1
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Ndirangu K, Chabot I, Lewis K, Lambert A, Zhao Q, Lucero M, Meier G. Disease landscape of advanced HER2-breast cancer patients by treatment line in three EU countries and USA. Future Oncol 2024:1-18. [PMID: 38861292 DOI: 10.2217/fon-2022-1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/26/2024] [Indexed: 06/12/2024] Open
Abstract
Aim: To report treatment patterns and quality of life (QoL) in HER2-negative advanced breast cancer patients. Methods: Data were drawn from a cross-sectional survey in Europe and USA. Results: Hormone plus targeted therapy was the most frequent first-line (1L, 62%) and second-line (2L, 45%) treatment for HR+/HER2-patients. Chemotherapy was most frequent at third-line or greater (3L+, 39%) for HR+/HER2- patients, 2L (51%) and 3L+ (48%) for triple negative breast cancer (TNBC) patients. Time to progression was 13.8 (2L) and 11.0 (3L+) months for HR+/HER2- patients. No comparisons were observed for TNBC patients. EQ-5D-5L scores were highest in patients at 1L and lowest at 3L+. Conclusion: Reduced QoL and treatment response were reported in patients at later lines of therapy.
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Affiliation(s)
| | - Isabelle Chabot
- Faculty of Pharmacy, University of Montreal, Quebec, H3T 1J4, Canada
| | - Katie Lewis
- Adelphi Real World, Bollington, SK10 5JB, UK
| | | | - Qi Zhao
- Eisai Inc. Nutley, NJ 07110, USA
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2
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Qu HM, Zhong HY, Xiao T, Li YJ, Ren P, Chen XJ. Perceived control, self-management efficacy, and quality of life in patients treated with radiation therapy for breast cancer: a longitudinal study. Support Care Cancer 2024; 32:284. [PMID: 38607445 DOI: 10.1007/s00520-024-08485-4] [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: 12/07/2023] [Accepted: 04/03/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE This longitudinal study aims to examine the present state of perceived control, self-management efficacy, and overall quality of life (QoL) in patients with breast cancer undergoing radiotherapy, and gain insight into the dynamic trends and factors that influence the quality of life experienced by patients during the course of radiotherapy. METHODS Participants completed the Cancer Experience and Efficacy Scale (CEES), Strategies Used by People to Promote Health (SUPPH), and Functional Assessment of Cancer Therapy- Breast (FACT-B). The data was analyzed using the software SPSS26.0. Repeated measures analysis of variance (ANOVA) and mixed-effects linear models were used to analyze trends in perceived control, self-management efficacy, and QoL at three-time points, as well as factors affecting QoL during radiotherapy. RESULTS Perceived control and self-management efficacy were associated with QoL over the course of the radiotherapy. Self-management efficacy (β = 0.30, P < 0.001), presence of chemotherapy (β = 18.33, P = 0.024), and duration of illness (β = 2.25, P = 0.028) had a positive effect on the change in QoL, while time (β = - 2.95, P < 0.001), cancer experience (β = - 0.46, P < 0.001), and type of medical insurance (β = - 2.77, P = 0.021) had the negative effect on the change in QoL. CONCLUSION The QoL, perceived control, and self-efficacy of patients with breast cancer show dynamic changes during radiotherapy. The higher the self-efficacy, the better the QoL, and the worse the QoL when the sense of disease control is poor. At the same time, more attention should be paid to the QoL of breast cancer radiotherapy patients with a long course of the disease, receiving chemotherapy, and different medical payment methods.
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Affiliation(s)
- Hai-Mei Qu
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Nursing, Xuanhan County People's Hospital, Dazhou, Sichuan, China
| | - Hong-Yue Zhong
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Tian Xiao
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Yan-Jun Li
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Nursing, Suining Central Hospital, Suining, Sichuan, China
| | - Pan Ren
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Xiao-Ju Chen
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China.
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3
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Zhang J, Liu S, Song J, Zhou J, Zeng Q, Lin Z, Yu K, Zhang S, Qiu M, Chen Y, Hu Z. Improvement of postoperative quality of life in patients with esophageal squamous cell carcinoma: does tea consumption have a role? BMC Public Health 2022; 22:2165. [DOI: 10.1186/s12889-022-14646-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/16/2022] [Indexed: 11/25/2022] Open
Abstract
Abstract
Background
To investigate the effect of tea consumption on the improvement of postoperative quality of life in male patients with esophageal squamous cell carcinoma (ESCC).
Methods
The quality of life information of 290 male patients with ESCC was collected. The time to deterioration and the number of events in each area of quality of life was calculated by time-to-deterioration (TTD) model. The association between postoperative tea drinking and postoperative quality of life in male ESCC patients was investigated using the Cox proportional risk model.
Results
Postoperative tea-drinking patients experienced delayed TTD in multiple domains, including general health, physical, role, emotional, and cognitive function, fatigue, nausea and vomiting, dyspnea, loss of appetite, constipation, diarrhea, eating problems, difficulty swallowing, choking while swallowing saliva, dry mouth, taste difficulties, coughing, and speech problems. The multivariate Cox regression analysis showed that drinking tea after surgery improved quality of life, including physical function (HR = 0.722, 95% CI: 0.559-0.933), role function (HR = 0.740, 95% CI: 0.557-0.983), eating problems (HR = 0.718, 95% CI: 0.537-0.960), odynophagia (HR = 0.682, 95% CI: 0.492-0.945), trouble swallowing saliva (HR = 0.624, 95% CI: 0.444-0.877), coughing (HR = 0.627, 95% CI: 0.442-0.889) and speech problems (HR = 0.631, 95% CI: 0.441-0.903). Furthermore, the improvement was more significant in patients who drank tea before surgery and continued to drink tea after surgery.
Conclusions
Postoperative tea drinking had a positive effect on delay in clinical deterioration and improvements in multiple functions and symptoms associated with ESCC in men.
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Haidari RE, Anota A, Dabakuyo-Yonli TS, Guillemin F, Conroy T, Velten M, Jolly D, Causeret S, Cuisenier J, Graesslin O, Abbas LA, Nerich V. Utility values and its time to deterioration in breast cancer patients after diagnosis and during treatments. Qual Life Res 2022; 31:3077-3085. [PMID: 35590124 DOI: 10.1007/s11136-022-03157-4] [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: 05/01/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The potential effects of breast cancer (BC) on health-related quality of life (HRQoL) should be considered in clinical and policy decision-making, as the economic burden of BC management is currently assessed. In the last decades, time-to-HRQoL score deterioration (TTD) has been proposed as an approach to the analysis of longitudinal HRQoL in oncology. The main objectives of the current study were to investigate the evolution of the utility values in BC patients after diagnosis and during follow-ups and to evaluate the TTD in utility values among women in all stages of BC. METHODS Health-state utility values (HSUV) were assessed using the EuroQol 5-Dimension 3-Level at diagnosis, at the end of the first hospitalization and 3 and 6 months after the first hospitalization. For a given baseline score, HSUV was considered to have deteriorated if this score decreased by ≥ 0.08 points of the EQ-5D utility index score and ≥ 7 points of the EQ visual analogue scale. TTD curves were calculated using the Kaplan-Meier estimation method. RESULTS Overall 381 patients were enrolled between February 2006 and February 2008. The highest proportions of respondents at the baseline and all follow-ups reporting some and extreme problems were in pain discomfort and anxiety/depression dimensions; more than 80% of patients experienced a deterioration in EQ-5D utility index score and EQ VAS score with a median TTD of 3.15 months and 6.24 Months, respectively. CONCLUSIONS BC patients undergoing therapy need psychological support to cope with their discomfort, pain, depression, anxiety, and fear during the process of diagnosis and treatment to improve their QoL.
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Affiliation(s)
- Rana El Haidari
- INSERM (French Institut of Health and Medical Research), UMR1098 (Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique), EFS BFC (Etablissement Français du Sang Bourgogne Franche-Comté), University of Bourgogne Franche-Comté, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire Et Génique, 25000, Besançon, France.
| | - Amelie Anota
- Biostatistics Unit, Department of Clinical Research and Innovation & Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France.,French National Platform Quality of Life and Cancer, Montpellier, France
| | - Tienhan S Dabakuyo-Yonli
- French National Platform Quality of Life and Cancer, Montpellier, France.,Biostatistics and Epidemiology Unit, Centre Georges François Leclerc, 1 rue Professeur Marion, Dijon, France
| | - Francis Guillemin
- French National Platform Quality of Life and Cancer, Montpellier, France.,CHRU Nancy, Inserm, Université de Lorraine, CIC Epidemiologie Clinique, Nancy, France
| | - Thierry Conroy
- Institut de Cancérologie de Lorraine, Medical Oncology Department, 54519, Vandoeuvre-lès-Nancy, France.,Université de Lorraine, APEMAC, Équipe MICS, 54000, Nancy, France
| | - Michel Velten
- French National Platform Quality of Life and Cancer, Montpellier, France.,Department of Epidemiology and Public Health, Faculty of Medicine, University of Strasbourg, 3430, Strasbourg, EA, France.,Department of Epidemiology and Biostatistics, Paul Strauss Comprehensive Cancer Center, Strasbourg, France
| | - Damien Jolly
- French National Platform Quality of Life and Cancer, Montpellier, France.,Clinical Epidemiology Department, Hôpital Robert. Debré, University Hospital, Rue du Général Koenig, 51092, Reims cedex, France
| | - Sylvain Causeret
- Surgery Department, Centre Georges François Leclerc, Dijon, France
| | - Jean Cuisenier
- Surgery Department, Centre Georges François Leclerc, Dijon, France
| | - Olivier Graesslin
- Gynecological and Obstetric Department, Institut Mère Enfant, University Hospital of Reims, URCA (Université de Reims Champagne Ardenne), Reims, France
| | - Linda Abou Abbas
- Faculty of Medical Sciences, Neuroscience Research Center, Lebanese university, Beirut, 1001, Lebanon
| | - Virginie Nerich
- Biostatistics Unit, Department of Clinical Research and Innovation & Department of Human and Social Sciences, Centre Léon Bérard, Lyon, France.,Department of Pharmacy, University Hospital of Besançon, 25030, Besançon, France
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5
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Brusniak K, Feisst M, Sebesteny L, Hartkopf A, Graf J, Engler T, Schneeweiss A, Wallwiener M, Deutsch TM. Measuring the Time to Deterioration for Health-Related Quality of Life in Patients With Metastatic Breast Cancer Using a Web-Based Monitoring Application: Longitudinal Cohort Study. JMIR Cancer 2021; 7:e25776. [PMID: 34636732 PMCID: PMC8548964 DOI: 10.2196/25776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/27/2021] [Accepted: 07/21/2021] [Indexed: 01/30/2023] Open
Abstract
Background Health-related quality of life (HRQoL) is used to evaluate the treatment of metastatic breast cancer. In a long-term therapy setting, HRQoL can be used as an important benchmark for treatment success. With the help of digital apps, HRQoL monitoring can be extended to more remote areas and be administered on a more frequent basis. Objective This study aims to evaluate 3 common HRQoL questionnaires in metastasized breast cancer in terms of TTD in a digital, web-based setting. We further aim to examine the development of the HRQoL in different systemic treatment groups in each of these evaluation instruments. Methods A total of 192 patients with metastatic breast cancer were analyzed in this bicentric prospective online cohort study at two German university hospitals. Patients completed questionnaires on HRQoL (EuroQol Visual Analog Scale [EQ-VAS], EuroQol 5 Dimension 5 Level [EQ-5D-5L], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 item [EORTC QLQ-C30]) via an online platform over a 6-month period. Treatment schedules and medical history were retrieved from medical records. Unadjusted Cox regression analysis on treatment-related factors was performed. We conducted subgroup analyses in regard to TTD events between different treatments. Results The EQ-VAS showed a higher rate of deterioration after 8 weeks (84/179, 46.9%) than the EQ-5D-5L (47/163, 28.8%) and EORTC QLQ-C30 (65/176, 36.9%). Unadjusted Cox regression revealed significant connections between known metastases in the liver (P=.03, HR 1.64, 95% CI 1.06-2.52) and pleura (P=.04, HR 0.42, 95% CI 0.18-0.96) in the EQ-VAS. Significant relations between EQ-VAS events and single EQ-5D-5L items and the EQ-5D-5L summary score were demonstrated. All treatment groups significantly differed from the CDK4/6 inhibition subgroup in the EQ-VAS. Conclusions Compared to the EQ-5D-5L and QLQ-C30, the EQ-VAS showed a higher rate of deterioration after 8 weeks. Significant connections to certain metastatic locations were only detected in the EQ-VAS. The EQ-VAS is capable of reflecting the distinctive HRQoL profiles of different systemic treatments as well as the different aspects of HRQoL presented in the EQ-5D-5L. TTD with the EQ-VAS is an adequate mean of examining longitudinal development of HRQoL among breast cancer patients.
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Affiliation(s)
- Katharina Brusniak
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Manuel Feisst
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Linda Sebesteny
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Hartkopf
- Department of Women's Health, University Hospital Tübingen, Tübingen, Germany
| | - Joachim Graf
- Department of Women's Health, University Hospital Tübingen, Tübingen, Germany.,Department of Midwifery Science, Institute for Health Sciences, University Hospital Tübingen, Tübingen, Germany
| | - Tobias Engler
- Department of Women's Health, University Hospital Tübingen, Tübingen, Germany.,Department of Midwifery Science, Institute for Health Sciences, University Hospital Tübingen, Tübingen, Germany
| | - Andreas Schneeweiss
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany.,German Cancer Research Center, Heidelberg, Germany
| | - Markus Wallwiener
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany
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6
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Curb Your Enthusiasm: Definitions, Adaptation, and Expectations for Quality of Life in ICU Survivorship. Ann Am Thorac Soc 2021; 17:406-411. [PMID: 31944829 DOI: 10.1513/annalsats.201910-772ip] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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7
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Sutradhar R, Barbera L. Multistate Models for Examining the Progression of Intermittently Measured Patient-Reported Symptoms Among Patients With Cancer: The Importance of Accounting for Interval Censoring. J Pain Symptom Manage 2021; 61:54-62. [PMID: 32688014 DOI: 10.1016/j.jpainsymman.2020.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/07/2020] [Accepted: 07/11/2020] [Indexed: 11/22/2022]
Abstract
CONTEXT Patients with cancer in Ontario, Canada, receive symptom monitoring in a standardized fashion using the Edmonton Symptom Assessment System (ESAS). These measurements can be used to understand symptom progression during the cancer trajectory. OBJECTIVES This study demonstrates the implementation of multistate models for examining symptom progression, while appropriately accounting for intermittent observation. We also compare the estimates when the panel nature of the data is ignored. METHODS This was a population-based retrospective cohort study using linked administrative health-care databases. The cohort consisted of patients who were newly diagnosed with a primary cancer and had at least one ESAS assessment completed between 2007 and 2015 in Ontario, Canada. A 5-state model was developed to examine the progression of symptom severity, where estimation was conducted with and without accommodating for the panel nature of the symptom data. RESULTS The study cohort consisted of 212,615 patients diagnosed with cancer, collectively having 1,006,360 ESAS assessments within the first year after diagnosis. The median (interquartile range) of the number of ESAS assessments per patient was 3 (1-6), and the average gap time between consecutive assessments was approximately three months. The estimated mean sojourn time in each state was consistently and significantly greater when ignoring interval censoring than when accounting for it. This held true for all states and symptoms. CONCLUSION Our work demonstrates the use of multistate models and the importance of accommodating for intermittent observation when examining symptom progression using ESAS among patients with cancer. This work serves as a methodological guide for applied researchers interested in modeling disease progression under the presence of intermittent observation.
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Affiliation(s)
- Rinku Sutradhar
- ICES, Toronto, Ontario, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Lisa Barbera
- ICES, Toronto, Ontario, Canada; Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
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8
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Yu HW, An AR, Kang HI, Suh YJ, Kwon H, Kim SJ, Chai YJ, Choi JY, Choi H, Lee KE, Cho B. Does Thyroidectomy Impact Quality of Life: Retrospective Case-Control Study of Post-Thyroidectomy Patients and Matched Individuals from the General Population. ACTA ACUST UNITED AC 2020; 56:medicina56110603. [PMID: 33182641 PMCID: PMC7697461 DOI: 10.3390/medicina56110603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/01/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: The study assesses quality of life (QoL) in patients who underwent thyroidectomy compared to the general population. Materials and Methods: QoL data from post-thyroidectomy patients and individuals with no subjective health concerns, who had attended a routine health screening visit, were evaluated. QoL was assessed using the modified version of Korean Short Form 12 questionnaire (SF-12). Patients and controls were matched using the propensity score approach and a ratio of 1:4. Results: Data from a total of 105 patients and 420 controls were analyzed. For five SF-12 items, lower QoL was found in patients (p < 0.05). Multivariate analysis revealed that a follow-up duration of <1-year, female sex, and an age of >50 years were independent risk factors. No significant difference was found between controls and patients who were >1-year post-surgery. Conclusions: For specific SF-12 items, QoL was lower in post-thyroidectomy patients than in controls. No intergroup difference in QoL was found >1-year post-surgery.
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Affiliation(s)
- Hyeong Won Yu
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (H.W.Y.); (J.Y.C.)
| | - Ah Reum An
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center and College of Medicine, Seoul 06236, Korea; (A.R.A.); (B.C.)
| | - Hye In Kang
- Department of Surgery, Seoul National University Hospital, Seoul 03080, Korea;
| | - Yong Joon Suh
- Department of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Korea;
| | - Hyungju Kwon
- Department of Surgery, Ewha Womans University College of Medicine, Seoul 07985, Korea;
| | - Su-jin Kim
- Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul 03080, Korea;
- Correspondence: (S.-j.K.); (H.C.)
| | - Young Jun Chai
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul 07061, Korea;
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea; (H.W.Y.); (J.Y.C.)
| | - Hochun Choi
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center and College of Medicine, Seoul 06236, Korea; (A.R.A.); (B.C.)
- Correspondence: (S.-j.K.); (H.C.)
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul 03080, Korea;
| | - Belong Cho
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center and College of Medicine, Seoul 06236, Korea; (A.R.A.); (B.C.)
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Ilie G, Bradfield J, Moodie L, Lawen T, Ilie A, Lawen Z, Blackman C, Gainer R, Rutledge RDH. The Role of Response-Shift in Studies Assessing Quality of Life Outcomes Among Cancer Patients: A Systematic Review. Front Oncol 2019; 9:783. [PMID: 31482068 PMCID: PMC6710367 DOI: 10.3389/fonc.2019.00783] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/02/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: Response-shift has been cited as an important measurement consideration when assessing patient reported quality of life (QoL) outcomes over time among patients with severe chronic conditions. Here we report the results of a systematic review of response shift in studies assessing QoL among cancer patients. Methods: A systematic review using MEDLINE, EMBASE, and PsychINFO along with a manual search of the cited references of the articles selected, was conducted. A quality review was performed using STROBE criteria and reported according to PRISMA guidelines. Results: A systematic review of 1,487 records published between 1,887 and December 2018 revealed 104 potentially eligible studies, and 35 studies met inclusion criteria for content and quality. The most common cancer patient populations investigated in these studies were breast (18 studies), lung (14 studies), prostate (eight studies), and colorectal (eight studies). Response shift was identified among 34 of the 35 studies reviewed. Effect sizes were reported in 17 studies assessing QoL outcomes among cancer patients; 12 of which had negligible to small effect sizes, four reported medium effect sizes which were related to physical, global QoL, pain, and social (role) functioning and one reported a large effect size (fatigue). The most prevalent method for assessing response shift was the then-test, which is prone to recall bias, followed by the pre-test and post-test method. Given the heterogeneity among the characteristics of the samples and designs reviewed, as well as the overall small to negligible effect sizes for the effects reported, conclusions stating that changes due to internal cognitive shifts in perceived QoL should account for changes observed in cancer patients' QoL outcomes should be interpreted with caution. Conclusion: Further work is needed in this area of research. Future studies should control for patient characteristics, time elapsed between diagnosis and baseline assessment and evaluate their contribution to the presence of response shift. Time between assessments should include short and longer periods between assessments and evaluate whether the presence of response shift holds over time. Possible avenues for inquiry for future investigation are discussed.
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Affiliation(s)
- Gabriela Ilie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Urology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Jillian Bradfield
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Louise Moodie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Tarek Lawen
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Urology, Halifax Infirmary-QEII-Nova Scotia Health Authority, Halifax Regional Municipality, NS, Canada
| | - Alzena Ilie
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Zeina Lawen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Chloe Blackman
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Ryan Gainer
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Robert D H Rutledge
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada.,Nova Scotia Cancer Centre, Queen Elizabeth II Health Sciences Centre, Halifax Regional Municipality, NS, Canada
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10
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Villar RR, Fernández SP, Garea CC, Pillado MTS, Barreiro VB, Martín CG. Quality of life and anxiety in women with breast cancer before and after treatment. Rev Lat Am Enfermagem 2017; 25:e2958. [PMID: 29267541 PMCID: PMC5738954 DOI: 10.1590/1518-8345.2258.2958] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/30/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives: to determine the quality of life and anxiety in patients with breast cancer and
the changes they experience after treatments. Method: prospective study. Breast cancer statistics (n=339, confidence=95%, accuracy= ±
5.32%). The quality of life questionnaires (QLQ) used were QLQ C-30 and QLQ Br23,
and the State-Trait Anxiety Inventory (STAI) was used for anxiety. A multivariate
analysis was performed to identify variables associated with baseline quality of
life and anxiety as well as pre- and post-treatment differences. Authorization was
obtained from the Ethics Committee, and informed consent was provided by all
patients. Results: the baseline quality of life dimensions with the lowest score were future
prospects (46.0/100) and sexual enjoyment (55.7/100). The dimensions with the
highest score were body image (94.2/100) and role (93.3/100). The most disturbing
symptoms were insomnia, fatigue and concern about hair loss. After treatment, the
dimensions of physical function, role, body image, financial concerns and
symptomatology worsened, whereas emotional function and future prospects improved.
Severe anxiety presented as a state (48.6%) and as a trait (18.2%). The highest
baseline state anxiety was associated with married-widowed status and anxiolytic
medication. The greatest trait anxiety was associated with an inactive work
situation, anxiolytic medication, breast swelling and advanced stage at diagnosis.
After treatment, anxiety significantly decreased. Conclusions: After treatment, the quality of life score was positively modified, while state
and trait anxiety decreased.
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Affiliation(s)
- Raquel Rey Villar
- Doctoral student, Universidad de A Coruña, A Coruña, A Coruña, Spain. RN, Universidad de A Coruña, A Coruña, A Coruña, Spain
| | | | - Carmen Cereijo Garea
- Doctoral student, Universidad de A Coruña, A Coruña, A Coruña, Spain. RN, Universidad de A Coruña, A Coruña, A Coruña, Spain
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11
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Zhou Z, Tang DH, Xie J, Ayyagari R, Wu E, Niravath PA. Systematic Literature Review of the Impact of Endocrine Monotherapy and in Combination with Targeted Therapy on Quality of Life of Postmenopausal Women with HR+/HER2- Advanced Breast Cancer. Adv Ther 2017; 34:2566-2584. [PMID: 29143928 DOI: 10.1007/s12325-017-0644-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Indexed: 12/22/2022]
Abstract
INTRODUCTION A major treatment goal for advanced breast cancer (ABC) is to maintain or ideally improve patient quality of life (QoL). Given the changing disease landscape, this systematic literature review (SLR) aims to assess the impact of endocrine therapies (ET), including ET monotherapy (ET mono) and ET combined with targeted therapy (ET + TT), on QoL of women with HR+/HER2- ABC. METHODS A SLR was conducted to identify randomized controlled trials (RCTs) meeting the following criteria: (1) included ET mono or ET + TT, (2) reported QoL outcomes, (3) focused on women with HR+/HER2- ABC, and (4) published after 2007 (when standardized HER2 testing became available). The databases searched included MEDLINE, EMBASE, Cochrane Library, and key conference proceedings from 2013 to 2016. QoL outcomes for ET mono, ET + TT, and comparisons between the two were summarized from the identified trials. RESULTS A total of 11 studies (representing 6 RCTs) were identified. The study populations included first-line (5 studies) and ET-failure settings (6 studies). Across settings, global health status (GHS) maintained or deteriorated slightly on these treatments during the trial period. Time to deterioration (TTD) in QoL measured by GHS was analyzed in 6 studies and 4 RCTs. In the first-line setting, reported median TTD in GHS was similar between ET mono and ET + TT (7.2-13.8 months in ET mono; 11.1 months in ET + TT). In the ET-failure setting, ET + TT showed significantly longer TTD vs. ET mono in GHS (median 5.6-8.4 months in ET mono and 8.3-11.7 months in ET + TT) and some additional domains. CONCLUSIONS ET + TT users experienced similar QoL in the first-line and ET-failure setting relative to patients on ET mono. Moreover, ET + TT users experienced better QoL outcomes in some domains in the ET-failure setting relative to ET mono users. FUNDING Novartis.
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12
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Hinz A. Using Anchoring Vignettes in the Evaluation of Breast Cancer Survivors' Quality of Life. Breast Care (Basel) 2017; 12:34-38. [PMID: 28611539 DOI: 10.1159/000455002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast cancer survivors often rate their general health as good even though they experience detriments in functioning and multiple symptoms. The hypothesis of this study is that breast cancer survivors changed their frames of reference for evaluating their own health. METHODS A sample of 308 breast cancer survivors were asked to assess their state of health on a 0-100 scale. In addition, 2 vignettes (fictional persons suffering from various health complaints) were designed. The cancer survivors were asked to assess the health of the characters in these vignettes as well. A sample of the general population (n = 639) served as controls. RESULTS There were only marginal differences between the cancer survivors (M = 65.8) and the controls (M = 65.5) in how they assessed their own state of health. However, the cancer survivors rated the vignette character with physical problems as being significantly healthier compared to the general population (effect size: d = 0.55). The group differences in the assessment of the vignette character with mental problems was markedly lower (d = 0.12). CONCLUSIONS It is not sufficient to assess the general self-assessed health state of cancer survivors. Anchoring vignettes are a promising tool for use in correcting for response shift effects.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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Elberg Dengsø K, Hillingsø J, Marcussen AM, Thomsen T. Health-related quality of life and anxiety and depression in patients diagnosed with cholangiocarcinoma: a prospective cohort study. Acta Oncol 2017; 56:198-204. [PMID: 28042709 DOI: 10.1080/0284186x.2016.1266088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cholangiocarcinoma (CCA) is a rare cancer associated with a poor prognosis. Psychosocial challenges may negatively affect daily functioning and health-related quality of life (HRQOL). The primary aim was to evaluate HRQOL, and to assess anxiety and depression in these patients. MATERIAL AND METHODS From 93 eligible patients diagnosed with CCA, 76 were included in a prospective cohort over a period of 15 months. Patients answered the European Organization for Research and Treatment of Cancer QLQ C30 (EORTC QLQ C30) and Hospital Anxiety and Depression Scale (HADS) questionnaires at baseline, one, three and six months after initial treatment; defined as radical operation, explorative laparotomy, chemotherapy or drainage of the bile ducts. Scores were compared between the radically operated patients (n = 25) and palliative patients (n = 51; 12 of these had explorative laparotomy), using repeated measures ANOVA and unpaired ANOVA. RESULTS The groups were similar in demographic characteristics, except for fewer radically operated men (p = 0.015). There was no significant change over time in HRQOL in total or between groups. At baseline nausea and vomiting scores were higher in the palliative group (p = 0.035), and at one month follow-up, the radical group had higher pain scores (p = 0.009). The majority reported normal/mild anxiety and depression throughout the study; there were no differences between the groups. CONCLUSIONS It was not possible to measure any differences between the groups, regarding HRQOL, anxiety or depression, despite the fact that one of the groups had the prospect of total cure. In clinical settings, observed mean changes in HRQOL scores are generally small; probably due to psychological adaptation by patients to changing health status over time.
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Affiliation(s)
- Kristine Elberg Dengsø
- Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Copenhagen, Denmark
| | - Jens Hillingsø
- Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Copenhagen, Denmark
| | | | - Thordis Thomsen
- Abdominal Centre, Rigshospitalet, University of Copenhagen, Health and Medical Sciences, Copenhagen, Denmark
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Is there a response shift in generic health-related quality of life 6 months after glioma surgery? Acta Neurochir (Wien) 2017; 159:377-384. [PMID: 27928631 PMCID: PMC5241331 DOI: 10.1007/s00701-016-3040-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/23/2016] [Indexed: 11/27/2022]
Abstract
Background Patients may recalibrate internal standards when faced with a serious diagnosis or neurological deficits. This so-called response shift is important to understand in longitudinal health-related quality of life (HRQoL) data, but this is not quantitatively assessed in glioma patients. Methods Patients with gliomas were eligible for this HRQoL study. We used EuroQol-5D 3 L to assess generic HRQoL with assessment preoperatively and at 6 months postoperatively. At time of follow-up, patients scored how they considered their baseline HRQoL in retrospect using the same questionnaire (“then-test”). Results Seventy-three patients were enrolled between January 2013 and September 2015. With the then-test approach, the mean EQ-5D 3 L index was similar compared to baseline (0.77, mean difference 0.01, 95% CI −0.57 to 0.07, p = 0.82). Also, then-test and baseline VAS score were similar (mean difference 0, 95% CI −7 to 7, p = 0.97). However, a 0.10–0.13 difference from baseline was observed in patients that improved or deteriorated in HRQoL at follow-up according to the then-test EQ-5D 3 L index value. The direction of change as observed from the then-test was similar to the direction of clinical change, reducing the impact of any HRQoL change from baseline to follow-up. Conclusions On average, we observed no response shift using EQ-5D 3 L in the selection of glioma patients able to participate at 6 months after surgery. However, following change in HRQoL at follow-up, response shift seems to reduce the effects of HRQoL changes by lowering of internal standards in patients that deteriorate and raising the standards in patients that improve.
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Evaluation of efficacy and safety for recombinant human adenovirus-p53 in the control of the malignant pleural effusions via thoracic perfusion. Sci Rep 2016; 6:39355. [PMID: 27976709 PMCID: PMC5157052 DOI: 10.1038/srep39355] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/22/2016] [Indexed: 02/08/2023] Open
Abstract
A certain number of studies have showed that p53 gene transfer has an anti-tumor activity in vitro and in vivo. This study was to evaluate the efficacy and safety of thoracic perfusion of recombinant human adenovirus p53 (rAd-p53, Gendicine) for controlling malignant pleural effusion (MPE). We searched for the relevant studies from the database of MEDLINE, Web of Science, EMBASE, Cochrance Library and CNKI to collect the trials concerning the efficacy and safety of rAd-p53 to treat MPE. Fourteen randomised controlled trials (RCTs) with 879 patients were involved in this analysis. The rAd-p53 combined with chemotherapeutic agents significantly improved the overall response rate (ORR) (P < 0.001; odds ratio = 3.73) and disease control rate (DCR) (P < 0.001; odds ratio = 2.32) of patients with MPE as well as the quality of life (QOL) of patients (P < 0.001; odds ratio = 4.27), compared with that of chemotherapeutic agents alone. In addition, the participation of rAd-p53 did not have an obvious impact on the most of incidence of adverse reactions (AEs) (P < 0.05) except the fever (P < 0.001). However, the fever was self-limited and could be tolerated well. The application of rAd-p53 through thoracic perfusion for treating MPE had a better efficacy and safety, which could be a potential choice for controlling MPE.
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Ousmen A, Conroy T, Guillemin F, Velten M, Jolly D, Mercier M, Causeret S, Cuisenier J, Graesslin O, Hamidou Z, Bonnetain F, Anota A. Impact of the occurrence of a response shift on the determination of the minimal important difference in a health-related quality of life score over time. Health Qual Life Outcomes 2016; 14:167. [PMID: 27914467 PMCID: PMC5135836 DOI: 10.1186/s12955-016-0569-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 11/29/2016] [Indexed: 11/12/2022] Open
Abstract
Background An important challenge of the longitudinal analysis of health-related quality of life (HRQOL) is the potential occurrence of a Response Shift (RS) effect. While the impact of RS effect on the longitudinal analysis of HRQOL has already been studied, few studies have been conducted on its impact on the determination of the Minimal Important Difference (MID). This study aims to investigate the impact of the RS effect on the determination of the MID over time for each scale of both EORTC QLQ-C30 and QLQ-BR23 questionnaires in breast cancer patients. Methods Patients with breast cancer completed the EORTC QLQ-C30 and the EORTC QLQ-BR23 questionnaires at baseline (time of diagnosis; T0), three months (T1) and six months after surgery (T2). Four hospitals and care centers participated in this study: cancer centers of Dijon and Nancy, the university hospitals of Reims and Strasbourg At T1 and T2, patients were asked to evaluate their HRQOL change during the last 3 months using the Jaeschke transition question. They were also asked to assess retrospectively their HRQOL level of three months ago. The occurrence of the RS effect was explored using the then-test method and its impact on the determination of the MID by using the Anchor-based method. Results Between February 2006 and February 2008, 381 patients were included of mean age 58 years old (SD = 11). For patients who reported a deterioration of their HRQOL level at each follow-up, an increase of RS effect has been detected between T1 and T2 in 13/15 dimensions of QLQ-C30 questionnaire, and 4/7 dimensions of QLQ-BR23 questionnaire. In contrast, a decrease of the RS effect was observed in 8/15 dimensions of QLQ-C30 questionnaire and in 5/7 dimensions of QLQ-BR23 questionnaire in case of improvement. At T2, the MID became ≥ 5 points when taking into account the RS effect in 10/15 dimensions of QLQ-C30 questionnaire and in 5/7 dimensions of QLQ-BR23 questionnaire. Conclusions This study highlights that the RS effect increases over time in case of deterioration and decreases in case of improvement. Moreover, taking the RS into account produces a reliable and significant MID. Electronic supplementary material The online version of this article (doi:10.1186/s12955-016-0569-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ahmad Ousmen
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France. .,INSERM UMR 1098, University of Franche-Comte, Besançon, France.
| | - Thierry Conroy
- Medical Oncology Department, Centre Alexis Vautrin, Nancy, France.,French National Platform Quality of Life and Cancer, Besançon, France
| | - Francis Guillemin
- French National Platform Quality of Life and Cancer, Besançon, France.,Inserm CIC-EC 1433, and CHU, Clinical Epidemiology and Evaluation Department, Nancy, France
| | - Michel Velten
- French National Platform Quality of Life and Cancer, Besançon, France.,Department of Epidemiology and Public Health, Faculty of Medicine, EA 3430, University of Strasbourg, Strasbourg, France
| | - Damien Jolly
- French National Platform Quality of Life and Cancer, Besançon, France.,Pôle Recherche - Innovations, University Hospital of Reims, Reims, France
| | - Mariette Mercier
- INSERM UMR 1098, University of Franche-Comte, Besançon, France.,French National Platform Quality of Life and Cancer, Besançon, France
| | - Sylvain Causeret
- Surgery Department, Centre Georges François Leclerc, Dijon, France
| | - Jean Cuisenier
- Surgery Department, Centre Georges François Leclerc, Dijon, France
| | - Olivier Graesslin
- Gynecological and Obstetric Department, Institut Mère Enfant, University Hospital of Reims, Reims, France
| | - Zeinab Hamidou
- French National Platform Quality of Life and Cancer, Besançon, France.,Public health laboratory, EA 3279, Aix-Marseille University, Marseille, France
| | - Franck Bonnetain
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France.,INSERM UMR 1098, University of Franche-Comte, Besançon, France.,French National Platform Quality of Life and Cancer, Besançon, France
| | - Amélie Anota
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France.,INSERM UMR 1098, University of Franche-Comte, Besançon, France.,French National Platform Quality of Life and Cancer, Besançon, France
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17
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Tang F, Wang J, Tang Z, Kang M, Deng Q, Yu J. Quality of Life and Its Association with Physical Activity among Different Types of Cancer Survivors. PLoS One 2016; 11:e0164971. [PMID: 27812130 PMCID: PMC5094752 DOI: 10.1371/journal.pone.0164971] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 10/04/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose The main goal of this study was to compare the quality of life (QOL) and its association with physical activity (PA) among patients diagnosed with different types of cancer. Based on the results, we tentatively present suggestions for the cancer health care model. Method A cross-sectional study was conducted with 2915 cancer survivors recruited from multi-community cancer rehabilitation centers, all of which were affiliated with the Shanghai Cancer Rehabilitation Club. We collected data including socio-demographic characteristics and information about PA. All the subjects included were asked to complete the European Organization for Research and Treatment Quality of Life Questionnaires (EORTC QLQ-C30) and Functional Assessment of Cancer Therapy—General Questionnaire (FACT-G). Multiple linear regression models were employed to control the potential confounding factors. Results Lung cancer survivors reported the worst dyspnea. Colorectal cancer survivors claimed the highest level of constipation and diarrhea. Liver cancer survivors indicated greatest loss of appetite and financial difficulties. Generally, survivors with PA tended to reported better QOL, although these associations among liver cancer survivors were not statistically significant. Moreover, survivors of all cancer types who performed PA did not report significant lower level of constipation or diarrhea. The relationship between PA frequency and QOL among cancer survivors remained unexplored. Conclusions Both QOL and its association with PA vary among survivors of different cancer types. The detailed results can assist clinicians and public health practitioners with improving health care management.
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Affiliation(s)
- Furong Tang
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Jiwei Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Zheng Tang
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Mei Kang
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Qinglong Deng
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Jinming Yu
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- * E-mail:
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Ho PJ, Marlton P, Tam C, Stevenson W, Ritchie D, Bird R, Dunlop LC, Durrant S, Ross DM. Practical management of myelofibrosis with ruxolitinib. Intern Med J 2015; 45:1221-30. [DOI: 10.1111/imj.12921] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 09/17/2015] [Indexed: 12/24/2022]
Affiliation(s)
- P. J. Ho
- Institute of Haematology; Royal Prince Alfred Hospital; Sydney New South Wales Australia
- University of Sydney; Sydney New South Wales Australia
| | - P. Marlton
- Princess Alexandra Hospital; Brisbane Queensland Australia
- University of Queensland School of Medicine; Brisbane Queensland Australia
| | - C. Tam
- Department of Haematology; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - W. Stevenson
- Department of Haematology and Transfusion Medicine; Royal North Shore Hospital; Sydney New South Wales Australia
| | - D. Ritchie
- Clinical Haematology and BMT Service; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - R. Bird
- Princess Alexandra Hospital; Brisbane Queensland Australia
- School of Medicine; Griffith University; Brisbane Queensland Australia
| | - L. C. Dunlop
- Haematology Department; Liverpool Hospital; Sydney New South Wales Australia
- School of Medicine; Western Sydney University; Sydney New South Wales Australia
| | - S. Durrant
- Department of Bone Marrow Transplant and Clinical Haematology; Royal Brisbane Hospital; Brisbane Queensland Australia
| | - D. M. Ross
- Haematology Directorate; SA Pathology; Adelaide South Australia Australia
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Kao HY, Wu WH, Liang TY, Lee KT, Hou MF, Shi HY. Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery. PLoS One 2015; 10:e0139252. [PMID: 26422018 PMCID: PMC4589455 DOI: 10.1371/journal.pone.0139252] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 09/09/2015] [Indexed: 11/18/2022] Open
Abstract
Objective Although recent studies have improved understanding of quality of life (QOL) outcomes of breast conserving surgery, few have used longitudinal data for more than two time points, and few have examined predictors of QOL over two years. Additionally, the longitudinal data analyses in such studies rarely apply the appropriate statistical methodology to control for censoring and inter-correlations arising from repeated measures obtained from the same patient pool. This study evaluated an internet-based system for measuring longitudinal changes in QOL and developed a cloud-based system for managing patients after breast conserving surgery. Methods This prospective study analyzed 657 breast cancer patients treated at three tertiary academic hospitals. Related hospital personnel such as surgeons and other healthcare professionals were also interviewed to determine the requirements for an effective cloud-based system for surveying QOL in breast cancer patients. All patients completed the SF-36, Quality of Life Questionnaire (QLQ-C30) and its supplementary breast cancer measure (QLQ-BR23) at baseline, 6 months, 1 year, 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 before and after surgery. Results All breast cancer surgery patients had significantly improved QLQ-C30 and QLQ-BR23 subscale scores throughout the 2-year follow-up period (p<0.05). During the study period, QOL generally had a negative association with advanced age, high Charlson comorbidity index score, tumor stage III or IV, previous chemotherapy, and long post-operative LOS. Conversely, QOL was positively associated with previous radiotherapy and hormone therapy. Additionally, patients with high scores for preoperative QOL tended to have high scores for QLQ-C30, QLQ-BR23 and SF-36 subscales. Based on the results of usability testing, the five constructs were rated on a Likert scale from 1–7 as follows: system usefulness (5.6±1.8), ease of use (5.6±1.5), information quality (5.4±1.4), interface quality (5.5±1.4), and overall satisfaction (5.5±1.6). Conclusions The current trend in clinical medicine is applying therapies and interventions that improve QOL. Therefore, a potentially vast amount of internet-based QOL data is available for use in defining patient populations that may benefit from therapeutic intervention. Additionally, before undergoing breast conserving surgery, patients should be advised that their postoperative QOL depends not only on the success of the surgery, but also on their preoperative functional status.
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Affiliation(s)
- Hao-Yun Kao
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
| | - Wen-Hsiung Wu
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
| | - Tyng-Yeu Liang
- Department of Electrical Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, R.O.C.
| | - King-The Lee
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
| | - Ming-Feng Hou
- Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
- Cancer Center, Kaohsiung Medical University Hospital, 807 Kaohsiung, Taiwan, R.O.C.
- National Sun Yat-Sen University-Kaohsiung Medical University Joint Research Center, 80708 Kaohsiung, Taiwan, R.O.C.
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
- * E-mail:
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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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Anota A, Barbieri A, Savina M, Pam A, Gourgou-Bourgade S, Bonnetain F, Bascoul-Mollevi C. Comparison of three longitudinal analysis models for the health-related quality of life in oncology: a simulation study. Health Qual Life Outcomes 2014; 12:192. [PMID: 25551580 PMCID: PMC4326524 DOI: 10.1186/s12955-014-0192-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/12/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Health-Related Quality of Life (HRQoL) is an important endpoint in oncology clinical trials aiming to investigate the clinical benefit of new therapeutic strategies for the patient. However, the longitudinal analysis of HRQoL remains complex and unstandardized. There is clearly a need to propose accessible statistical methods and meaningful results for clinicians. The objective of this study was to compare three strategies for longitudinal analyses of HRQoL data in oncology clinical trials through a simulation study. METHODS The methods proposed were: the score and mixed model (SM); a survival analysis approach based on the time to HRQoL score deterioration (TTD); and the longitudinal partial credit model (LPCM). Simulations compared the methods in terms of type I error and statistical power of the test of an interaction effect between treatment arm and time. Several simulation scenarios were explored based on the EORTC HRQoL questionnaires and varying the number of patients (100, 200 or 300), items (1, 2 or 4) and response categories per item (4 or 7). Five or 10 measurement times were considered, with correlations ranging from low to high between each measure. The impact of informative missing data on these methods was also studied to reflect the reality of most clinical trials. RESULTS With complete data, the type I error rate was close to the expected value (5%) for all methods, while the SM method was the most powerful method, followed by LPCM. The power of TTD is low for single-item dimensions, because only four possible values exist for the score. When the number of items increases, the power of the SM approach remained stable, those of the TTD method increases while the power of LPCM remained stable. With 10 measurement times, the LPCM was less efficient. With informative missing data, the statistical power of SM and TTD tended to decrease, while that of LPCM tended to increase. CONCLUSIONS To conclude, the SM model was the most powerful model, irrespective of the scenario considered, and the presence or not of missing data. The TTD method should be avoided for single-item dimensions of the EORTC questionnaire. While the LPCM model was more adapted to this kind of data, it was less efficient than the SM model. These results warrant validation through comparisons on real data.
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Affiliation(s)
- Amélie Anota
- Quality of Life in Oncology National Platform, Besançon, France. .,Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital of Besançon, Besançon, France.
| | - Antoine Barbieri
- Biostatistic unit, Institut régional du Cancer de Montpellier (ICM) - Val d'Aurelle, Montpellier, France. .,Institut de Mathématiques et de Modélisation de Montpellier, University of Montpellier 2, Montpellier, France.
| | - Marion Savina
- INSERM, Clinical and EpidemiologicalResearch Unit (CIC-EC 7) - CTD INCa, Institut Bergonié, Bordeaux, France. .,INSERM CIC-EC7 Axe Cancer, Université de Bordeaux, Bordeaux, France.
| | - Alhousseiny Pam
- Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital of Besançon, Besançon, France.
| | - Sophie Gourgou-Bourgade
- Biostatistic unit, Institut régional du Cancer de Montpellier (ICM) - Val d'Aurelle, Montpellier, France.
| | - Franck Bonnetain
- Quality of Life in Oncology National Platform, Besançon, France. .,Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital of Besançon, Besançon, France.
| | - Caroline Bascoul-Mollevi
- Biostatistic unit, Institut régional du Cancer de Montpellier (ICM) - Val d'Aurelle, Montpellier, France.
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