Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery

Quinten, Chantal and Kenis, Cindy and Decoster, Lore and Debruyne, Philip R. and De Groof, Inge and Focan, Christian and Cornélis, Frank and Verschaeve, Vincent and Bachmann, Christian and Bron, Dominique and Luce, Sylvie and Debugne, Gwenaëlle and Van den Bulck, Heidi and Goeminne, Jean-Charles and Baitar, Abdelbari and Geboers, Katrien and Petit, Benedicte and Langenaeken, Christine and Van Rijswijk, Ruud and Specenier, Pol and Jerusalem, Guy and Praet, Jean-Philippe and Vandenborre, Katherine and Lycke, Michelle and Flamaing, Johan and Milisen, Koen and Lobelle, Jean-Pierre and Wildiers, Hans (2019) Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery. Quality of Life Research, 28 (3). pp. 663-676. ISSN 1573-2649

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Official URL: http://dx.doi.org/10.1007/s11136-018-2062-6

Abstract

PURPOSE: Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes. METHODS: Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes. RESULTS: The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment. CONCLUSION: The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.

Item Type: Journal Article
Keywords: Cancer, Elderly patients with cancer, Geriatric assessment, Quality of life, Minimal important differences
Faculty: Faculty of Health, Education, Medicine & Social Care
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 11 Sep 2019 10:39
Last Modified: 03 Dec 2019 02:02
URI: http://arro.anglia.ac.uk/id/eprint/704745

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