found electronic SSPedi difficult to complete or understand. All children understood the app features and each of the 4 more difficult to understand concepts after using the help menu. 19 of 20 children thought the app was a good way to communicate with doctors and nurses.ConclusionsWe finalised an electronic version of SSPedi that is easy to use and understand with features specifically designed to facilitate child self-report. Future work will evaluate the psychometric properties of electronic SSPedi.
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Rosenberg AR, Orellana L, Ullrich C, Kang T, Geyer JR, Feudtner C, Dussel V, Wolfe J. Quality of Life in Children With Advanced Cancer: A Report From the PediQUEST Study. J Pain Symptom Manage 2016; 52:243-53. [PMID: 27220948 PMCID: PMC4996729 DOI: 10.1016/j.jpainsymman.2016.04.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/07/2016] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
Abstract
CONTEXT Modifiable factors of health-related quality of life (HRQOL) are poorly described among children with advanced cancer. Symptom distress may be an important factor for intervention. OBJECTIVES We aimed to describe patient-reported HRQOL and its relationship to symptom distress. METHODS Prospective, longitudinal data from the multicenter Pediatric Quality of Life and Symptoms Technology study included primarily patient-reported symptom distress and HRQOL, measured at most weekly with the Memorial Symptoms Assessment Scale and Pediatric Quality of Life inventory, respectively. Associations were evaluated using linear mixed-effects models adjusting for sex, age, cancer type, intervention arm, treatment intensity, and time since disease progression. RESULTS Of 104 enrolled patients, 49% were female, 89% were white, and median age was 12.6 years. Nine hundred and twenty surveys were completed over nine months of follow-up (84% by patients). The median total Pediatric Quality of Life score was 74 (interquartile range 63-87) and was "poor/fair" (e.g., <70) 38% of the time. "Poor/fair" categories were highest in physical (53%) and school (48%) compared to emotional (24%) and social (16%) subscores. Thirteen of 24 symptoms were independently associated with reductions in overall or domain-specific HRQOL. Patients commonly reported distress from two or more symptoms, corresponding to larger HRQOL score reductions. Neither cancer type, time since progression, treatment intensity, sex, nor age was associated with HRQOL scores in multivariable models. Among 25 children completing surveys during the last 12 weeks of life, 11 distressing symptoms were associated with reductions in HRQOL. CONCLUSION Symptom distress is strongly associated with HRQOL. Future research should determine whether alleviating distressing symptoms improves HRQOL in children with advanced cancer.
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Affiliation(s)
- Abby R Rosenberg
- Seattle Children's Hospital Cancer and Blood Disorders Center, Seattle, Washington, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Christina Ullrich
- Department of Psychosocial Oncology and Palliative Care, Boston, Massachusetts, USA; Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | - Tammy Kang
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - J Russell Geyer
- Seattle Children's Hospital Cancer and Blood Disorders Center, Seattle, Washington, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Chris Feudtner
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Veronica Dussel
- Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, USA; Center for Research and Implementation in Palliative Care, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care, Boston, Massachusetts, USA; Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
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Rosenberg AR, Bona K, Wharton CM, Bradford M, Shaffer ML, Wolfe J, Baker KS. Adolescent and Young Adult Patient Engagement and Participation in Survey-Based Research: A Report From the "Resilience in Adolescents and Young Adults With Cancer" Study. Pediatr Blood Cancer 2016; 63:734-6. [PMID: 26681427 PMCID: PMC4755794 DOI: 10.1002/pbc.25843] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 10/22/2015] [Indexed: 11/11/2022]
Abstract
Conducting patient-reported outcomes research with adolescents and young adults (AYAs) is difficult due to low participation rates and high attrition. Forty-seven AYAs with newly diagnosed cancer at two large hospitals were prospectively surveyed at the time of diagnosis and 3-6 and 12-18 months later. A subset participated in 1:1 semistructured interviews. Attrition prompted early study closure at one site. The majority of patients preferred paper-pencil to online surveys. Interview participants were more likely to complete surveys (e.g., 93% vs. 58% completion of 3-6 month surveys, P = 0.02). Engaging patients through qualitative methodologies and using patient-preferred instruments may optimize future research success.
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Affiliation(s)
- Abby R. Rosenberg
- Seattle Children’s Hospital, Cancer and Blood Disorders Center; Seattle, WA,Seattle Children’s Research Institute, Center for Clinical and Translational Research; Seattle, WA,Seattle Children’s Hospital, Treuman Katz Center for Pediatric Bioethics; Seattle, WA,University of Washington, Department of Pediatrics; Seattle, WA
| | - Kira Bona
- Boston Children’s Hospital, Department of Medicine; Boston, MA,Dana-Farber Cancer Institute; Department of Pediatric Oncology; Boston, MA,Harvard Medical School, Department of Pediatric Hematology/Oncology; Boston, MA
| | - Claire M. Wharton
- Seattle Children’s Hospital, Cancer and Blood Disorders Center; Seattle, WA,Seattle Children’s Research Institute, Center for Clinical and Translational Research; Seattle, WA
| | - Miranda Bradford
- Seattle Children’s Research Institute, Center for Clinical and Translational Research; Seattle, WA
| | - Michele L. Shaffer
- Seattle Children’s Research Institute, Center for Clinical and Translational Research; Seattle, WA,University of Washington, Department of Pediatrics; Seattle, WA
| | - Joanne Wolfe
- Boston Children’s Hospital, Department of Medicine; Boston, MA,Harvard Medical School, Department of Pediatric Hematology/Oncology; Boston, MA,Dana-Farber Cancer Institute; Department of Psychosocial Oncology and Palliative Care; Seattle, WA
| | - K. Scott Baker
- Seattle Children’s Hospital, Cancer and Blood Disorders Center; Seattle, WA,Seattle Children’s Research Institute, Center for Clinical and Translational Research; Seattle, WA,University of Washington, Department of Pediatrics; Seattle, WA,Fred Hutchinson Cancer Research Center, Clinical Research Division; Seattle, WA
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Haugen M, Kelly KP, Leonard M, Mills D, Sung L, Mowbray C, Landier W. Nurse-Led Programs to Facilitate Enrollment to Children's Oncology Group Cancer Control Trials. J Pediatr Oncol Nurs 2015; 33:387-91. [PMID: 26611754 DOI: 10.1177/1043454215617458] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The progress made over the past 50 years in disease-directed clinical trials has significantly increased cure rates for children and adolescents with cancer. The Children's Oncology Group (COG) is now conducting more studies that emphasize improving quality of life for young people with cancer. These types of clinical trials are classified as cancer control (CCL) studies by the National Cancer Institute and require different resources and approaches to facilitate adequate accrual and implementation at COG institutions. Several COG institutions that had previously experienced problems with low accruals to CCL trials have successfully implemented local nursing leadership for these types of studies. Successful models of nurses as institutional leaders and "champions" of CCL trials are described.
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Affiliation(s)
- Maureen Haugen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Katherine Patterson Kelly
- The George Washington University School of Nursing, Washington, DC, USA Children's National Health System, Washington, DC, USA
| | | | - Denise Mills
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lillian Sung
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Wendy Landier
- University of Alabama at Birmingham, Birmingham, AL, USA
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Stokke J, Sung L, Gupta A, Lindberg A, Rosenberg AR. Systematic review and meta-analysis of objective and subjective quality of life among pediatric, adolescent, and young adult bone tumor survivors. Pediatr Blood Cancer 2015; 62:1616-29. [PMID: 25820683 PMCID: PMC4515170 DOI: 10.1002/pbc.25514] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 02/23/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pediatric, adolescent, and young adult survivors of bone sarcomas are at risk for poor quality of life (QOL). We conducted a systematic review and meta-analysis to summarize the literature describing QOL in this population and differences in QOL based on local control procedures. PROCEDURE Included studies described ≥5 patients <25 years old who had completed local control treatment for bone sarcoma, defined QOL as a main outcome, and measured it with a validated instrument. Data extraction and quality assessments were conducted with standardized tools. Meta-analyses compared QOL based on surgical procedure (limb-sparing vs. amputation) and were stratified by assessment type (objective physical function, clinician-assessed disability, patient-reported disability, and patient-reported QOL). Effect sizes were reported as the standard mean difference when multiple instruments were used within a comparison and weighted mean difference otherwise. All were weighted by inverse variance and modeled with random effects. RESULTS Twenty-two of 452 unique manuscripts were included in qualitative syntheses, eight of which were included in meta-analyses. Manuscripts were heterogeneous with respect to included patient populations (age, tumor type, time since treatment) and QOL instruments. Prospective studies suggested that QOL improves over time, and that female sex and older age at diagnosis are associated with poor QOL. Meta-analyses showed no differences in outcomes between patients who underwent limb-sparing versus amputation for local control. CONCLUSION QOL studies among children and AYAs with bone sarcoma are remarkably diverse, making it difficult to detect trends in patient outcomes. Future research should focus on standardized QOL instruments and interpretations.
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Affiliation(s)
- Jamie Stokke
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA
| | - Lillian Sung
- Hospital for Sick Children; Toronto, Ontario, CANADA
| | - Abha Gupta
- Hospital for Sick Children; Toronto, Ontario, CANADA,University of Toronto; Toronto, Ontario, CANADA
| | - Antoinette Lindberg
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA
| | - Abby R. Rosenberg
- Seattle Children’s Hospital; Seattle, WA; USA,University of Washington; Seattle, WA; USA,Fred Hutchinson Cancer Research Center, Seattle, WA; USA,Treuman Katz Center for Pediatric Bioethics, Seattle, WA; USA
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Patient-Reported Outcome Coordinator Did Not Improve Quality of Life Assessment Response Rates: A Report from the Children's Oncology Group. PLoS One 2015; 10:e0125290. [PMID: 25915772 PMCID: PMC4411136 DOI: 10.1371/journal.pone.0125290] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/23/2015] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Health related quality of life (HRQL) assessments during therapy for pediatric cancer provide valuable information to better understand the patient experience. Our objective was to determine the impact of a patient-reported outcome (PRO) coordinator on HRQL questionnaire completion rates during a pediatric acute myeloid leukemia (AML) trial. METHODS AAML1031 is a multicenter Children's Oncology Group therapeutic trial for de novo AML with a secondary aim to assess HRQL of children and adolescents treated with chemotherapy and hematopoietic stem cell transplantation (HSCT). Parents/guardians are the primary respondents and four questionnaires are administered at eight time points. The questionnaires are the PedsQL 4.0 Generic Core Scales, PedsQL 3.0 Acute Cancer Module, PedsQL Multidimensional Fatigue Scale, and the Pediatric Inventory for Parents. To improve response rates, a central PRO coordinator was instituted and reminded sites about upcoming and delinquent questionnaires. The proportion of HRQL questionnaires completed were compared prior to, and following institution of the PRO coordinator. This analysis evaluated the first five assessment time points. RESULTS There were231 families who consented to participate in the HRQL aim. Overall response rates for all questionnaires were 73-83%. At time point 1, within 14 days of chemotherapy initiation, post-PRO coordinator completion rates were significantly higher for three of four questionnaires. However, the effect was not sustained and at time point 4, one month following last chemotherapy or HSCT, completion rates were significantly lower post-PRO coordinator for all four questionnaires. CONCLUSION Addition of a central PRO coordinator did not result in sustained improvement in HRQL questionnaire completion rates. Efforts to improve response rates must consider other strategies.
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Whitlow PG, Caparas M, Cullen P, Trask C, Schulte F, Embry L, Nagarajan R, Johnston DL, Sung L. Strategies to improve success of pediatric cancer cooperative group quality of life studies: a report from the Children's Oncology Group. Qual Life Res 2014; 24:1297-301. [PMID: 25429821 DOI: 10.1007/s11136-014-0855-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Quality of life (QoL) has been increasingly emphasized in National Cancer Institute (NCI)-sponsored multisite clinical trials. Little is known about the outcomes of these trials in pediatric cancer. Objectives were to describe the proportion of Children's Oncology Group (COG) QoL studies that successfully accrued subjects and were analyzed, presented or published. METHODS We conducted a survey to describe outcomes of COG QoL studies. We included studies that contained at least one QoL assessment and were closed to patient accrual at the time of survey dissemination. Respondents were the investigators most responsible for the QoL aim. RESULTS Sixteen studies were included; response rate was 100%. Nine (56%) studies were embedded into a cancer treatment trial. Only 3 (19%) studies accrued their intended sample size. Seven (44%) studies were analyzed, 9 (56%) were presented, and 6 (38%) were published. CONCLUSIONS NCI-sponsored pediatric QoL studies have high rates of failure to accrue. Many were not analyzed or disseminated. Using these data, strategies have been implemented to improve conduct in future trials. Monitoring of QoL studies is important to maximize the chances of study success.
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Affiliation(s)
- Puja G Whitlow
- Division of Oncology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave ML 7015, Cincinnati, OH, 45229, USA,
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