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Robins VR, Gelcich S, Absolom K, Velikova G. The impact of age on physical functioning after treatment for breast cancer, as measured by patient-reported outcome measures: A systematic review. Breast 2024; 76:103734. [PMID: 38691921 PMCID: PMC11070762 DOI: 10.1016/j.breast.2024.103734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/04/2024] [Accepted: 04/15/2024] [Indexed: 05/03/2024] Open
Abstract
PURPOSE This systematic review aims to explore the impact of age on physical functioning post-treatment for early-stage, locally advanced, or locally recurrent breast cancer, as measured by patient-reported outcome measures (PROMs), identify PROMs used and variations in physical functioning terms/labels. METHODS MEDLINE, EmBase, PsycINFO, CINAHL and AMED were searched, along with relevant key journals and reference lists. Risk of bias (quality) assessment was conducted using a Critical Appraisal Skills Programme checklist. Data was synthesised through tables and narrative. RESULTS 28,207 titles were extracted from electronic databases, resulting in 44 studies with age sub-groups, and 120 without age sub-groups. Of those with findings on the impact of age, there was variability in the way findings were reported and 21 % found that age did not have a significant impact. However, 66 % of the studies found that with older age, physical functioning declined post-treatment. Comorbidities were associated with physical functioning declines. However, findings from sub-groups (breast cancer stage, treatment type and time post-treatment) lacked concordance. Twenty-eight types of PROM were used: the EORTC QLQ-C30 was most common (50.6 %), followed by the SF-36 (32.3 %). There were 145 terms/labels for physical functioning: 'physical functioning/function' was used most often (82.3 %). CONCLUSIONS Findings point towards an older age and comorbidities being associated with more physical functioning declines. However, it was not possible to determine if stage, treatment type and time since treatment had any influence. More consistent use of the terminology 'physical functioning/function' would aid future comparisons of study results.
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Affiliation(s)
- V R Robins
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, England, UK.
| | - S Gelcich
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, England, UK.
| | - K Absolom
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, England, UK; Leeds Institute of Health Sciences, University of Leeds, Leeds, England, UK.
| | - G Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, England, UK; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, England, UK.
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de Ligt KM, Koppert LB, de Rooij BH, van de Poll-Franse LV, Velikova G, Cardoso F. Seizing the moment: The time for harnessing electronic patient-reported outcome measures for enhanced and sustainable metastatic breast cancer care is now. Breast 2024; 74:103676. [PMID: 38359564 PMCID: PMC10877629 DOI: 10.1016/j.breast.2024.103676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/11/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024] Open
Abstract
The sustainability of healthcare systems is under pressure. Unlike care for many other chronic diseases, cancer care has yet to empower patients in effectively self-managing both the medical and emotional consequences of their condition, including adapting to changes in lifestyle and work, which is essential to achieve optimal health and recovery. Although proposed as a potential solution for sustainable healthcare and support for optimal health and recovery already decades ago, practical implementation of digital care lags behind. We believe electronic patient reported outcome measures (ePROMs) could play an important role in creating sustainable healthcare, both to guide complex treatment pathways and to empower survivors to self-manage consequences of diagnosis and treatment. That is, ePROMs can be used for screening and monitoring of symptoms, but also for treatment decision-making and to facilitate communication about quality of life. We therefore see opportunities for improvements in quality of care, quality of life, and survival of cancer patients, as well as research opportunities, as ePROMs collection can lead to better understanding of care needs. The '10 Actions for Change report' of the Advanced Breast Cancer Global Alliance stresses a critical need for improvement of care for metastatic breast cancer (MBC) patients. We therefore in this paper focus on MBC care and research.
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Affiliation(s)
- K M de Ligt
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - L B Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
| | - B H de Rooij
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Godebaldkwartier 419, 3511 DT, Utrecht, the Netherlands; Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Warandelaan 2, 5037 AB, Tilburg, the Netherlands.
| | - L V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Godebaldkwartier 419, 3511 DT, Utrecht, the Netherlands; Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Warandelaan 2, 5037 AB, Tilburg, the Netherlands.
| | - G Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, St James's University Hospital, Woodhouse Lane, LS2 9JT, Leeds, United Kingdom; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Beckett St, Harehills, LS9 7LP, Leeds, United Kingdom.
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Avenida Brasília s/n, 1400-038, Lisbon, Portugal.
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de Ligt KM, de Rooij BH, Hedayati E, Karsten MM, Smaardijk VR, Velting M, Saunders C, Travado L, Cardoso F, Lopez E, Carney N, Wengström Y, Ives A, Velikova G, Sousa Fialho MDL, Seidler Y, Stamm TA, Koppert LB, van de Poll-Franse LV. International development of a patient-centered core outcome set for assessing health-related quality of life in metastatic breast cancer patients. Breast Cancer Res Treat 2023; 198:265-281. [PMID: 36662394 PMCID: PMC10020292 DOI: 10.1007/s10549-022-06827-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/30/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE For patients living with metastatic breast cancer (MBC), achieving best possible health-related quality of life, along with maximizing survival, is vital. Yet, we have no systemic way to determine if we achieve these goals. A Core Outcome Set (COS) that allows standardized measurement of outcomes important to patients, but also promotes discussing these outcomes during clinical encounters, is long overdue. METHODS An international expert group (EG) of patient advocates, researchers, medical specialists, nurse specialists, and pharmaceutical industry representatives (n = 17) reviewed a list of relevant outcomes retrieved from the literature. A broader group (n = 141: patients/patient advocates (n = 45), health care professionals/researchers (n = 64), pharmaceutical industry representatives (n = 28), and health authority representatives (n = 4)) participated in a modified Delphi procedure, scoring the relevance of outcomes in two survey rounds. The EG finalized the COS in a consensus meeting. RESULTS The final MBC COS includes 101 variables about: (1) health-related quality of life (HRQoL, n = 26) and adverse events (n = 24); (2) baseline patient characteristics (n = 9); and (3) clinical variables (n = 42). Many outcome that cover aspects of HRQoL relevant to MBC patients are included, e.g. daily functioning (including ability to work), psychosocial/emotional functioning, sexual functioning, and relationship with the medical team. CONCLUSION The COS developed in this study contains important administrative data, clinical records, and clinician-reported measures that captures the impact of cancer. The COS is important for standardization of clinical research and implementation in daily practice and has received accreditation by the International Consortium for Health Outcomes Measurement (ICHOM).
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Affiliation(s)
- K M de Ligt
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, PO Box 90203, 1006 BE, Amsterdam, The Netherlands.
| | - B H de Rooij
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - E Hedayati
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Solna, Stockholm, Sweden
- Breast Cancer Center, Cancer Theme, Karolinska University Hospital and Karolinska Comprehensive Cancer Centre, Stockholm, Sweden
| | - M M Karsten
- Department of Gynecology with Breast Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - V R Smaardijk
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - M Velting
- Dutch Breast Cancer Patient Association (Borstkankervereniging Nederland), Utrecht, The Netherlands
| | - C Saunders
- Department of Surgery, Melbourne Medical School, Melbourne, Australia
| | - L Travado
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - E Lopez
- Department of Radiation Oncology, Vithas Hospital La Milagrosa, GenesisCare, Madrid, Spain
| | - N Carney
- F.Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Y Wengström
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Solna, Stockholm, Sweden
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - A Ives
- Cancer and Palliative Care Research and Evaluation Unit, University of Western Australia, Crawley, WA, Australia
| | - G Velikova
- Leeds Institute of Medical Research at St James's, St James's University Hospital, University of Leeds, Leeds, UK
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK
| | | | - Y Seidler
- Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - T A Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - L B Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - L V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, PO Box 90203, 1006 BE, Amsterdam, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
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Hartup S, Ashley L, Briggs M, Velikova G, Johnson M. Developing an effective self-management web-based intervention using co-designed patient and multidisciplinary research: ePainQ. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01499-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Frances S, Murray L, Wright J, Velikova G, Boele F. P08.08.B Long-term survival and health-related quality of life in meningioma patients: a mixed-methods systematic review. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Meningiomas account for approximately 36% of all primary brain tumours. These tumours have a relatively favourable prognosis with approximately 92% of meningioma patients surviving >5 years after diagnosis. Yet, patients report high disease burden and survivorship issues even years after treatment, including cognitive issues and anxiety/depression affecting health-related quality of life (HRQOL). We aimed to systematically review the literature and synthesise evidence on HRQOL in meningioma patients across long-term survival, defined as >2 years post diagnosis.
Material and Methods
Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO, and Web of Science Core Collection up to November 2021. Two independent assessors carried out screening. Any published, peer reviewed article with primary quantitative or qualitative data covering the physical, mental, and/or social aspects of HRQOL were included. Quality was assessed using the Mixed Methods Appraisal Tool, before a data-based convergent synthesis design was used to interpret findings.
Results
The search returned 2252 articles. Following screening 12 papers were included in the review. The majority of studies used quantitative methods, with only one study reporting mixed-methodology. Two of these were articles from the same study. Most used cross-sectional assessments (n =10) with two reporting longitudinal assessments (n = 2). Included meningioma patient samples (n=2990 in total) represented a wide range of survival lengths (range: 24 months - 10 years). HRQOL was impacted predominantly through physical and mental issues, including persevering symptoms (e.g. headaches, fatigue, vision problems) and emotional difficulties (e.g. poorer mental and general health perceptions). Returning to work proved difficult for patients due to cognitive and social deficits (e.g. issues with concentration, procrastination and isolation). Factors including age and comorbidities, but also treatment type appears to affect patients’ satisfaction with their HRQOL.
Conclusion
While overall prognosis following a meningioma diagnosis is good, meningioma patients’ HRQOL appears affected throughout long-term survivorship. Findings from this review could be beneficial in addressing the HRQOL and supportive-care needs of patients across long-term survivorship.
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Affiliation(s)
- S Frances
- University of Leeds , Leeds , United Kingdom
| | - L Murray
- University of Leeds , Leeds , United Kingdom
| | - J Wright
- University of Leeds , Leeds , United Kingdom
| | - G Velikova
- University of Leeds , Leeds , United Kingdom
| | - F Boele
- University of Leeds , Leeds , United Kingdom
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Pompili C, Omar S, Hylias H, Campisi A, Velikova G, Valuckiene L, Brunelli A. 87P Patient reported physical function (PF) predicts long-term survival in early-stage NSCLC surgical patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pearce J, Swinson D, Cairns D, Nair S, Baxter M, Petty R, Seymour M, Hall P, Velikova G. Frailty and treatment outcome in advanced gastro-oesophageal cancer: an exploratory analysis of the GO2 trial. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00394-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Frances S, Velikova G, Klein M, Short S, Murray L, Wright J, Boele F. P11.02 Long-term impact of primary brain tumour diagnosis on health-related quality of life: a systematic review. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
A primary brain tumour (PrBT) diagnosis can be devastating, and results in a wide range of symptoms. Relatively little is known about the long-term challenges these symptoms pose on HRQOL. The aim of this review is to identify the long-term HRQOL issues reported at least two years following diagnosis of a PrBT.
MATERIAL AND METHODS
Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO and Web of Science Core Collection. Searches were designed to identify a range of reported HRQOL aspects defined as physical, mental or social issues, in adult WHO grade II or III patients. To capture the full extent of patients’ experience, studies of any design reporting on primary data where patients had at least two years follow-up from diagnosis were included. WHO grade I and grade IV tumours were excluded due to their different prognoses and the expected nature of their disease trajectories. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). Narrative synthesis was used to collate findings.
RESULTS
The search returned 8438 articles. 477 titles remained after title and abstract screening, with eighteen full text articles included in the final analysis. The majority of studies used quantitative methods, with only two articles reporting qualitative or mixed methodology. Articles were predominantly cross-sectional studies (n = 10), along with cohort studies (n = 3), clinical trials (n = 3) and pilot studies (n = 2). Results indicated that patients reported a variety of issues influencing their HRQOL, with emotional/psychological/cognitive changes being the most commonly reported. Physical complaints included problems with fatigue, seizures and maintaining daily activity. Social challenges included strained social relationships and issues managing finances. Patient coping strategies were found to significantly influence wellbeing and subsequent HRQOL.
CONCLUSION
PrBT patients’ long-term HRQOL and daily functioning can be impacted by their physical, mental and social wellbeing. Findings from this review lay the groundwork for efforts to improve patient HRQOL in long-term survivorship.
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Affiliation(s)
- S Frances
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, United Kingdom
| | - G Velikova
- University of Leeds, St James Institute of Oncology, Leeds, United Kingdom
| | - M Klein
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - S Short
- University of Leeds, St James Institute of Oncology, Leeds, United Kingdom
| | - L Murray
- Leeds Institute of Molecular Research, University of Leeds, Leeds, United Kingdom
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, United Kingdom
| | - J Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - F Boele
- Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, United Kingdom
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Vasudev N, Ainsworth G, Brown S, Pickering L, Waddell T, Fife K, Griffiths R, Sharma A, Katona E, Howard H, Velikova G, Maraveyas A, Brown J, Venugopal B, Patel P, Jain A, Symeonides S, Nathan P, Collinson F, Powles T. LBA29 Nivolumab in combination with alternatively scheduled ipilimumab in first-line treatment of patients with advanced renal cell carcinoma: A randomized phase II trial (PRISM). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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10
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Slade AL, Retzer A, Ahmed K, Kyte D, Keeley T, Armes J, Brown JM, Calman L, Gavin A, Glaser AW, Greenfield DM, Lanceley A, Taylor RM, Velikova G, Turner G, Calvert MJ. Systematic review of the use of translated patient-reported outcome measures in cancer trials. Trials 2021; 22:306. [PMID: 33902699 PMCID: PMC8074490 DOI: 10.1186/s13063-021-05255-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 04/08/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) are used in clinical trials to assess the effectiveness and tolerability of interventions. Inclusion of participants from different ethnic backgrounds is essential for generalisability of cancer trial results. PRO data collection should include appropriately translated patient-reported outcome measures (PROMs) to minimise missing data and sample attrition. METHODS Protocols and/or publications from cancer clinical trials using a PRO endpoint and registered on the National Institute for Health Research Portfolio were systematically reviewed for information on recruitment, inclusion of ethnicity data, and use of appropriately translated PROMs. Semi-structured interviews were conducted with key stakeholders to explore barriers and facilitators for optimal PRO trial design, diverse recruitment and reporting, and use of appropriately translated PROMs. RESULTS Eighty-four trials met the inclusion criteria, only 14 (17%) (n = 4754) reported ethnic group data, and ethnic group recruitment was low, 611 (13%). Although 8 (57%) studies were multi-centred and multi-national, none reported using translated PROMs, although available for 7 (88%) of the studies. Interviews with 44 international stakeholders identified a number of perceived barriers to ethnically diverse recruitment including diverse participant engagement, relevance of ethnicity to research question, prominence of PROs, and need to minimise investigator burden. Stakeholders had differing opinions on the use of translated PROMs, the impact of trial designs, and recruitment strategies on diverse recruitment. Facilitators of inclusive research were described and examples of good practice identified. CONCLUSIONS Greater transparency is required when PROs are used as primary or secondary outcomes in clinical trials. Protocols and publications should demonstrate that recruitment was accessible to diverse populations and facilitated by trial design, recruitment strategies, and appropriate PROM usage. The use of translated PROMs should be made explicit when used in cancer clinical trials.
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Affiliation(s)
- A L Slade
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. .,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK. .,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, West Midlands, UK.
| | - A Retzer
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - K Ahmed
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - D Kyte
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.,National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK
| | - T Keeley
- Patient Centred Outcomes, GlaxoSmithKline, Brentford, UK
| | - J Armes
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,School of Health Sciences, University of Surrey, Guildford, UK.,NIHR Applied Research Collaboration Kent Surrey & Sussex University of Surrey, Guildford, UK
| | - J M Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - L Calman
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Macmillan Survivorship Research Group, Health Sciences, University of Southampton, Highfield Campus, Southampton, UK
| | - A Gavin
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Northern Ireland Cancer Registry, Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - A W Glaser
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - D M Greenfield
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - A Lanceley
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - R M Taylor
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - G Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - G Turner
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - M J Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, West Midlands, UK.,National Institute for Health Research Applied Research Collaboration, University of Birmingham, Birmingham, West Midlands, UK.,Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, West Midlands, UK
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Musoro JZ, Sodergren SC, Coens C, Pochesci A, Terada M, King MT, Sprangers MAG, Groenvold M, Cocks K, Velikova G, Flechtner HH, Bottomley A. Minimally important differences for interpreting the EORTC QLQ-C30 in patients with advanced colorectal cancer treated with chemotherapy. Colorectal Dis 2020; 22:2278-2287. [PMID: 32767619 DOI: 10.1111/codi.15295] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022]
Abstract
AIM The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) assesses the health-related quality of life of patients in cancer trials. There are currently no minimally important difference (MID) guidelines for the EORTC QLQ-C30 for colorectal cancer (CRC). This study aims to estimate MIDs for the EORTC QLQ-C30 scales in patients with advanced CRC treated with chemotherapy and enrolled in clinical trials. METHOD The data were obtained from three published EORTC trials that treated CRC patients using chemotherapy. Potential anchors were selected from clinical variables based on their correlation with EORTC QLQ-C30 scales. Anchor-based MIDs for within-group change and between-group change were estimated via the mean change method and linear regression, respectively, and summarized using weighted correlation. Distribution-based MIDs were also examined. RESULTS Anchor-based MIDs were determined for deterioration in 8 of the 14 EORTC QLQ-C30 scales and in 9 scales for improvement, and varied by scale, direction of change and anchor. MIDs for improvement (deterioration) ranged from 6 to 18 (-11 to -5) points for within-group change and 5 to 15 (-10 to -4) for between-group change. Summarized MIDs (in absolute values) per scale mostly ranged from 5 to 10 points. CONCLUSIONS These findings have clinical relevance for the interpretation of treatment efficacy and the design of clinical trials by informing sample size requirements.
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Affiliation(s)
- J Z Musoro
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - S C Sodergren
- School of Health Sciences, University of Southampton, Southampton, UK
| | - C Coens
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - A Pochesci
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - M Terada
- Japan Clinical Oncology Group, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - M T King
- Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - M A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M Groenvold
- Department of Public Health, University of Copenhagen and Bispebjerg Hospital, Copenhagen, Denmark
| | - K Cocks
- Adelphi Values, Bollington, Cheshire, UK
| | - G Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - H-H Flechtner
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany
| | - A Bottomley
- European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
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Spencer K, Hall P, Henry A, Velikova G, Whalley S, Birch R, Le Calvez K, Williams M, Morris E. PH-0522: Fractionation and early mortality in palliative radiotherapy across the English NHS. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Henry A, Holch P, Routledge J, Absolom K, Walker K, Gibson A, Carter R, Brown J, Velikova G. Pilot Randomized Trial of Online Self-Monitoring of Symptoms During Pelvic Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Spencer K, Bojke C, Henry A, Velikova G, Morris E, Van der Linden Y, Van den Hout W, Hall P. OC-0079: Can SABR for painful bone metastases ever be cost-effective in the NHS? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00105-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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15
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Henry A, Holch P, Routledge J, Absolom K, Walker K, Gibson A, Carter R, Brown J, Velikova G. OC-0314: Pilot randomised trial of online self-monitoring of symptoms during pelvic radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00338-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Seligmann JF, Wright-Hughes A, Pottinger A, Velikova G, Oughton JB, Murden G, Rizwanullah M, Price C, Passant H, Heudtlass P, Marshall H, Johnston S, Dodwell D. Lapatinib plus Capecitabine versus Trastuzumab plus Capecitabine in the Treatment of Human Epidermal Growth Factor Receptor 2-positive Metastatic Breast Cancer with Central Nervous System Metastases for Patients Currently or Previously Treated with Trastuzumab (LANTERN): a Phase II Randomised Trial. Clin Oncol (R Coll Radiol) 2020; 32:656-664. [PMID: 32600919 DOI: 10.1016/j.clon.2020.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/14/2020] [Accepted: 06/03/2020] [Indexed: 11/12/2022]
Abstract
AIMS Brain (central nervous system; CNS) metastases occur in 30-50% of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC). A substantive evidence base for treatment is lacking, but activity with lapatinib plus capecitabine (lap-cap) has been reported. We compared lap-cap with trastuzumab plus capecitabine (tras-cap) in patients with HER2-positive MBC with CNS metastases previously treated with trastuzumab. MATERIALS AND METHODS This open-label randomised phase II screening trial aimed to randomise 130 participants over 2 years to receive lap-cap or tras-cap. Eligible patients had HER2-positive MBC with newly diagnosed or recently progressed CNS metastases; previous, or current, treatment included: trastuzumab, a taxane or anthracycline and recent completion of local cranial therapy. The primary end point was time to progression of CNS metastases within the 24-week trial period. Secondary objectives included CNS response rate, progression-free survival, steroid use for CNS symptoms and feasibility of recruitment to a large phase III trial. RESULTS Between September 2011 and October 2013, 30 participants were randomised, 16 to lap-cap and 14 to tras-cap. Recruitment to a large phase III trial was determined not to be feasible. At 24 weeks, CNS disease progression was 41.8% (95% confidence interval 16.1-67.5%) in lap-cap and 41.2% (95% confidence interval 12.8-69.6%) in tras-cap arms; progression-free survival was 44.4% (95% confidence interval 18.1-70.8%) in lap-cap and 50.0% (95% confidence interval 20.9-79.1%) in tras-cap arms. CONCLUSION Poor recruitment confirmed that a larger phase III trial would not be feasible and prohibited a preliminary evaluation of the superiority of lap-cap over tras-cap. Descriptive statistics are presented to inform the limited evidence base and future study design.
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Affiliation(s)
- J F Seligmann
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - A Wright-Hughes
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - A Pottinger
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - G Velikova
- St James's Institute of Oncology, St James University Hospital, Leeds, UK
| | - J B Oughton
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - G Murden
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - M Rizwanullah
- Department of Clinical Oncology, The Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - C Price
- Department of Medical Oncology, University Hospitals, Bristol, UK
| | - H Passant
- Department of Medical Oncology, Velindre Hospital, Cardiff, UK
| | - P Heudtlass
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - H Marshall
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - S Johnston
- Department of Medical Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - D Dodwell
- St James's Institute of Oncology, St James University Hospital, Leeds, UK; Nuffield Department of Population Health, Oxford University, Oxford, UK.
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Richards HS, Portal A, Absolom K, Blazeby JM, Velikova G, Avery KNL. Patient experiences of an electronic PRO tailored feedback system for symptom management following upper gastrointestinal cancer surgery. Qual Life Res 2020; 30:3229-3239. [PMID: 32535864 PMCID: PMC8528794 DOI: 10.1007/s11136-020-02539-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 11/26/2022]
Abstract
Purpose Complications following upper gastrointestinal (UGI) surgery are common. Symptom-monitoring following discharge is not standardized. An electronic patient-reported outcome (ePRO) system providing feedback to patients and clinicians could support patients and improve outcomes. Little is known about patients’ experiences of using such systems. This qualitative sub-study explored patients’ perspectives of the benefits of using a novel ePRO system, developed as part of the mixed methods eRAPID pilot study, to support recovery following discharge after UGI surgery. Methods Patients completed the online ePRO symptom-report system post-discharge. Weekly interviews explored patients’ experiences of using ePRO, the acceptability of feedback generated and its value for supporting their recovery. Interviews were audio-recorded and targeted transcriptions were thematically analysed. Results Thirty-five interviews with 16 participants (11 men, mean age 63 years) were analysed. Two main themes were identified: (1) reassurance and (2) empowerment. Feelings of isolation were common; many patients felt uninformed regarding their expectations of recovery and whether their symptoms warranted clinical investigation. Participants were reassured by tailored feedback advising them to contact their care team, alleviating their anxiety. Patients reported feeling empowered by the ePRO system and in control of their symptoms and recovery. Conclusion Patients recovering at home following major cancer surgery regarded electronic symptom-monitoring and feedback as acceptable and beneficial. Patients perceived that the system enhanced information provision and provided a direct link to their care team. Patients felt that the system provided reassurance at a time of uncertainty and isolation, enabling them to feel in control of their symptoms and recovery. Electronic supplementary material The online version of this article (10.1007/s11136-020-02539-w) contains supplementary material, which is available to authorised users.
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Affiliation(s)
- H S Richards
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - A Portal
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - K Absolom
- Leeds Institute of Medical Research at St James, St James's Hospital, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - J M Blazeby
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - G Velikova
- Leeds Institute of Medical Research at St James, St James's Hospital, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - K N L Avery
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
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18
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Richards HS, Blazeby JM, Portal A, Harding R, Reed T, Lander T, Chalmers KA, Carter R, Singhal R, Absolom K, Velikova G, Avery KNL. A real-time electronic symptom monitoring system for patients after discharge following surgery: a pilot study in cancer-related surgery. BMC Cancer 2020; 20:543. [PMID: 32522163 PMCID: PMC7285449 DOI: 10.1186/s12885-020-07027-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 06/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background Advances in peri-operative care of surgical oncology patients result in shorter hospital stays. Earlier discharge may bring benefits, but complications can occur while patients are recovering at home. Electronic patient-reported outcome (ePRO) systems may enhance remote, real-time symptom monitoring and detection of complications after hospital discharge, thereby improving patient safety and outcomes. Evidence of the effectiveness of ePRO systems in surgical oncology is lacking. This pilot study evaluated the feasibility of a real-time electronic symptom monitoring system for patients after discharge following cancer-related upper gastrointestinal surgery. Methods A pilot study in two UK hospitals included patients who had undergone cancer-related upper gastrointestinal surgery. Participants completed the ePRO symptom-report at discharge, twice in the first week and weekly post-discharge. Symptom-report completeness, system actions, barriers to using the ePRO system and technical performance were examined. The ePRO surgery system is an online symptom-report that allows clinicians to view patient symptom-reports within hospital electronic health records and was developed as part of the eRAPID project. Clinically derived algorithms provide patients with tailored self-management advice, prompts to contact a clinician or automated clinician alerts depending on symptom severity. Interviews with participants and clinicians determined the acceptability of the ePRO system to support patients and their clinical management during recovery. Results Ninety-one patients were approached, of which 40 consented to participate (27 male, mean age 64 years). Symptom-report response rates were high (range 63–100%). Of 197 ePRO completions analysed, 76 (39%) triggered self-management advice, 72 (36%) trigged advice to contact a clinician, 9 (5%) triggered a clinician alert and 40 (20%) did not require advice. Participants found the ePRO system reassuring, providing timely information and advice relevant to supporting their recovery. Clinicians regarded the system as a useful adjunct to usual care, by signposting patients to seek appropriate help and enhancing their understanding of patients’ experiences during recovery. Conclusion Use of the ePRO system for the real-time, remote monitoring of symptoms in patients recovering from cancer-related upper gastrointestinal surgery is feasible and acceptable. A definitive randomised controlled trial is needed to evaluate the impact of the system on patients’ wellbeing after hospital discharge.
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Affiliation(s)
- H S Richards
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - J M Blazeby
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.,Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - A Portal
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - R Harding
- Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - T Reed
- Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - T Lander
- Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - K A Chalmers
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - R Carter
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, St James's Hospital, Leeds, LS9 7TF, UK
| | - R Singhal
- Queen Elizabeth Hospital Birmingham, Mindelson Way, Edgbaston, Birmingham, B15 2WB, UK
| | - K Absolom
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, St James's Hospital, Leeds, LS9 7TF, UK
| | - G Velikova
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, St James's Hospital, Leeds, LS9 7TF, UK
| | - K N L Avery
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
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19
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Bjelic-Radisic V, Cardoso F, Cameron D, Brain E, Kuljanic K, da Costa RA, Conroy T, Inwald EC, Serpentini S, Pinto M, Weis J, Morag O, Lindviksmoen Astrup G, Tomaszewski KA, Pogoda K, Sinai P, Sprangers M, Aaronson N, Velikova G, Greimel E, Arraras J, Bottomley A. Corrigendum to An international update of the EORTC questionnaire for assessing quality of life in breast cancer patients: EORTC QLQ-BR45: Ann Oncol 2020; Volume 31, Issue 2, Pages 283-288. Ann Oncol 2020; 31:552. [PMID: 32089397 DOI: 10.1016/j.annonc.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- V Bjelic-Radisic
- Breast Unit, Helios University Clinic, University Witten/Herdecke, Wuppertal, Germany.
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - D Cameron
- Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - E Brain
- Department of Medical Oncology Institute Curie - Hôpital René Huguenin, Saint-Cloud, France
| | - K Kuljanic
- Department of Obstetrics and Gynecology, Clinical Center Rijeka, Rijeka, Croatia
| | - R A da Costa
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, Barretos, Brazil
| | - T Conroy
- Department of Medical Oncology, Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - E C Inwald
- Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany
| | - S Serpentini
- Unit for Psychooncology, Veneto Institute of Oncology IOVeIRCCS, Padua, Italy
| | - M Pinto
- National Tumor Institute, Instituto Nazionale Tumori Fondazione Pascale Naples, Naples, Italy
| | - J Weis
- Comprehensive Cancer Center, Medical Faculty, University Medical Center Freiburg, Freiburg, Germany
| | - O Morag
- Unit Pain Clinic, ShebaeTel Ha Shomer Hospital, Tel Aviv, Israel
| | | | - K A Tomaszewski
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - K Pogoda
- Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - P Sinai
- Southmead Hospital, University of Bristol, Bristol, UK
| | - M Sprangers
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam
| | - N Aaronson
- Department of Psychosocial Research, NKI Netherlands, Amsterdam, The Netherlands
| | - G Velikova
- LeedsInstitute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - E Greimel
- Department of Gynecology and Obstetrics, Medical University Graz, Graz, Austria
| | - J Arraras
- Oncology Department, Hospital of Navarre, Pamplona, Spain
| | - A Bottomley
- EORTC HQ, Quality of Life Department, Brussels, Belgium
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20
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Bjelic-Radisic V, Cardoso F, Cameron D, Brain E, Kuljanic K, da Costa RA, Conroy T, Inwald EC, Serpentini S, Pinto M, Weis J, Morag O, Lindviksmoen Astrup G, Tomaszweksi KA, Pogoda K, Sinai P, Sprangers M, Aaronson N, Velikova G, Greimel E, Arraras J, Bottomley A. An international update of the EORTC questionnaire for assessing quality of life in breast cancer patients: EORTC QLQ-BR45. Ann Oncol 2019; 31:283-288. [PMID: 31959345 DOI: 10.1016/j.annonc.2019.10.027] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR23 was one of the first disease-specific questionnaires developed in 1996 to assess quality of life (QoL) in patients with breast cancer (BC). However, since 1996 major changes in BC treatment have occurred, requiring an update of the EORTC BC module. This study presents the results of the phase I-III update of the QLQ-BR23 questionnaire. PATIENTS AND METHODS The update of the EORTC QLQ-BR23 module followed standard EORTC guidelines. A systematic literature review revealed 83 potential relevant QoL issues during phases I and II. After shortening the issues list and following interviews with patients and health care providers, 15 relevant issues were transformed into 27 items. The preliminary module was pretested in an international, multicentre phase III study to identify and solve potential problems with wording comprehensibility and acceptability of the items. Descriptive statistics are provided. Analyses were qualitative and quantitative. We provide a psychometric structure of the items. RESULTS The phase I and II results indicated the need to supplement the original QLQ-BR23 with additional items related to newer therapeutic options. The phase III study recruited a total of 250 patients (from 12 countries). The final updated phase III module contains a total of 45 items: 23 items from the QLQ-BR23 and 22 new items. The new items contain two multi-item scales: a target symptom scale and a satisfaction scale. The target symptom scale can be divided into three subscales: endocrine therapy, endocrine sexual and skin/mucosa scale. CONCLUSION Our work has led to the development of a new EORTC QLQ-BR45 module that provides a more accurate and comprehensive assessment of the impact of new and scalable treatments on patients' QoL. The final version of the EORTC QLQ-BR45 is currently available for use in clinical practice. The final phase IV study is underway to confirm psychometric properties of the module.
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Affiliation(s)
- V Bjelic-Radisic
- Breast Unit, Helios University Clinic, University Witten/Herdecke, Wuppertal, Germany.
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - D Cameron
- Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, UK
| | - E Brain
- Department of Medical Oncology Institute Curie - Hôpital René Huguenin, Saint-Cloud, France
| | - K Kuljanic
- Department of Obstetrics and Gynecology, Clinical Center Rijeka, Rijeka, Croatia
| | - R A da Costa
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, Barretos, Brazil
| | - T Conroy
- Department of Medical Oncology, Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - E C Inwald
- Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany
| | - S Serpentini
- Unit for Psychooncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - M Pinto
- National Tumor Institute, Instituto Nazionale Tumori Fondazione Pascale Naples, Naples, Italy
| | - J Weis
- Comprehensive Cancer Center, Medical Faculty, University Medical Center Freiburg, Freiburg, Germany
| | - O Morag
- Unit Pain Clinic, Sheba - Tel Ha Shomer Hospital, Tel Aviv, Israel
| | | | - K A Tomaszweksi
- Department of Surgery, Jagillonian University Medical College Krakow, Krakow, Poland
| | - K Pogoda
- Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - P Sinai
- Southmead Hospital, University of Bristol, Bristol, UK
| | - M Sprangers
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - N Aaronson
- Department of Psychosocial Research, NKI Netherlands, Amsterdam, The Netherlands
| | - G Velikova
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - E Greimel
- Department of Gynecology and Obstetrics, Medical University Graz, Graz, Austria
| | - J Arraras
- Oncology Department, Hospital of Navarre, Pamplona, Spain
| | - A Bottomley
- EORTC HQ, Quality of Life Department, Brussels, Belgium
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Hall P, Swinson D, Lord S, Handforth C, Cairns D, Marshall H, Petty R, Bennett M, Velikova G, Seymour M. Chemotherapy for frail and elderly patients (pts) with advanced gastroesophageal cancer (aGOAC): Quality of Life (QoL) results from the GO2 phase III trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Liu Y, Siejka P, Velikova G, Bi Y, Tomkova M, Schuster-Boeckler B, Song CX. Abstract 825: TAPS: A bisulfite-free, base-resolution and quantitative sequencing method for cytosine modifications. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Aberrant DNA methylation changes are powerful prognostic and predictive biomarkers in cancer diagnosis and treatment. For decades bisulfite sequencing has been the gold standard for DNA methylation analysis. However, this method relies on harsh deamination reaction of unmodified cytosine to uracil which degrades the majority of DNA and generates sequencing libraries with low complexity. Those drawbacks limit the applications on low-input samples and lead to poor sequencing quality, low mapping rates, uneven genome coverage and increased sequencing cost. Here, we present a novel bisulfite-free and base-resolution sequencing method, TET Assisted Pyridine borane Sequencing (TAPS), for direct detection of 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) without affecting unmodified cytosine. We utilised TET enzymes to readily oxidize 5mC and 5hmC to 5-carboxylcytosine (5caC), which was then converted to dihydrouracil by pyridine borane via a previously unknown reductive decarboxylation/deamination reaction. This non-destructive method enables high-throughput sequencing with nanoscale input materials (genomic DNA and cell-free DNA) and preserve DNA up to 10 kbs long which could allow long read sequencing. We demonstrated that TAPS could directly replace bisulfite sequencing with higher mapping rates, more even coverage and lower sequencing costs, and enable more comprehensive, cheaper and faster methylome analyses. This would be a revolutionary tool for epigenetic study and facilitate both academic research and clinical diagnostics.
Citation Format: Yibin Liu, Paulina Siejka, Gergana Velikova, Ying Bi, Marketa Tomkova, Benjamin Schuster-Boeckler, Chun-Xiao Song. TAPS: A bisulfite-free, base-resolution and quantitative sequencing method for cytosine modifications [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 825.
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Affiliation(s)
- Yibin Liu
- Ludwig Institute for Cancer Research, Oxford, United Kingdom
| | - Paulina Siejka
- Ludwig Institute for Cancer Research, Oxford, United Kingdom
| | | | - Ying Bi
- Ludwig Institute for Cancer Research, Oxford, United Kingdom
| | - Marketa Tomkova
- Ludwig Institute for Cancer Research, Oxford, United Kingdom
| | | | - Chun-Xiao Song
- Ludwig Institute for Cancer Research, Oxford, United Kingdom
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Kumaran G, Razzaq M, Velikova G, Papaxoinis G, Corker S, Fox F, Peters R, Kamposioras K. Patient understanding of the aim and duration of treatment during the consent process. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Liu Y, Siejka-Zielińska P, Velikova G, Bi Y, Yuan F, Tomkova M, Bai C, Chen L, Schuster-Böckler B, Song CX. Bisulfite-free direct detection of 5-methylcytosine and 5-hydroxymethylcytosine at base resolution. Nat Biotechnol 2019; 37:424-429. [PMID: 30804537 DOI: 10.1038/s41587-019-0041-2] [Citation(s) in RCA: 211] [Impact Index Per Article: 42.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 01/22/2019] [Indexed: 02/07/2023]
Abstract
Bisulfite sequencing has been the gold standard for mapping DNA modifications including 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) for decades1-4. However, this harsh chemical treatment degrades the majority of the DNA and generates sequencing libraries with low complexity2,5,6. Here, we present a bisulfite-free and base-level-resolution sequencing method, TET-assisted pyridine borane sequencing (TAPS), for detection of 5mC and 5hmC. TAPS combines ten-eleven translocation (TET) oxidation of 5mC and 5hmC to 5-carboxylcytosine (5caC) with pyridine borane reduction of 5caC to dihydrouracil (DHU). Subsequent PCR converts DHU to thymine, enabling a C-to-T transition of 5mC and 5hmC. TAPS detects modifications directly with high sensitivity and specificity, without affecting unmodified cytosines. This method is nondestructive, preserving DNA fragments over 10 kilobases long. We applied TAPS to the whole-genome mapping of 5mC and 5hmC in mouse embryonic stem cells and show that, compared with bisulfite sequencing, TAPS results in higher mapping rates, more even coverage and lower sequencing costs, thus enabling higher quality, more comprehensive and cheaper methylome analyses.
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Affiliation(s)
- Yibin Liu
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Paulina Siejka-Zielińska
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Gergana Velikova
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Ying Bi
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Fang Yuan
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Peking University, Beijing, China
| | - Marketa Tomkova
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Chunsen Bai
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- College of Chemistry, Nankai University, Tianjin, China
| | - Lei Chen
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Center for Mitochondrial Biology and Medicine and Center for Translational Medicine, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Benjamin Schuster-Böckler
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Chun-Xiao Song
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Avery K, Richards H, Portal A, Reed T, Harding R, Carter R, Absolom K, Velikova G, Blazeby J. Systematic electronic capture of patient reported outcomes after cancer surgery: A valuable adjunct to post-operative care. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Collinson F, Brown S, Buckley H, Ainsworth G, Howard H, Poad H, Carr G, Banks R, Brown J, Velikova G, Larkin J, Nathan P, Powles T, Vasudev N. PRISM: A randomised phase II trial of nivolumab in combination with alternatively scheduled ipilimumab in first-line treatment of patients with advanced or metastatic renal cell carcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Nicklin E, Velikova G, Hulme C, Boele F. OS5.6 Issues and needs experienced by adolescent and young adult brain tumour survivors and their caregivers: A systematic review. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Nicklin
- University of Leeds, Leeds, United Kingdom
| | - G Velikova
- University of Leeds, Leeds, United Kingdom
| | - C Hulme
- University of Leeds, Leeds, United Kingdom
| | - F Boele
- University of Leeds, Leeds, United Kingdom
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Holch P, Warrington L, Bamforth LCA, Keding A, Ziegler LE, Absolom K, Hector C, Harley C, Johnson O, Hall G, Morris C, Velikova G. Development of an integrated electronic platform for patient self-report and management of adverse events during cancer treatment. Ann Oncol 2018; 28:2305-2311. [PMID: 28911065 DOI: 10.1093/annonc/mdx317] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Significant adverse events (AE) during cancer therapy disrupt treatment and escalate to emergency admissions. Approaches to improve the timeliness and accuracy of AE reporting may improve safety and reduce health service costs. Reporting AE via patient reported outcomes (PROs), can improve clinician-patient communication and making data available to clinicians in 'real-time' using electronic PROs (ePROs) could potentially transform clinical practice by providing easily accessible records to guide treatment decisions. This manuscript describes the development of eRAPID (electronic patient self-Reporting of Adverse-events: Patient Information and aDvice) is a National Institute for Health Research-funded programme, a system for patients to self-report and manage AE online during and after cancer treatment. Materials and methods A multidisciplinary team of IT experts, staff and patients developed using agile principles a secure web application interface (QStore) between an existing online questionnaire builder (QTool) displaying real-time ePRO data to clinicians in the electronic patient record at Leeds Teaching Hospitals NHS Trust. Hierarchical algorithms were developed corresponding to Common Terminology Criteria for Adverse Events grading using the QTool question dependency function. Patient advocates (N = 9), patients (N = 13), and staff (N = 19) usability tested the system reporting combinations of AE. Results The eRAPID system allows patients to report AE from home on PC, tablet or any web enabled device securely during treatment. The system generates immediate self-management advice for low or moderate AE and for severe AE advice to contact the hospital immediately. Clinicians can view patient AE data in the electronic patient record and receive email notifications when patients report severe AE. Conclusions Evaluation of the system in a randomised controlled trial in breast, gynaecological and colorectal cancer patients undergoing systemic therapy is currently underway. To adapt eRAPID for different treatment groups, pilot studies are being undertaken with patients receiving pelvic radiotherapy and upper gastrointestinal surgery. ISRCTN88520246.
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Affiliation(s)
- P Holch
- Psychology Group, School of Social Sciences, Faculty of Health and Social Sciences, City Campus, Leeds Beckett University, Leeds.,Patient Reported Outcomes Group: Leeds Institute of Cancer Studies and Pathology, Bexley Wing, St James's Hospital, University of Leeds, Leeds
| | - L Warrington
- Patient Reported Outcomes Group: Leeds Institute of Cancer Studies and Pathology, Bexley Wing, St James's Hospital, University of Leeds, Leeds
| | - L C A Bamforth
- Patient Reported Outcomes Group: Leeds Institute of Cancer Studies and Pathology, Bexley Wing, St James's Hospital, University of Leeds, Leeds.,Leeds Teaching Hospitals NHS Trust, St James's Institute of Oncology, Bexley Wing, St James's Hospital, Leeds
| | - A Keding
- Department of Health Sciences, Heslington, University of York, York
| | | | - K Absolom
- Patient Reported Outcomes Group: Leeds Institute of Cancer Studies and Pathology, Bexley Wing, St James's Hospital, University of Leeds, Leeds
| | - C Hector
- Psychology Group, School of Social Sciences, Faculty of Health and Social Sciences, City Campus, Leeds Beckett University, Leeds
| | - C Harley
- School of Healthcare: Baines Wing
| | - O Johnson
- School of Computing, University of Leeds, Leeds.,X-Lab Limited, Hanover Walk, Leeds
| | - G Hall
- Leeds Teaching Hospitals NHS Trust, St James's Institute of Oncology, Bexley Wing, St James's Hospital, Leeds
| | - C Morris
- eRAPID Project Management Group, Leeds, UK
| | - G Velikova
- Patient Reported Outcomes Group: Leeds Institute of Cancer Studies and Pathology, Bexley Wing, St James's Hospital, University of Leeds, Leeds
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Spencer K, Van den Hout W, Henry A, Morris E, Velikova G, Hall P, Tubeuf S, Van der Linden Y. PO-0847: Pain response and quality of life with survival post palliative radiotherapy for bone metastases. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31157-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Gilbert A, Davidson S, Velikova G, Sebag-Montefiore D. SP-0519: Collecting PROs in clinical practice to assess radiotherapy toxicity and develop normal tissue complication probability models. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30959-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Jones GL, Hughes J, Mahmoodi N, Greenfield D, Brauten-Smith G, Skull J, Gath J, Yeomanson D, Baskind E, Snowden JA, Jacques RM, Velikova G, Collins K, Stark D, Phillips R, Lane S, Bekker HL. Observational study of the development and evaluation of a fertility preservation patient decision aid for teenage and adult women diagnosed with cancer: the Cancer, Fertility and Me research protocol. BMJ Open 2017; 7:e013219. [PMID: 28289046 PMCID: PMC5353284 DOI: 10.1136/bmjopen-2016-013219] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 12/12/2016] [Accepted: 12/19/2016] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Women diagnosed with cancer and facing potentially sterilising cancer treatment have to make time-pressured decisions regarding fertility preservation with specialist fertility services while undergoing treatment of their cancer with oncology services. Oncologists identify a need for resources enabling them to support women's fertility preservation decisions more effectively; women report wanting more specialist information to make these decisions. The overall aim of the 'Cancer, Fertility and Me' study is to develop and evaluate a new evidence-based patient decision aid (PtDA) for women with any cancer considering fertility preservation to address this unmet need. METHODS AND ANALYSIS This is a prospective mixed-method observational study including women of reproductive age (16 years +) with a new diagnosis of any cancer across two regional cancer and fertility centres in Yorkshire, UK. The research involves three stages. In stage 1, the aim is to develop the PtDA using a systematic method of evidence synthesis and multidisciplinary expert review of current clinical practice and patient information. In stage 2, the aim is to assess the face validity of the PtDA. Feedback on its content and format will be ascertained using questionnaires and interviews with patients, user groups and key stakeholders. Finally, in stage 3 the acceptability of using this resource when integrated into usual cancer care pathways at the point of cancer diagnosis and treatment planning will be evaluated. This will involve a quantitative and qualitative evaluation of the PtDA in clinical practice. Measures chosen include using count data of the PtDAs administered in clinics and accessed online, decisional and patient-reported outcome measures and qualitative feedback. Quantitative data will be analysed using descriptive statistics, paired sample t-tests and CIs; interviews will be analysed using thematic analysis. ETHICS AND DISSEMINATION Research Ethics Committee approval (Ref: 16/EM/0122) and Health Research Authority approval (Ref: 194751) has been granted. Findings will be published in open access peer-reviewed journals, presented at conferences for academic and health professional audiences, with feedback to health professionals and program managers. The Cancer, Fertility and Me patient decision aid (PtDA) will be disseminated via a diverse range of open-access media, study and charity websites, professional organisations and academic sources. External endorsement will be sought from the International Patient Decision Aid Standards (IPDAS) Collaboration inventory of PtDAs and other relevant professional organisations, for example, the British Fertility Society. TRIAL REGISTRATION NUMBER NCT02753296; pre-results.
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Affiliation(s)
- G L Jones
- Department of Psychology, School of Social Sciences, Leeds Beckett University, City Centre Campus, Leeds, UK
| | - J Hughes
- Department of Psychology, School of Social Sciences, Leeds Beckett University, City Centre Campus, Leeds, UK
| | - N Mahmoodi
- Department of Psychology, School of Social Sciences, Leeds Beckett University, City Centre Campus, Leeds, UK
| | - D Greenfield
- Department of Oncology, Sheffield Teaching NHS Hospitals Foundation Trust, Sheffield University, Sheffield, UK
| | | | - J Skull
- Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - J Gath
- Independent Cancer Patients' Voice, London, UK
| | - D Yeomanson
- Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - E Baskind
- Seacroft Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - J A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - R M Jacques
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - G Velikova
- University of Leeds, St James Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - K Collins
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - D Stark
- University of Leeds, St James Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - R Phillips
- Center for Review and Dissemination, University of York, Leeds General Infirmary, Leeds Teaching Hospitals, York, UK
| | - S Lane
- Oxford Radcliffe Hospitals NHS Trust, Oxford, UK
| | - H L Bekker
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
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Hall PS, Lord SR, Collinson M, Marshall H, Jones M, Lowe C, Howard H, Swinson D, Velikova G, Anthoney A, Roy R, Dent J, Cheeseman S, Last K, Seymour MT. A randomised phase II trial and feasibility study of palliative chemotherapy in frail or elderly patients with advanced gastroesophageal cancer (321GO). Br J Cancer 2017; 116:472-478. [PMID: 28095397 PMCID: PMC5318975 DOI: 10.1038/bjc.2016.442] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 11/08/2016] [Accepted: 12/05/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Elderly patients are commonly under-represented in cancer clinical trials. The 321GO was undertaken in preparation for a definitive phase three trial assessing different chemotherapy regimens in a frail and/or elderly population with advanced gastroesophageal (GO) cancer. METHODS Patients with advanced GO cancer considered unfit for conventional dose chemotherapy were randomly assigned in a 1 : 1 : 1 ratio to: epirubicin, oxaliplatin and capecitabine (EOX); oxaliplatin and capecitabine (OX); and capecitabine alone (X) (all 80% of full dose and unblinded). The primary end point was patient recruitment over an 18-month period. A registration study recorded treatment choice for all patients with advanced GO cancer at trial centres. RESULTS A total of 313 patients were considered for palliative chemotherapy for GO cancer over the 18-month period: 115 received full dose treatment, 89 less than standard treatment or entered 321GO and 111 no treatment. Within 321GO, 55 patients were randomly assigned (19 to OX and X; 17 to EOX). Progression-free survival (PFS) for all patients was 4.4 months and by arm 5.4, 5.6 and 3.0 months for EOX, OX and X, respectively. The number of patients with a good overall treatment utility (OTU), a novel patient-centred endpoint, at 12 weeks was 3 (18%), 6 (32%) and 1 (6%) for EOX, OX and X, respectively. At 6 weeks, 22 patients (41%) had experienced a non-haematologic toxicity ⩾grade 3, most commonly lethargy or diarrhoea. The OTU was prognostic for overall survival in patients alive at week 12 (logrank test P=0.0001). CONCLUSIONS It is feasible to recruit elderly and/or frail patients with advanced GO cancer to a randomised clinical trial. The OX is the preferred regimen for further study. Overall treatment utility shows promise as a comparator between treatment regimens for feasibility and randomised trials in the elderly and/or frail GO cancer population.
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Affiliation(s)
- P S Hall
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - S R Lord
- Department of Oncology, University of Oxford, Oxford, UK
| | - M Collinson
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - H Marshall
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - M Jones
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - C Lowe
- NIHR Cancer Research Network Coordinating Centre, Leeds, UK
| | - H Howard
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - D Swinson
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - A Anthoney
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - R Roy
- Department of Oncology, Castle Hill Hospital, Hull, UK
| | - J Dent
- Department of Oncology, Huddersfield Royal Infirmary, Huddersfield, UK
| | - S Cheeseman
- Department of Oncology, The York Hospital, York, UK
| | - K Last
- Department of Oncology, The York Hospital, York, UK
- Department of Oncology, Bradford Royal Infirmary, Bradford, UK
| | - M T Seymour
- NIHR Cancer Research Network Coordinating Centre, Leeds, UK
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Abstract
Glioblastoma multiforme is the most common and deadliest form of brain cancer. Glioblastomas are infiltrated by a high number of microglia, which promote tumor growth and surrounding tissue invasion. However, it is unclear how microglia and glioma cells physically interact and if there are differences, depending on glioma cell type. Hence, we have developed a novel live imaging assay to study microglia-glioma interactions in vivo in the zebrafish brain. We transplanted well-established human glioblastoma cell lines, U87 and U251, into transgenic zebrafish lines with labelled macrophages/microglia. Our confocal live imaging results show distinct interactions between microglia and U87, as well as U251 glioblastoma cells that differ in number and nature. Importantly these interactions do not appear to be antitumoral as zebrafish microglia do not engulf and phagocytose the human glioblastoma cells. Finally, xenotransplants into the irf8-/- zebrafish mutant that lacks microglia, as well as pharmacological inhibition of the CSF-1 receptor (CSF-1R) on microglia, confirm a prominent role for zebrafish microglia in promoting human glioblastoma cell growth. This new model will be an important tool for drug screening and the development of future immunotherapeutics targeting microglia within glioma.
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Affiliation(s)
- Lloyd Hamilton
- Centre for Neuroregeneration, University of Edinburgh , Edinburgh, United Kingdom
| | - Katy R Astell
- Centre for Neuroregeneration, University of Edinburgh , Edinburgh, United Kingdom
| | - Gergana Velikova
- Centre for Neuroregeneration, University of Edinburgh , Edinburgh, United Kingdom
| | - Dirk Sieger
- Centre for Neuroregeneration, University of Edinburgh , Edinburgh, United Kingdom
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Sebag-Montefiore D, Adams R, Bell S, Berkman L, Gilbert D, Glynne-Jones R, Goh V, Gregory W, Harrison M, Kachnic L, Lee M, McParland L, Muirhead R, O'Neill B, Hutchins G, Rao S, Renehan A, Smith A, Velikova G, Hawkins M. The Development of an Umbrella Trial (PLATO) to Address Radiation Therapy Dose Questions in the Locoregional Management of Squamous Cell Carcinoma of the Anus. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pompili C, White J, Velikova G, O'Connor T, Ying JM, Dixon S, Kefaloyannis E, Brunelli A. O-025POOR PREOPERATIVE PATIENT-REPORTED QUALITY OF LIFE IS ASSOCIATED WITH COMPLICATIONS FOLLOWING PULMONARY LOBECTOMY FOR LUNG CANCER. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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36
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Harji D, Griffiths B, Velikova G, Sagar P, Brown J. Systematic review of health-related quality of life in patients undergoing pelvic exenteration. Eur J Surg Oncol 2016; 42:1132-45. [DOI: 10.1016/j.ejso.2016.01.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 12/30/2015] [Accepted: 01/12/2016] [Indexed: 10/22/2022] Open
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Fatayer H, Sharma N, Manuel D, Kim B, Keding A, Perren T, Velikova G, Lansdown M, Shaaban AM, Dall B. Serial MRI scans help in assessing early response to neoadjuvant chemotherapy and tailoring breast cancer treatment. Eur J Surg Oncol 2016; 42:965-72. [PMID: 27260848 DOI: 10.1016/j.ejso.2016.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 03/06/2016] [Accepted: 03/14/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Tailoring neoadjuvant chemotherapy (NAC) during breast cancer treatment is performed to improve overall tumour response, with increasing evidence to support its role. This study evaluates our breast unit's experience in MRI assessment of tumour response as an aid in tailoring NAC. MATERIALS AND METHODS This is a retrospective study of patients treated with NAC for breast cancer between 2005 and 2009 who underwent MRI to assess tumour response. Response to NAC was monitored before NAC and after 2 and/or 4 cycles of anthracycline and cyclophosphamide (AC) chemotherapy. Taxane was substituted for AC if MRI response was deemed inadequate. Tumour response on last MRI was correlated with final pathology against different tumour subtypes and in inflammatory tumours. Strength of agreement was measured using Kappa analysis. Potential predictive factors for MRI response were assessed for significance. RESULTS 166 tumours were assessed with serial MRI scans. MRI showed high sensitivity rate (93.1%) in predicting response to NAC particularly for tumours showing partial (PR) or complete (CR) response on pathology (p < 0.001) with fair agreement on Kappa analysis (K = 0.31). MRI seems more accurate in triple negative, HR+/HER2+ and high-grade tumours. Early identification of non-responders on MRI resulted in early tailoring of NAC, with improved rates of tumour response seen in 74.2% following switching NAC. Logistic regression showed that PR or CR observed on MRI after 2 NAC cycles significantly predicted pCR (p < 0.001). CONCLUSION Serial MRI can be used to assess patterns of tumour response to NAC. This study shows that tailoring NAC according to pattern of response can improve overall tumour response rates.
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Affiliation(s)
- H Fatayer
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK.
| | - N Sharma
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - D Manuel
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - B Kim
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - A Keding
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - T Perren
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - G Velikova
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK; University of Leeds, Leeds Institute of Cancer and Pathology, UK
| | - M Lansdown
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - A M Shaaban
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
| | - B Dall
- St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
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Norman R, Viney R, Aaronson NK, Brazier JE, Cella D, Costa DSJ, Fayers PM, Kemmler G, Peacock S, Pickard AS, Rowen D, Street DJ, Velikova G, Young TA, King MT. Erratum to: Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format. Qual Life Res 2016; 25:2401. [PMID: 27060090 DOI: 10.1007/s11136-016-1289-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- R Norman
- School of Public Health, Curtin University, Perth, Australia. .,Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia.
| | - R Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia
| | - N K Aaronson
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J E Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D S J Costa
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - G Kemmler
- Innsbruck Medical University, Innsbruck, Austria
| | - S Peacock
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,Canadian Centre for Applied Research in Cancer Control (ARCC), Vancouver, Canada.,British Columbia Cancer Agency, Vancouver, Canada
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D J Street
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, Australia
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.,St James's Hospital, Leeds, UK
| | - T A Young
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - M T King
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia.,Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
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King MT, Costa DSJ, Aaronson NK, Brazier JE, Cella DF, Fayers PM, Grimison P, Janda M, Kemmler G, Norman R, Pickard AS, Rowen D, Velikova G, Young TA, Viney R. QLU-C10D: a health state classification system for a multi-attribute utility measure based on the EORTC QLQ-C30. Qual Life Res 2016; 25:625-36. [PMID: 26790428 DOI: 10.1007/s11136-015-1217-y] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To derive a health state classification system (HSCS) from the cancer-specific quality of life questionnaire, the EORTC QLQ-C30, as the basis for a multi-attribute utility instrument. METHODS The conceptual model for the HSCS was based on the established domain structure of the QLQ-C30. Several criteria were considered to select a subset of dimensions and items for the HSCS. Expert opinion and patient input informed a priori selection of key dimensions. Psychometric criteria were assessed via secondary analysis of a pooled dataset comprising HRQOL and clinical data from 2616 patients from eight countries and a range of primary cancer sites, disease stages, and treatments. We used confirmatory factor analysis (CFA) to assess the conceptual model's robustness and generalisability. We assessed item floor effects (>75 % observations at lowest score), disordered item response thresholds, coverage of the latent variable and differential item function using Rasch analysis. We calculated effect sizes for known group comparisons based on disease stage and responsiveness to change. Seventy-nine cancer patients assessed the relative importance of items within dimensions. RESULTS CFA supported the conceptual model and its generalisability across primary cancer sites. After considering all criteria, 12 items were selected representing 10 dimensions: physical functioning (mobility), role functioning, social functioning, emotional functioning, pain, fatigue, sleep, appetite, nausea, bowel problems. CONCLUSIONS The HSCS created from QLQ-C30 items is known as the EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D). The next phase of the QLU-C10D's development involves valuation studies, currently planned or being conducted across the globe.
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Affiliation(s)
- M T King
- Psycho-Oncology Cooperative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.
- Central Clinical School, Sydney Medical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
| | - D S J Costa
- Psycho-Oncology Cooperative Research Group (PoCoG), School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - N K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J E Brazier
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D F Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - P Grimison
- Chris O'Brien Lifehouse, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - M Janda
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - G Kemmler
- Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria
| | - R Norman
- School of Public Health, Curtin University, Perth, WA, Australia
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Rowen
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital, Leeds, UK
| | - T A Young
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - R Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, NSW, Australia
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Harji DP, Koh C, Solomon M, Velikova G, Sagar PM, Brown J. Development of a conceptual framework of health-related quality of life in locally recurrent rectal cancer. Colorectal Dis 2015; 17:954-64. [PMID: 25760765 DOI: 10.1111/codi.12944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 02/09/2015] [Indexed: 02/08/2023]
Abstract
AIM The surgical management of locally recurrent rectal cancer (LRRC) has become widely accepted to afford cure and improve quality of life in this subset of patients. Thus far, traditional surgical and oncological markers have been used to highlight the success of surgical intervention. The use of patient-reported outcomes, specifically health-related quality of life (HRQoL), is sparse in these patients. This may be in part due to the lack of well-designed, validated instruments. This study identifies HRQoL issues relevant to patients undergoing surgery for LRRC, with the aim of developing a conceptual framework of HRQoL specific to LRRC to enable measurement of patient-reported outcomes in this cohort of patients. METHOD Qualitative focus groups were undertaken at two institutions to identify relevant HRQoL themes. The principles of thematic content analysis were used to analysis data. NViVo10 was used to analyse data. RESULTS Twenty-one patients participated in six consecutive focus groups. Two patterns of themes emerged related to HRQoL and healthcare service delivery and utilization. Identified themes related to HRQoL included symptoms, sexual function, psychological impact, role and social functioning and future perspective. Under healthcare service and delivery and utilization the subdomain of disease management, treatment expectations and healthcare professionals were identified. CONCLUSION This is the first qualitative study undertaken exclusively in patients with LRRC to ascertain relevant HRQoL outcomes. The impact of LRRC on patients is wide-ranging and extends beyond traditional HRQoL outcomes. The study operationalizes the identified outcomes into a conceptual framework, which will provide the basis for the development of a LRRC-specific patient-reported outcome measure.
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Affiliation(s)
- D P Harji
- School of Medicine and Health, University of Leeds, Leeds, UK.,The John Goligher Colorectal Unit, St James' University Hospital, Leeds, UK
| | - C Koh
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - M Solomon
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, University of Sydney, Sydney, New South Wales, Australia
| | - G Velikova
- Leeds Institute of Cancer and Oncology, University of Leeds, Leeds, UK.,St James's Institute of Oncology, St James's University Hospital, Leeds, UK
| | - P M Sagar
- The John Goligher Colorectal Unit, St James' University Hospital, Leeds, UK
| | - J Brown
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
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Norman R, Viney R, Aaronson NK, Brazier JE, Cella D, Costa DSJ, Fayers PM, Kemmler G, Peacock S, Pickard AS, Rowen D, Street DJ, Velikova G, Young TA, King MT. Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format. Qual Life Res 2015; 25:637-49. [PMID: 26342928 DOI: 10.1007/s11136-015-1115-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess the feasibility of using a discrete choice experiment (DCE) to value health states within the QLU-C10D, a utility instrument derived from the QLQ-C30, and to assess clarity, difficulty, and respondent preference between two presentation formats. METHODS We ran a DCE valuation task in an online panel (N = 430). Respondents answered 16 choice pairs; in half of these, differences between dimensions were highlighted, and in the remainder, common dimensions were described in text and differing attributes were tabulated. To simplify the cognitive task, only four of the QLU-C10D's ten dimensions differed per choice set. We assessed difficulty and clarity of the valuation task with Likert-type scales, and respondents were asked which format they preferred. We analysed the DCE data by format with a conditional logit model and used Chi-squared tests to compare other responses by format. Semi-structured telephone interviews (N = 8) explored respondents' cognitive approaches to the valuation task. RESULTS Four hundred and forty-nine individuals were recruited, 430 completed at least one choice set, and 422/449 (94 %) completed all 16 choice sets. Interviews revealed that respondents found ten domains difficult but manageable, many adopting simplifying heuristics. Results for clarity and difficulty were identical between formats, but the "highlight" format was preferred by 68 % of respondents. Conditional logit parameter estimates were monotonic within domains, suggesting respondents were able to complete the DCE sensibly, yielding valid results. CONCLUSION A DCE valuation task in which only four of the QLU-C10D's ten dimensions differed in any choice set is feasible for deriving utility weights for the QLU-C10D.
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Affiliation(s)
- R Norman
- School of Public Health, Curtin University, Perth, Australia. .,Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia.
| | - R Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Sydney, Australia
| | - N K Aaronson
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J E Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D S J Costa
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia
| | - P M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.,Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - G Kemmler
- Innsbruck Medical University, Innsbruck, Austria
| | - S Peacock
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,Canadian Centre for Applied Research in Cancer Control (ARCC), Vancouver, Canada.,British Columbia Cancer Agency, Vancouver, Canada
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - D J Street
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, Australia
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.,St James's Hospital, Leeds, UK
| | - T A Young
- School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK
| | - M T King
- Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, Australia.,Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
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Zikos E, Ghislain I, Coens C, Quinten C, Balta V, Tryfonidis K, Piccart M, Zardavas D, Velikova G, Nagele E, Bjelic-Radisic V, Cardoso F, Sprangers M, Bottomley A. 1835 Health-related quality of life in advanced breast cancer: A systematic review on reporting of methodological and clinical issues in randomized controlled trials. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30786-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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43
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Chapman H, Bloomfield D, Cameron D, Bliss J, Barrett-Lee P, Canney P, Morden J, Velikova G, Hall P. 1231 Cost-effectiveness analysis of the use of pegfilgrastim to enable accelerated adjuvant chemotherapy in the TACT2 trial (CRUK/05/019). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30535-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Horne B, Newsham A, Velikova G, Liebersbach S, Gilleece M, Wright P. Development and evaluation of a specifically designed website for haematopoietic stem cell transplant patients in Leeds. Eur J Cancer Care (Engl) 2015. [DOI: 10.1111/ecc.12352] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- B. Horne
- Psychosocial Oncology and Clinical Practice Research Group; Leeds Institute of Cancer and Pathology (LICAP); University of Leeds; Leeds UK
| | - A. Newsham
- Leeds Institute of Cancer and Pathology; University of Leeds; Leeds UK
| | - G. Velikova
- Psychosocial Oncology and Clinical Practice Research Group; Leeds Institute of Cancer and Pathology (LICAP); University of Leeds; Leeds UK
| | - S. Liebersbach
- St James's University Hospital; Leeds Teaching Hospitals NHS Trust; Leeds UK
| | - M. Gilleece
- St James's University Hospital; Leeds Teaching Hospitals NHS Trust; Leeds UK
| | - P. Wright
- Psychosocial Oncology and Clinical Practice Research Group; Leeds Institute of Cancer and Pathology (LICAP); University of Leeds; Leeds UK
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Holch P, Davidson S, Routledge J, Henry A, Franks K, Gilbert A, Bamforth L, Absolom K, Velikova G. OC-0416: eRAPID: Electronic self-report and management of adverse-events for radical prostate radiotherapy (RT) patients. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40412-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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46
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Hall PS, Hamilton P, Hulme CT, Meads DM, Jones H, Newsham A, Marti J, Smith AF, Mason H, Velikova G, Ashley L, Wright P. Costs of cancer care for use in economic evaluation: a UK analysis of patient-level routine health system data. Br J Cancer 2015; 112:948-56. [PMID: 25602964 PMCID: PMC4453947 DOI: 10.1038/bjc.2014.644] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 11/17/2014] [Accepted: 12/01/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The rising financial burden of cancer on health-care systems worldwide has led to the increased demand for evidence-based research on which to base reimbursement decisions. Economic evaluations are an integral component of this necessary research. Ascertainment of reliable health-care cost and quality-of-life estimates to inform such studies has historically been challenging, but recent advances in informatics in the United Kingdom provide new opportunities. METHODS The costs of hospital care for breast, colorectal and prostate cancer disease-free survivors were calculated over 15 months from initial diagnosis of cancer using routinely collected data within a UK National Health Service (NHS) Hospital Trust. Costs were linked at patient level to patient-reported outcomes and registry-derived sociodemographic factors. Predictors of cost and the relationship between costs and patient-reported utility were examined. RESULTS The study population included 223 breast cancer patients, 145 colorectal and 104 prostate cancer patients. The mean 15-month cumulative health-care costs were £12 595 (95% CI £11 517-£13 722), £12 643 (£11 282-£14 102) and £3722 (£3263-£4208), per-patient respectively. The majority of costs occurred within the first 6 months from diagnosis. Clinical stage was the most important predictor of costs for all cancer types. EQ-5D score was predictive of costs in colorectal cancer but not in breast or prostate cancer. CONCLUSION It is now possible to evaluate health-care cost using routine NHS data sets. Such methods can be utilised in future retrospective and prospective studies to efficiently collect economic data.
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Affiliation(s)
- P S Hall
- Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK
- St James Institute of Oncology, Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK
| | - P Hamilton
- Manchester Royal Infirmary, Manchester Institute of Nephrology and Transplantation, Oxford Road, Manchester M139WL, UK
| | - C T Hulme
- Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK
| | - D M Meads
- Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK
| | - H Jones
- Leeds Institute of Cancer and Pathology, University of Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK
| | - A Newsham
- Leeds Institute of Cancer and Pathology, University of Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK
| | - J Marti
- Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK
| | - A F Smith
- Academic Unit of Health Economics, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Woodhouse, Leeds LS2 9LJ, UK
| | - H Mason
- Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield, South Yorkshire S5 7AU, UK
| | - G Velikova
- Leeds Institute of Cancer and Pathology, University of Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK
| | - L Ashley
- School of Social, Psychological and Communication Sciences, Faculty of Health and Social Sciences, Leeds Beckett University, Calverley Building, City Campus, Leeds LS1 3HE, UK
| | - P Wright
- Leeds Institute of Cancer and Pathology, University of Leeds, Bexley Wing, St James University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK
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Absolom K, Holch P, Woroncow B, Wright EP, Velikova G. Beyond lip service and box ticking: how effective patient engagement is integral to the development and delivery of patient-reported outcomes. Qual Life Res 2015; 24:1077-85. [PMID: 25577498 DOI: 10.1007/s11136-014-0909-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND In the UK, demonstration of patient and public involvement (PPI) is now a funding requirement. Despite advice being available to researchers regarding PPI, levels of engagement are variable. Patient involvement has been at the core of the Leeds Psychosocial Oncology and Clinical Practice Research Group since 2007 when a local Research Advisory Group (RAG) was established. In addition, we work with experienced patient advocates from national groups. METHODS The RAG is led by designated researchers who manage and communicate with members. The RAG is invited to twice yearly meetings with the full research team when study findings are disseminated and advice sought. The meetings are also an opportunity to socialise and thank members. Effective partnerships and engagement require good communication, building relationships over time and tailoring involvement to individuals' skills and experience. RESULTS Patients have been involved in design, planning new projects and assisting with grant proposals; development, pilot testing of interview strategies and question generation, project steering groups and management teams, development of self-management advice for online patient portals; implementation, extensive beta testing of new questionnaire builder software to enable collection of online patient-reported outcomes (PRO) and study websites, cognitive interviews to develop PRO items; dissemination, co-authorship of papers and presentations, attendance/representation of the group at conferences. CONCLUSION The involvement of patient advocates is integral to ensuring PRO development remains patient-centred. Having a co-operative, well-established local PPI group and nationally active patient collaborators has had a rewarding and significant impact on our research programmes.
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Affiliation(s)
- K Absolom
- Psychosocial Oncology and Clinical Practice Research Group, St James' Institute of Oncology, University of Leeds, Level 3, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK,
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Costa DSJ, Aaronson NK, Fayers PM, Pallant JF, Velikova G, King MT. Testing the measurement invariance of the EORTC QLQ-C30 across primary cancer sites using multi-group confirmatory factor analysis. Qual Life Res 2014; 24:125-33. [DOI: 10.1007/s11136-014-0799-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2014] [Indexed: 11/29/2022]
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49
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Stark D, Cook A, Brown J, Velikova G, Brundage M, Embleton A, Raja F, Ledermann J. Quality of Life in a Randomised Double-Blind Phase III Trial of Cediranib (Azd2171) in Relapsed Platinum Sensitive Ovarian Cancer (Icon6). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu338.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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50
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Velikova G, Hudgens S, Forsythe A, McCutcheon S, Cortes J. Health-Related Quality of Life (Hrqol) and Disease Symptoms in Patients (Pts) with Locally Advanced or Metastatic Breast Cancer (Mbc) Treated with Eribulin (Eri) or Capecitabine (Cap) in a Post Anthracycline and Taxane Setting. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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