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Christiansen MG, Pappot H, Jensen PT, Mirza MR, Jarden M, Piil K. A multi-method approach to selecting PRO-CTCAE symptoms for patient-reported outcome in women with endometrial or ovarian cancer undergoing chemotherapy. J Patient Rep Outcomes 2023; 7:72. [PMID: 37462855 PMCID: PMC10354345 DOI: 10.1186/s41687-023-00611-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Women with endometrial or ovarian cancer experience a variety of symptoms during chemotherapy. Patient-Reported outcomes (PROs) can provide insight into the symptoms they experience. A PRO tool tailored to this patient population can help accurately monitor adverse events and manage symptoms. The objective of this study was to identify items in the National Cancer Institute's measurement system Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®) appropriate for use in a PRO tool for a population of women with endometrial or ovarian cancer undergoing treatment with taxanes (paclitaxel or docetaxel) in combination with carboplatin. METHODS A two-phase, sequential multi-methods approach was applied. In phase one, a comprehensive literature search was done to map the toxicity of the applied chemotherapeutics and phase III clinical studies. Phase two, which comprised selecting the PRO-CTCAE items, included discussions with and feedback from a patient advisory board, an additional literature search, and focus group interviews with senior oncologists and specialized oncology nurses. A national expert panel facilitated both phases in terms of carefully select items from the PRO-CTCAE library. RESULTS Phase one identified 18 symptoms and phase two, three additional ones, leading to the inclusion of 21 PRO-CTCAE symptoms in the final PRO tool. Since PRO-CTCAE also contains one to three sub-questions on the frequency, severity, and interference with daily activities of symptoms, there were 44 potential items. CONCLUSIONS This study describes taking a multi-method approach to selecting items from the PRO-CTCAE library for use in a population of women with endometrial or ovarian cancer undergoing chemotherapy. By systematically combining diverse approaches, we carefully selected 21 clinically relevant symptoms covered by 44 items in the PRO-CTCAE library. Future studies should investigate the psychometric properties of this PRO tool for women with endometrial or ovarian cancer.
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Affiliation(s)
- Mille Guldager Christiansen
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Helle Pappot
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Tine Jensen
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, University of Aarhus, Aarhus, Denmark
| | - Mansoor Raza Mirza
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mary Jarden
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of People and Technology, Roskilde University, Roskilde, Denmark
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Schroeder KM, Rizzieri T, Lion RR, Mtenga N, Gisiri M, McFatrich M, Reeve BB. Swahili translation and cultural adaptation of the pediatric patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). J Patient Rep Outcomes 2023; 7:56. [PMID: 37306774 PMCID: PMC10260717 DOI: 10.1186/s41687-023-00598-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The pediatric patient-reported outcomes version of the common terminology criteria for adverse event measure was developed and validated for use in pediatric cancer clinical trials to better capture the symptom experiences through direct self-report. The study aim was to develop and validate a Swahili language version of the patient-reported outcomes version of the common terminology criteria for adverse event measure. METHODS The pediatric version of 15 core symptom adverse events, and the corresponding questions, were selected from the patient-reported outcomes version of the common terminology criteria for adverse event library, then forward and back translated into Swahili by bilingual translators. The translated items were further refined using concurrent cognitive interviewing. Each round of interviews included five children, ages 8-17 years-old, receiving cancer therapy at Bugando Medical Centre, the cancer referral hospital for Northwest Tanzania, and continued until at least 80% of participants understood the question. RESULTS Three rounds of cognitive interviews were completed involving 13 patients and 5 caregivers. Among patients, 50% of questions (19/38) were fully comprehended after the first interview round. Two Adverse Events (anxiety and peripheral neuropathy) were the most difficult for participants to understand, associated with education level and experience. Goal comprehension was achieved after three rounds of interviews with no further revisions required. All parents in the first cognitive interview group comprehended the survey, with no additional revisions. CONCLUSION A Swahili patient-reported outcomes version of the common terminology criteria for adverse event was effective in eliciting patient-reported Adverse Events related to cancer treatment, with good comprehension for children aged 8-17 years. This survey is important to incorporate patient self-reporting of symptomatic toxicities and is an effective tool to increase capacity for pediatric cancer clinical trials throughout East Africa, further reducing global disparities in cancer care.
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Affiliation(s)
| | | | | | | | | | | | - Bryce B Reeve
- Duke Department of Population Health Sciences, Durham, USA
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Li M, Shi J, Sheng Y, Zhang Y, Wu T, Yang J, Zhang K, Sun W, Kong X. Effect of focused power ultrasound-mediated perirenal fat modification on primary hypertension: protocol of a multicenter, randomized, double-blinded, sham-controlled study. Trials 2023; 24:221. [PMID: 36959658 PMCID: PMC10035202 DOI: 10.1186/s13063-023-07249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
Background Perirenal fat plays a key role in sustaining pathological high blood pressure. We aim to investigate the efficacy of intervention for perirenal fat mediated by focused power ultrasound (FPU) on primary hypertension. Methods A multicenter, randomized, sham-controlled, double-blinded trial will be implemented in 200 participants with mild to moderate hypertension. All enrolled participants will be randomly allocated to perirenal fat modification (PFM) intervention using FPU or sham-procedure at a ratio of 1:1 and will be followed up at 24 h, 14 days, 30 days, and 90 days after the intervention. The primary endpoint is changes in office systolic blood pressure (SBP) at 30 days compared with baseline. The secondary endpoints include the changes in office SBP from baseline to 90 days, changes in 24-h mean SBP from baseline to 30 days and 90 days, and changes in heart rate from baseline to 30 days. Safety endpoint is defined as any severe adverse events related to the intervention. Discussion The present study is the first to use noninvasive FPU to intervene in perirenal fat to achieve the goal of reducing blood pressure for patients with essential hypertension. Our study is expected to provide a new treatment strategy to control high blood pressure. Trial registration ClinicalTrials.gov. NCT05049096. Registered on September 7, 2021. Protocol version: Version 1.3.1, data 23 August 2021. Sponsor: Prof. Xiangqing Kong is the principal investigator of this trial.
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Affiliation(s)
- Menghuan Li
- grid.412676.00000 0004 1799 0784Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000 China
| | - Jing Shi
- grid.412676.00000 0004 1799 0784Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000 China
| | - Yanhui Sheng
- grid.412676.00000 0004 1799 0784Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000 China
- grid.89957.3a0000 0000 9255 8984Gusu School, Nanjing Medical University, Suzhou, 215100 China
| | - Yuqing Zhang
- grid.89957.3a0000 0000 9255 8984Department of Cardiology, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 210000 China
| | - Tingting Wu
- grid.412676.00000 0004 1799 0784Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000 China
| | - Jiaming Yang
- grid.412676.00000 0004 1799 0784Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000 China
| | - Kerui Zhang
- grid.89957.3a0000 0000 9255 8984Gusu School, Nanjing Medical University, Suzhou, 215100 China
| | - Wei Sun
- grid.412676.00000 0004 1799 0784Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000 China
| | - Xiangqing Kong
- grid.412676.00000 0004 1799 0784Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210000 China
- grid.89957.3a0000 0000 9255 8984Gusu School, Nanjing Medical University, Suzhou, 215100 China
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Translation Into Simplified Chinese and Cultural Validation of the Pediatric Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events Using Cognitive Interviewing. Cancer Nurs 2023; 46:E31-E40. [PMID: 35583994 DOI: 10.1097/ncc.0000000000001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The original English Pediatric Patient-Reported Outcome version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) captures symptomatic adverse events (AEs) in cancer clinical trials from the perspective of pediatric patients. A Chinese version was needed to encourage the use of the Pediatric PRO-CTCAE among Chinese pediatric oncology patients. OBJECTIVE This study translated and linguistically validated a simplified Chinese version of the Pediatric PRO-CTCAE for oncological patients aged 7 to 18 years. METHODS Following the Functional Assessment of Chronic Illness Therapy translation methodology, 130 questions were translated into Chinese. Semistructured cognitive interviews investigated the comprehensibility and clarity of terms for symptoms, attributes, and response options. Two rounds of interviews were conducted with 48 native Chinese-speaking children aged 7 to 18 years who were undergoing chemotherapy or radiotherapy treatment. RESULTS Most items, response options, and recall periods were well understood by children across the age range in round 1. Nineteen items posed comprehension difficulties for 9 participants and were revised and retested without further difficulties. CONCLUSIONS The Pediatric PRO-CTCAE was successfully developed and linguistically validated among Chinese oncology patients. The results indicated that the Chinese Pediatric PRO-CTCAE was semantically and conceptually equivalent to the English version. IMPLICATIONS FOR PRACTICE The availability of the simplified Chinese Pediatric PRO-CTCAE will facilitate the generation of patient-reported outcome data about symptomatic AEs for children with cancer in China and thus improve our understanding of children's experience of treatment-related symptoms.
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Nielsen SW, Hasselsteen SD, Dominiak HSH, Labudovic D, Reiter L, Dalton SO, Herrstedt J. Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy. Support Care Cancer 2022; 30:9441-9451. [PMID: 35933415 DOI: 10.1007/s00520-022-07312-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/03/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE To assess the safety, dosing, and preventive effects of cannabidiol (CBD) on chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving oxaliplatin- or paclitaxel-based chemotherapy. METHODS Patients with cancer scheduled to undergo treatment with carboplatin and paclitaxel (Carbo-Tax) or capecitabine and oxaliplatin (CAPOX) received 150 mg CBD oil twice daily (300 mg/daily) for 8 days beginning 1 day before initiation of chemotherapy. Ten CIPN-specific patient-reported outcome (PRO) measures were captured at baseline and each day after the first cycle of chemotherapy for 8 days. Multi-frequency vibrometry (MF-V) was captured at baseline and day 4 ± 1 after initiation of chemotherapy. Controls were obtained from a similar patient cohort that did not receive CBD. Adverse events were captured using the CTCAE ver. 4.03. RESULTS From March to December 2021, 54 patients were recruited. CBD-treated patients were significantly older (p = 0.013/0.037, CAPOX/Carbo-Tax) compared to controls. Patients receiving CBD and CAPOX or Carbo-Tax showed significantly lower (better) change in Z-scores in high-frequency MF-V (125 and 250 Hz) compared to controls. This difference was most pronounced for patients receiving Carbo-Tax (- 1.76, CI-95 = [- 2.52; - 1.02] at 250 Hz). CAPOX patients treated with CBD had significantly lower peak baseline-adjusted difference in three PRO items on cold sensitivity to touch, discomfort swallowing cold liquids, and throat discomfort (- 2.08, - 2.06, and - 1.81, CI-95 = [- 3.89; - 0.12], NRS 0-10). No significant differences in PRO items were found for patients receiving Carbo-Tax. Possible side effects included stomach pain (grades 1-2) for patients receiving CAPOX. CONCLUSION CBD attenuated early symptoms of CIPN with no major safety concerns. Long-term follow-up is ongoing. Results should be confirmed in a larger, randomized study. TRIAL REGISTRATION NUMBER NCT 04,167,319 (U.S National Library of Medicine; ClinicalTrials.gov). Date of registration: November 18, 2019.
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Affiliation(s)
- Sebastian W Nielsen
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Vestermarksvej 9, 4000, Roskilde, Denmark.
| | - Simone Dyring Hasselsteen
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Vestermarksvej 9, 4000, Roskilde, Denmark
| | - Helena Sylow Heilmann Dominiak
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Vestermarksvej 9, 4000, Roskilde, Denmark
| | - Dejan Labudovic
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Vestermarksvej 9, 4000, Roskilde, Denmark
| | - Lars Reiter
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Vestermarksvej 9, 4000, Roskilde, Denmark
| | - Susanne Oksbjerg Dalton
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Vestermarksvej 9, 4000, Roskilde, Denmark.,Survivorship & Inequality in Cancer, Danish Cancer Society Research Center, 2100, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165, Copenhagen, Denmark
| | - Jørn Herrstedt
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Vestermarksvej 9, 4000, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165, Copenhagen, Denmark
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Caminiti C, Bryce J, Riva S, Ng D, Diodati F, Iezzi E, Sparavigna L, Novello S, Porta C, Del Mastro L, Procopio G, Cinieri S, Falzetta A, Calabrò F, Lorusso V, Cogoni AA, Tortora G, Maruzzo M, Passalacqua R, Cognetti F, Adamo V, Capelletto E, Ferrari A, Bagnalasta M, Bassi M, Nicelli A, De Persis D, D'Acunti A, Iannelli Patient E, Perrone F, Mitchell SA. Cultural adaptation of the Italian version of the Patient-Reported Outcomes Common Terminology Criteria for Adverse Event (PRO-CTCAE®). TUMORI JOURNAL 2022:3008916221099558. [PMID: 35674125 DOI: 10.1177/03008916221099558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION US National Cancer Institute's (NCI) Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®) is a library of 78 symptom terms and 124 items enabling patient reporting of symptomatic adverse events in cancer trials. This multicenter study used mixed methods to develop an Italian language version of this widely accepted measure, and describe the content validity and reliability in a diverse sample of Italian-speaking patients. METHODS All PRO-CTCAE items were translated in accordance with international guidelines. Subsequently, the content validity of the PRO-CTCAE-Italian was explored and iteratively refined through cognitive debriefing interviews. Participants (n=96; 52% male; median age 64 years; 26% older adults; 18% lower educational attainment) completed a PRO-CTCAE survey and participated in a semi-structured interview to determine if the translation captured the concepts of the original English language PRO-CTCAE, and to evaluate comprehension, clarity and ease of judgement. Test-retest reliability of the finalized measure was explored in a second sample (n=135). RESULTS Four rounds of cognitive debriefing interviews were conducted. The majority of PRO-CTCAE symptom terms, attributes and associated response choices were well-understood, and respondents found the items easy to judge. To improve comprehension and clarity, the symptom terms for nausea and pain were rephrased and retested in subsequent interview rounds. Test-retest reliability was excellent for 41/49 items (84%); the median intraclass correlation coefficient was 0.83 (range 0.64-0.94). DISCUSSION Results support the semantic, conceptual and pragmatic equivalence of PRO-CTCAE-Italian to the original English version, and provide preliminary descriptive evidence of content validity and reliability.
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Affiliation(s)
- Caterina Caminiti
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | - Jane Bryce
- Ascension St. John Clinical Research Institute, Tulsa, Oklahoma, USA
| | - Silvia Riva
- Department of Psychology, St Mary's University, London, UK
| | - Diane Ng
- Westat Inc, Rockville, Maryland, USA
| | - Francesca Diodati
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | - Elisa Iezzi
- Research and Innovation Unit, University Hospital of Parma, Parma, Italy
| | - Lucia Sparavigna
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - Silvia Novello
- Department of Oncology, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Italy
| | - Camillo Porta
- Division of Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy.,Department of Biomedical Sciences and Human Oncology, University of Bari A. Moro, Bari, Italy
| | - Lucia Del Mastro
- Department of Medical Oncology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
| | - Giuseppe Procopio
- Fondazione IRCCS, Istituto Nazionale dei Tumori, Oncology Unit 1, Milan, Italy
| | - Saverio Cinieri
- Medical Oncology & Breast Unit, Antonio Perrino Hospital, Brindisi, Italy
| | | | - Fabio Calabrò
- Department of Oncology, San Camillo Forlanini Hospital, Rome, Italy
| | - Vito Lorusso
- Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Oncologico, Bari, Italy
| | | | - Giampaolo Tortora
- Department of Oncology, G.B. Rossi Hospital, University of Verona, Verona, Italy
| | - Marco Maruzzo
- Oncology Unit 1, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | | | - Francesco Cognetti
- Department of Clinical and Molecular Medicine, Università La Sapienza di Roma, Roma, Italy
| | - Vincenzo Adamo
- Medical Oncology Unit, A.O. Papardo & Department of Human Pathology University of Messina, Messina, Italy
| | - Enrica Capelletto
- Department of Oncology, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Orbassano, Italy
| | - Alessandra Ferrari
- Division of Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy
| | | | | | | | - Davide De Persis
- Federazione Italiana delle Associazioni di Volontariato in Oncologia - F.A.V.O., Rome, Italy
| | - Alessia D'Acunti
- Associazione Italiana Malati di Cancro, parenti ed amici - AIMaC, Rome Italy
| | | | - Francesco Perrone
- Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Napoli, Italy
| | - Sandra A Mitchell
- Division of Cancer Control and Population Sciences, Outcomes Research Branch, National Cancer Institute, Rockville, Maryland, USA
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Bamgboje-Ayodele A, Arnold B, Durcinoska I, Avery S, Vinod S, Rincones O, Thomas T, Descallar J, Smith B, Delaney GP, Girgis A. Implementing patient-reported outcomes into routine care: an audit of cancer patients from two local health districts in New South Wales to understand their capabilities and preferences. AUST HEALTH REV 2022; 46:331-337. [PMID: 35545809 DOI: 10.1071/ah21270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/03/2022] [Indexed: 11/23/2022]
Abstract
ObjectiveIt has been established that the implementation of patient-reported outcome measures (PROMs) in routine care provides significant benefits to patients, providers and health services. However, there are patient-level barriers that must be identified and addressed for the successful implementation of PROMs. This study aimed to understand the capabilities and preferences of our cancer patient population prior to implementation of electronically collected PROMs (ePROMs). Specifically, we conducted a clinic audit to determine the proportion of patients in clinics with access to out-of-clinic internet; those preferring to complete PROMs on paper or via an electronic device; those capable of completing PROMs in English; and those anticipating requiring assistance to complete PROMs.MethodsPatients receiving cancer treatment or follow-up care at two Local Health Districts (LHDs) in New South Wales, Australia, completed a questionnaire (audit form) with items about internet and mobile access, communication preferences and assistance needed to complete PROMs. Participant demographic and treatment information were extracted from their electronic medical records.ResultsAcross both LHDs, 637 of 1668 participants (38%) completed the audit forms. Mean participant age was 65 years (range = 23-98), 53% were female, and 92% were outpatients. Patients in the two LHDs differed in their levels of internet and email access, and ability to complete PROMs independently in English, suggesting that some LHD-specific tailoring of implementation strategies is necessary to optimise ePROMs uptake.ConclusionThis study highlights the importance of understanding the specific local contexts and patient populations, including potential technology and language barriers, which can influence patient ability to complete ePROMs.
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Affiliation(s)
- Adeola Bamgboje-Ayodele
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia; and South Western Sydney Clinical School, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; and Present address: Faculty of Medicine and Health, School of Medical Sciences, Biomedical Informatics and Digital Health, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Belinda Arnold
- Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW 2500, Australia
| | - Ivana Durcinoska
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia
| | - Sandra Avery
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia; and South Western Sydney Clinical School, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; and Liverpool Cancer Therapy Centre, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia
| | - Shalini Vinod
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia; and South Western Sydney Clinical School, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; and Liverpool Cancer Therapy Centre, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia
| | - Orlando Rincones
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia
| | - Tien Thomas
- Liverpool Cancer Therapy Centre, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia; and South Western Sydney Clinical School, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
| | - Ben Smith
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia; and South Western Sydney Clinical School, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
| | - Geoff P Delaney
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia; and South Western Sydney Clinical School, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; and Liverpool Cancer Therapy Centre, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research, Liverpool, NSW 1871, Australia; and South Western Sydney Clinical School, UNSW Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia
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Christiansen MG, Jarden M, Bager L, Mirza MR, Pappot H, Piil K. SystematiC nurse-led cONsultations based oN Electronic patient-reported outcome among women with ovarian- or endometrial Cancer during chemoTherapy - protocol for the CONNECT study. Acta Oncol 2022; 61:602-607. [PMID: 35311443 DOI: 10.1080/0284186x.2022.2046850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Mille Guldager Christiansen
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Mary Jarden
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Louise Bager
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Mansoor Raza Mirza
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Faculty of Health, University of Aarhus, Aarhus, Denmark
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Nielsen SW, Lindberg S, Ruhlmann CHB, Eckhoff L, Herrstedt J. Addressing Chemotherapy-Induced Peripheral Neuropathy Using Multi-Frequency Vibrometry and Patient-Reported Outcomes. J Clin Med 2022; 11:jcm11071862. [PMID: 35407470 PMCID: PMC8999713 DOI: 10.3390/jcm11071862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023] Open
Abstract
(1) The study evaluated correlations between multi-frequency vibrometry (MF-V) and the measure of chemotherapy-induced peripheral neuropathy developed by the European Organization for the Research and Treatment of Cancer (CIPN18). (2) Patients with cancer scheduled to undergo treatment with capecitabine and oxaliplatin (CAPOX) or carboplatin and paclitaxel (Carbo-Tax) were recruited in a prospective, observational study with MF-V and the CIPN18 from baseline to one year after end of treatment. (3) The study recruited 31 evaluable patients. All MF-V measurements correlated significantly with the CIPN18 scores (r = 0.25−0.48, p > 0.003), with a low frequency (32 Hz) from metatarsals showing the best correlation coefficients (0.059 Z-score per CIPN18 point change, r = 0.48, CI-95 = [0.32; 0.60], p > 0.0001). The largest change in MF-V scores from baseline was seen in low-frequency VPTs taken from metatarsals at 8 Hz three months after end of treatment (from −0.26, CI-95 [−0.85, 0.38] to 1.15, CI-95 [0.53, 1.84]) for patients treated with oxaliplatin and at 32 Hz one year after end of treatment (from 0.09, CI-95 [−0.56, 0.77] to 0.88, CI-95 [0.34, 1.47]) for patients treated with paclitaxel. (4) Low-frequency vibration perception thresholds (8 and 32 Hz) correlated better with CIPN18 scores than high-frequency ones (128 and 250 Hz). If validated, this finding will advance CIPN pathophysiological understanding and inform the development of assessment methods.
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Affiliation(s)
- Sebastian W. Nielsen
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, 4000 Roskilde, Denmark; (S.L.); (J.H.)
- Correspondence:
| | - Sanne Lindberg
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, 4000 Roskilde, Denmark; (S.L.); (J.H.)
| | - Christina Halgaard Bruvik Ruhlmann
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark;
- Department of Oncology R, Odense University Hospital, 5000 Odense C, Denmark;
| | - Lise Eckhoff
- Department of Oncology R, Odense University Hospital, 5000 Odense C, Denmark;
| | - Jørn Herrstedt
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, 4000 Roskilde, Denmark; (S.L.); (J.H.)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
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Rasmussen IML, Soerensen AV, Møller AK, Persson GF, Palshof JA, Taarnhøj GA, Pappot H. How to individualise oncological treatment of patients with metastatic non-clear cell renal cell carcinoma by using gene sequencing and Patient-Reported Outcomes: INDIGO study protocol (Preprint). JMIR Res Protoc 2022; 11:e36632. [PMID: 36107483 PMCID: PMC9523525 DOI: 10.2196/36632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/19/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background No phase 3 studies have yet been conducted for patients with non–clear cell (CC) renal cell carcinoma (RCC) exclusively due to the rare occurrence of the disease and the heterogenicity in tumor morphology. Consequently, there is no evidence of the optimal treatment, and new approaches are needed. One approach is individualizing treatment based on the gene sequencing of tumor tissue. Additionally, recent studies involving the patient-reported outcomes (PROs) of patients treated for metastatic cancer have shown significant benefits for quality of life, median overall survival, and overall survival. The use of gene sequencing and PROs can be of great importance to patients with rare cancer types, including patients with non-CC RCC, and should be investigated in clinical trials, especially for cases where evidence based on phase 3 studies is difficult to obtain. Objective We describe the INDIGO study, in which patients, based on gene analyses, will be allocated into 4 treatment arms containing 14 treatments and use electronic PROs. We aim to improve the treatment of patients with non-CC RCC. The end points in the study will be the overall response rate (complete and partial) in the total patient population, which will be based on the RECIST (Response Evaluation Criteria in Solid Tumors) version 1.1 criteria, and the time to treatment failure. Methods INDIGO is a prospective phase 2 trial, and 30 patients will be enrolled. The patients will receive systemic treatment based on genetic analyses of their tumor tissue. All patients will receive electronic questionnaires in a dedicated app—a questionnaire regarding symptoms and side effects and another regarding health-related quality of life. Depending on the treatment regimen, the patients will be seen by a medical doctor every third, fourth, or sixth week, and the effect of the systemic treatment will be evaluated every 6 weeks via a computed tomography scan. The study has been approved by the Danish Medicines Agency and the National Committee on Health Research Ethics (approval number: H-19041833), complies with good clinical practice guidelines, follows the General Data Protection Regulation, and is registered at the Capital Region of Denmark. Results Recruitment started in March 2020, and at the time of submitting this paper (June 2022), a total of 9 patients have been enrolled. Conclusions We aim to explore methods for improving the treatment outcomes of patients with non-CC RCC, and the INDIGO study will contribute further data on personalized medicine for rare types of RCC and provide new knowledge on the active use of electronic PROs. Trial Registration ClinicalTrials.gov NCT04644432, https://clinicaltrials.gov/ct2/show/NCT04644432 ; European Union Drug Regulating Authorities Clinical Trials Database 2019-001316-38, https://tinyurl.com/2p8mb4aw International Registered Report Identifier (IRRID) DERR1-10.2196/36632
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Affiliation(s)
- Ida Marie Lind Rasmussen
- Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, København, Denmark
| | - Anne Vest Soerensen
- Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | | | - Gitte Fredberg Persson
- Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, København, Denmark
| | | | | | - Helle Pappot
- Department of Clinical Medicine, University of Copenhagen, København, Denmark
- Department of Oncology, Rigshospitalet, København, Denmark
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11
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Lehmann E, Hodiamont F, Landmesser M, Knobloch CS, Nauck F, Ostgathe C, Grüne B, Bausewein C. Adaptation of the Australian Palliative Care Phase concept to the German palliative care context: a mixed-methods approach using cognitive interviews and cross-sectional data. BMC Palliat Care 2021; 20:128. [PMID: 34391419 PMCID: PMC8364299 DOI: 10.1186/s12904-021-00825-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Palliative care phases (stable, unstable, deteriorating, terminal and bereavement) are routinely used in Australia and the UK to describe the clinical situation of patients and their families and to evaluate the associated care plan. In addition, it serves as a benchmark developed by the Australian Palliative Care Outcome Collaboration (PCOC) and is used nationwide for comparisons between services. In Germany, the concept is not used consistently due to various translations. Furthermore, there is no nationwide systematic approach to routinely assess clinical outcomes in palliative care. The study aims to develop a German version of the palliative care phase definitions by adapting them culturally, and to examine the inter-rater reliability of the adjusted definitions with healthcare professionals. METHODS Mixed-methods approach: Cognitive interview study using 'think aloud' and verbal probing techniques and a consecutive multi-center cross-sectional study with two clinicians independently assigning the phase definitions. Interviewees/participants were selected through convenience and purposive sampling in specialist palliative care inpatient units, advisory and community services and in three specialist palliative care units with doctors, nursing staff and allied health professionals. RESULTS Fifteen interviews were conducted. Identified difficulties were: Some translated terms were 1) not self-explanatory (e.g. 'family/carer' or 'care plan') and (2) too limited to the medical dimension neglecting the holistic approach of palliative care. (3) Problems of comprehension regarding the concept in general occurred, e.g. in differentiating between the 'unstable' and 'deteriorating' phase. Inter-rater reliability was moderate (kappa = 0.44; 95% CI = 0.39-0.52). The assignment of the phase 'deteriorating' has caused the most difficulties. CONCLUSION Overall, the adapted palliative care phases are suitable to use in the German specialist palliative care setting. However, the concept of the phases is not self-explanatory. To implement it nationwide for outcome measurement/benchmarking, it requires further education, on-the-job training and experience as well as the involvement of healthcare professionals in implementation process. For the use of international concepts in different healthcare systems, a deeper discussion and cultural adaptation is necessary besides the formal translation.
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Affiliation(s)
- Eva Lehmann
- Department, of Palliative Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
| | - Farina Hodiamont
- Department, of Palliative Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Mirjam Landmesser
- Department of Palliative Medicine, University Medical Center Goettingen, Goettingen, Germany
| | - Carina S Knobloch
- Department of Palliative Medicine, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Friedemann Nauck
- Department of Palliative Medicine, University Medical Center Goettingen, Goettingen, Germany
| | - Christoph Ostgathe
- Department of Palliative Medicine, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bettina Grüne
- Department, of Palliative Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Claudia Bausewein
- Department, of Palliative Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
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12
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Chen Y, Gu J, Yin M, Wang C, Chen D, Yang L, Chen X, Lin Z, Du J, Cui S, Ma C, Luo H. Safety and efficacy of S1 monotherapy or combined with nab-paclitaxel in advanced elderly pancreatic cancer patients: A meta-analysis. Medicine (Baltimore) 2021; 100:e26342. [PMID: 34160399 PMCID: PMC8238291 DOI: 10.1097/md.0000000000026342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/28/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To evaluate the therapeutic efficacy and safety of S1 monotherapy or combination with nab-paclitaxel for the treatment of elderly patients with metastatic or locally advanced pancreatic adenocarcinoma. METHOD PubMed, Embase, Cochrane Central Library, China Biology Medicine, and China National Knowledge Infrastructure databases were searched without time limits according to the inclusion criteria. RevMan (Version 5.3) software was used for data extraction and meta-analysis. Objective response rate (ORR) and disease control rate (DCR) were used to evaluate therapeutic effects while side effects including leukopenia, thrombocytopenia, neurotoxicity, vomit, and alopecia were extracted for evaluation. There was no need for ethical review in this study because no ethical experiments were conducted and all data used were public data. All relevant data are within the paper and its Supporting Information files. RESULTS Four retrospective studies comprising 308 elderly patients with metastatic or locally advanced pancreatic adenocarcinoma were included in the analysis. One hundred fifty-one patients underwent S1 monotherapy and 157 received S1 combined nab-paclitaxel. Meta-analysis indicated that compared with S1 monotherapy, S1 combined with nab-paclitaxel had higher ORR (OR 2.25, 95% CI: 1.42-3.55; P = .0005) and DCR (OR 2.94, 95% CI: 1.55-5.58; P = .0009). The adverse reaction of leukopenia was higher in the combined therapy group (OR 1.85, 95% CI: 1.09-3.13, P = .02), but no significant difference was found in thrombocytopenia, neurotoxicity, vomiting, and alopecia between the 2 groups (P > .05). CONCLUSION Nab-paclitaxel plus S1 was more efficient in terms of ORR and DCR than S1 monotherapy in elderly pancreatic ductal adenocarcinoma patients while the side effect was controllable with a higher probability of leukopenia. Thus, combined nab-paclitaxel and S1 could be safely used in elderly patients.
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Affiliation(s)
- Yunlong Chen
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | - Jiangning Gu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | | | - Chenqi Wang
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | - Dan Chen
- Department of Pathology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lili Yang
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | - Xiang Chen
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | - Zhikun Lin
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | - Jian Du
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | - Shimeng Cui
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | - Chi Ma
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
| | - Haifeng Luo
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University
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13
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Taarnhøj GA, Lindberg H, Johansen C, Pappot H. Patient-Reported Outcomes, Health-Related Quality of Life, and Clinical Outcomes for Urothelial Cancer Patients Receiving Chemo- or Immunotherapy: A Real-Life Experience. J Clin Med 2021; 10:jcm10091852. [PMID: 33923176 PMCID: PMC8123186 DOI: 10.3390/jcm10091852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/06/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022] Open
Abstract
Patients with urothelial cell carcinoma (UCC) often have comorbidities, which cause trouble for the completion of oncological treatment, and little is known about their quality of life (QoL). The aim of the present study was to obtain and describe patient-reported outcomes (PRO) and QoL data from UCC patients in the treatment for locally advanced muscle-invasive or metastatic UCC. A total of 79 patients with UCC completed four questionnaires (EORTC QLQ-C30, QLQ-BLM30, HADS, and select PRO-CTCAE™ questions) once weekly during their treatment. From those, 26 patients (33%) underwent neoadjuvant treatment for local disease while 53 patients (67%) were treated for metastatic disease. Of all patients, 54% did not complete the planned treatment due to progression, nephrotoxicity, death, or intolerable symptoms during treatment. The five most prevalent PRO-CTCAE grade ≥ 2 symptoms were frequent urination (37%), fatigue (35%), pain (31%), dry mouth (23%), and swelling of the arms or legs (23%). The baseline mean overall QoL was 61 (±SD 24) for all patients (neoadjuvant (73, ±SD 19) and metastatic (54, ±SD 24)) and remained stable over the course of treatment for both groups. A stable overall QoL was observed for the patients in this study. More than half of the patients did not, however, complete the planned treatment. Further supportive care is warranted for bladder cancer patients.
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Affiliation(s)
- Gry Assam Taarnhøj
- Department of Oncology, University Hospital of Copenhagen, Rigshospitalet, 2100 Copenhagen, Denmark; (C.J.); (H.P.)
- Correspondence: ; Tel.: +45-3545-0737
| | - Henriette Lindberg
- Department of Oncology, University Hospital of Copenhagen, Herlev Hospital, 2730 Herlev, Denmark;
| | - Christoffer Johansen
- Department of Oncology, University Hospital of Copenhagen, Rigshospitalet, 2100 Copenhagen, Denmark; (C.J.); (H.P.)
| | - Helle Pappot
- Department of Oncology, University Hospital of Copenhagen, Rigshospitalet, 2100 Copenhagen, Denmark; (C.J.); (H.P.)
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Clinical effects of assessing electronic patient-reported outcomes monitoring symptomatic toxicities during breast cancer therapy: a nationwide and population-based study. Breast Cancer 2021; 28:1096-1099. [PMID: 33837509 DOI: 10.1007/s12282-021-01244-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
Abstract
The involvement of cancer patients in symptom reporting talks into our cultural narrative of empowerment and participation in decisions in health of both patients and professionals. Electronic patient-reported outcome (ePRO) is a tool applied for use in such interaction. Based on limited evidence and few empirical studies, health systems are rapidly implementing this instrument in managing patients in active treatment and in follow-up. In a cluster randomized trial of all Danish oncology departments treating breast cancer with adjuvant chemotherapy, we applied ePRO in 347 patients consecutively recruited. Our primary outcome, which was at least one treatment adjustment, was not significantly influenced using ePRO, 34% in the ePRO arm and 41% in the usual care arm received at least one treatment adjustment, p = 0.095. Number of hospitalizations and events of febrile neutropenia were not influenced by the intervention. We believe that one of the main reasons for this finding could be the application of PRO in a well-regulated treatment setting within a public health care system where the most impacting symptomatic toxicities are already taken care off.Trial registration: Clinicaltrials.gov identifier: NCT02996201, registered 19 Dec 2016, retrospectively registered.
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15
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Electronic Patient-Reported Outcome Measures Evaluating Cancer Symptoms: A Systematic Review. Semin Oncol Nurs 2021; 37:151145. [PMID: 33773879 DOI: 10.1016/j.soncn.2021.151145] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 11/30/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This systematic review aims to evaluate the psychometric properties and the methodologic quality of studies describing smartphone-, tablet- or computer-based questionnaires for Patient-Reported Outcome Measures (PROM) evaluating symptoms in oncology and hematology patients. DATA SOURCES A literature search was conducted in PubMed, Scopus, Cochrane, Cinahl, Cuiden, Lilacs, and PsycINFO. Criteria for inclusion were (i) primary studies evaluating scales for symptoms assessment, (ii) developed in adult population (>18 years) with an oncology or hematology malignancy diagnosis, (iii) validations tested via phone or computer, and (iv) describing at least one psychometric property. The exclusion criteria were (i) tools diagnosing any type of cancer and (ii) case series, surveys, and audits. The outcome variables were internal consistency, test-retest reliability, measurement error, content validity, structural validity, hypothesis testing, cross-cultural validity, and responsiveness. For the evaluation of the quality of methodology, the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used. CONCLUSION The present study gathered five tools in 12 articles to evaluate cancer symptoms through smartphone, tablet, or computer format. Although four were generic, one was specific for breast cancer. Although none of the tools had been fully validated, some of the items of the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) were successfully tested for content, reliability, construct validity, and responsiveness. IMPLICATIONS FOR NURSING PRACTICE Our results can guide professionals choosing symptoms assessment instruments when performing telepractice, and they raise awareness of using with precaution scales not intended for remote use.
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16
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Linguistic validation of the simplified Chinese version of the US National Cancer Institute's patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE™). BMC Cancer 2020; 20:1153. [PMID: 33243173 PMCID: PMC7690028 DOI: 10.1186/s12885-020-07631-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 11/12/2020] [Indexed: 11/21/2022] Open
Abstract
Background The aim of this study was to translate and linguistically validate the U.S. National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE™) into Simplified Chinese for use in Singapore. Methods All 124 items of the English source PRO-CTCAE item library were translated into Simplified Chinese using internationally established translation procedures. Two rounds of cognitive interviews were conducted with 96 cancer patients undergoing adjuvant treatment to determine if the translations adequately captured the PRO-CTCAE source concepts, and to evaluate comprehension, clarity and ease of judgement. Interview probes addressed the 78 PRO-CTCAE symptom terms (e.g. fatigue), as well as the attributes (e.g. severity), response choices, and phrasing of ‘at its worst’. Items that met the a priori threshold of ≥20% of participants with comprehension difficulties were considered for rephrasing and retesting. Items where < 20% of the sample experienced comprehension difficulties were also considered for rephrasing if better phrasing options were available. Results A majority of PRO-CTCAE-Simplified Chinese items were well comprehended by participants in Round 1. One item posed difficulties in ≥20% and was revised. Two items presented difficulties in < 20% but were revised as there were preferred alternative phrasings. Twenty-four items presented difficulties in < 10% of respondents. Of these, eleven items were revised to an alternative preferred phrasing, four items were revised to include synonyms. Revised items were tested in Round 2 and demonstrated satisfactory comprehension. Conclusions PRO-CTCAE-Simplified Chinese has been successfully developed and linguistically validated in a sample of cancer patients residing in Singapore.
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17
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Tolstrup LK, Bastholt L, Dieperink KB, Möller S, Zwisler AD, Pappot H. The use of patient-reported outcomes to detect adverse events in metastatic melanoma patients receiving immunotherapy: a randomized controlled pilot trial. J Patient Rep Outcomes 2020; 4:88. [PMID: 33125537 PMCID: PMC7599285 DOI: 10.1186/s41687-020-00255-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/11/2020] [Indexed: 02/06/2023] Open
Abstract
Background A randomized controlled pilot trial was conducted to assess if melanoma patients treated with immunotherapy had the number of grade 3 or 4 adverse events during treatment reduced by 50% using a tailored electronic patient-reported outcomes tool in addition to standard toxicity monitoring compared to standard monitoring alone. Secondary endpoints were: if more AEs were reported in the intervention group, if there was a difference between the two groups in the number of telephone consultations, extra out-patient visits, number of days in the hospital, days in steroid treatment and the time patients experienced grade 2 or higher toxicity. Patients and methods Melanoma patients receiving immunotherapy at the Department of Oncology, Odense University Hospital, Denmark participated. Standard care included assessment of AEs by a clinician before each treatment cycle using the Common Terminology Criteria for Adverse Events. In addition, patients randomized to the intervention reported their AEs weekly by an electronic PRO-tool based on the PRO-CTCAE platform. Results One hundred forty-six melanoma patients were randomized. In this study, we did not detect a difference between the two groups in the number of grade 3 or 4 AEs (P = 0.983), in the overall number of AEs (P = 0.560) or in the time the patients in the two groups experienced grade 2 or higher toxicity (0.516). The number of phone contacts was significantly higher in the intervention group (P = 0.009) and there was a tendency towards patients in the intervention group having more extra visits (P = 0.156). Conclusion It has been examined if the number of severe AEs for melanoma patients receiving immunotherapy could be reduced by involving the patients in the reporting of symptoms. The results do not justify the expansion of the pilot study into a regular phase III study with this particular set-up. However, a significant difference in the number of phone contacts was found as patients in the intervention group called more frequently, indicating that their attention to AEs was increased. Even though the use of an electronic PRO tool could not reduce the number of severe AEs in this melanoma population, a positive impact on other endpoints such as QoL, communication, or treatment-planning, cannot be excluded. Trial registration Clinicaltrials.gov NCT03073031 Registered 8 March 2017, Retrospectively registered.
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Affiliation(s)
- Lærke K Tolstrup
- Department of Oncology, Odense University Hospital, Odense, Denmark. .,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karin B Dieperink
- Department of Oncology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN - Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Ann-Dorthe Zwisler
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,The Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA), Nyborg, Denmark
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
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18
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Veldhuijzen E, Walraven I, Mitchell SA, Moore EY, McKown SM, Lauritzen M, Kim KJ, Belderbos JSA, Aaronson NK. Dutch translation and linguistic validation of the U.S. National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE™). J Patient Rep Outcomes 2020; 4:81. [PMID: 33025309 PMCID: PMC7538479 DOI: 10.1186/s41687-020-00249-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The U.S. National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE™) is a library of items for assessing symptomatic adverse events by patient self-report in oncology trials. The aim of this multi-site study was to generate and linguistically validate a Dutch language version of the U.S. PRO-CTCAE for use in the Netherlands and Dutch-speaking Belgium. METHODS All 124 items in the PRO-CTCAE item library were translated into Dutch using established translation procedures, including dual forward translations, reconciliation, back-translation, reconciliation of the source with the back-translation, and expert reviews. Harmonization of the translation for use in both the Netherlands and Belgium was achieved via an iterative review process in which the translations were discussed and reconciled by consensus of PRO experts, clinicians and bilingual Dutch translators. The translated PRO-CTCAE™ items were completed by a geographically-diverse sample of Dutch speaking patients from the Netherlands (n = 40) and Belgium (n = 60), and who were currently receiving or who had recently completed cancer-directed therapy. Patients were diverse with respect to age, sex, educational attainment, and cancer diagnosis. Cognitive debriefing, using a semi-structured interview guide, probed for comprehension and clarity of PRO-CTCAE symptom terms, attributes (e.g. frequency, severity, interference), response choices, and understanding of 'at its worst' and 'in the last 7 days'. Items for which the patient data indicated possible difficulties were considered for revision. RESULTS Three items underwent minor phrasing revision and retesting was not deemed necessary. The symptom term for stretch marks was poorly understood by 12.5% of participants, and this item was revised to include parenthetical phrasing. It was retested with 10 participants from Belgium (n = 5) and the Netherlands (n = 5) and demonstrated acceptable comprehension. CONCLUSIONS The Dutch language version of PRO-CTCAE has been successfully developed and linguistically validated for use in oncology studies in the Netherlands and Dutch-speaking Belgium. Extending the availability of NCI PRO-CTCAE in languages beyond English increases international consistency in the capture of Patient-Reported outcomes in patients participating in cancer clinical trials.
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Affiliation(s)
- Evalien Veldhuijzen
- Department of Radiation Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Iris Walraven
- Department of Radiation Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands.,Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sandra A Mitchell
- Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA
| | | | | | | | - Katherine J Kim
- Genentech - a member of the Roche Group, South San Francisco, USA
| | - José S A Belderbos
- Department of Radiation Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
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19
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Taarnhøj GA, Lindberg H, Dohn LH, Omland LH, Hjøllund NH, Johansen C, Pappot H. Electronic reporting of patient-reported outcomes in a fragile and comorbid population during cancer therapy - a feasibility study. Health Qual Life Outcomes 2020; 18:225. [PMID: 32653005 PMCID: PMC7353726 DOI: 10.1186/s12955-020-01480-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 07/07/2020] [Indexed: 02/05/2023] Open
Abstract
Background Electronic collection of patient-reported outcomes (ePROs) is becoming widespread in health care, but the implementation into routine cancer care during therapy remains to be seen. Especially, little is known of the use and success of electronic reporting during active cancer treatment in fragile and comorbid patients. The aim of this study was to test the feasibility of ePRO and its incorporation into routine cancer care, measured by physician compliance, for a fragile and comorbid bladder cancer (BC) population receiving chemo- or immunotherapy. Methods All BC patients initiating treatment for locally advanced or metastatic bladder cancer at Rigshospitalet or Herlev Hospital, Denmark, were approached during an 8 month period. Exclusion criteria were patients not speaking Danish or not being signed up for electronic communication with health authorities. Enrolled patients were prompted to complete weekly ePROs from home. Patients completed the European Organisation for Research and Treatment of Cancer’s general quality of life questionnaire, QLQ-C30, and the module for muscle-invasive bladder cancer QLQ-BLM30, the Hospital Anxiety and Depression Scale, HADS, and selected items from the Patient Reported-Outcomes version of the Common Terminology Criteria of Adverse Events (PRO-CTCAE), in total 158 questions weekly. If failing to report when prompted, patients were sent two e-mail reminders. Patients were informed that the physician would have an overview of the reported ePROs at their following clinical visits. Physicians were at all clinical visits informed to look at the ePROs in a software solution separate from the medical records. Physicians were logged to check their compliance to the task. No continuous surveillance of ePROs was established. Results Of 91 patients screened for enrolment, 19 patients (21%) were not found eligible for standard treatment, eight patients (9%) were not signed up for electronic communication with the health authorities and nine patients (10%) declined participation. Another six patients did not meet other inclusion criteria. In total 49 BC patients were enrolled, 29 initiating chemotherapy and 20 initiating immunotherapy. A total of 466 electronic questionnaires were completed. The overall adherence of the patients to complete ePROs was at an expected level for an elderly cancer population (75%) and remained above 70% until the 6th cycle of treatment. The physician’ compliance was in contrast low (0–52%) throughout the course of treatment. Conclusions Electronic reporting of PROs is feasible in a fragile and comorbid population of patients during routine active cancer treatment. Despite clear implementation strategies the physician compliance remained low throughout the study proving the need for further implementation strategies.
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Affiliation(s)
- Gry Assam Taarnhøj
- Department of Oncology, University of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
| | - Henriette Lindberg
- Department of Oncology, University of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Line Hammer Dohn
- Department of Oncology, University of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Lise Høj Omland
- Department of Oncology, University of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Niels Henrik Hjøllund
- AmbuFlex/WestChronic, Occupational Medicine, University Research Clinic, Aarhus University, Herning, Denmark.,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Christoffer Johansen
- Department of Oncology, University of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Helle Pappot
- Department of Oncology, University of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
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20
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Jang MK, Kim S, Collins EG, Quinn LT, Park CG, Ferrans CE. Enriching the quality of cross-cultural instrument development through cognitive interviewing: Implications for nursing research. Jpn J Nurs Sci 2019; 17:e12301. [PMID: 31721460 DOI: 10.1111/jjns.12301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 06/23/2019] [Accepted: 09/05/2019] [Indexed: 11/30/2022]
Abstract
AIM During cross-cultural instrument development, a gap commonly exists between the intended meaning of questionnaire items and the extent to which the participant understands that meaning. Because cognitive interviewing can provide such a powerful means for ensuring an accurate interpretation of items, the purpose of this report is to provide a practical guide to encourage its use in nursing research. METHODS This report provides in-depth information describing: (a) advantages of cognitive interviewing, particularly for cross-cultural instrument development; (b) specific problems it can identify and solve; (c) strategies for performing cognitive interviews, including the four-step model of the question-and-answer process; (d) practical guidance for conducting successful cognitive interviews. RESULTS To achieve linguistic validity as well as cultural relevance, a variety of factors need to be considered in addition to language, such as cultural interpretations, attitudes, and values. Examples of health-related studies are presented, demonstrating the advantages of cognitive interviewing for instrument development and cross-cultural research. These examples show how cognitive interviewing can be productively used to verify question clarity, patient comprehension, and patients' ease of response and judgment while also helping to establish content validity based on patients' perspectives. CONCLUSIONS Cognitive interviewing can help nurse researchers discover potential instrument flaws and correct them in advance, subsequently avoiding collection of inaccurate data. Thus, cognitive interviewing should be considered an effective pretesting method for development of accurate instruments, particularly in cross-cultural nursing research.
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Affiliation(s)
- Min Kyeong Jang
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Sue Kim
- Department of Biobehavioral Health Science, College of Nursing, Yonsei University, Mo-Im Kim Nursing Research Institute, Seoul, South Korea
| | - Eileen G Collins
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Lauretta T Quinn
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Chang G Park
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Carol E Ferrans
- Department of Biobehavioral Health Science, College of Nursing, Harriet H. Werley Endowed Chair in Nursing Research, University of Illinois at Chicago, Chicago, Illinois, USA
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21
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Nissen A, Bager L, Pappot H. The use of PRO in adverse event identification during cancer therapy - choosing the right questions to ask. Acta Oncol 2019; 58:596-602. [PMID: 30702003 DOI: 10.1080/0284186x.2018.1560496] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Adequate and timely monitoring of adverse events to cancer treatment is from our view dependent on a suitable Patient Reported Outcome (PRO) tool developed for the specific patient population based on cytostatic drugs included in the treatment. Therefore, a systematic method for construction of PRO questionnaires including selection of the appropriate questions is needed. Purpose: The purpose of the present study was to develop and test a method of item selection for a PRO questionnaire to monitor adverse events in oncologic routine treatment of metastatic prostate cancer patients. Patient and methods: Documentation on common symptomatic adverse events for the three drugs was collected from five different sources: 1) FDA product summary information; 2) EMA product summary information; 3) phase 3 Randomized Controlled Trials (RCT) leading to drug approval; 4) audit of the electronic patient files focusing on the oncologist's documentation of adverse events and 5) individual patient interview (n = 16) focusing on adverse events. The Patient Reported Outcome of Common Terminology Criteria for Adverse Events (PRO-CTCAE) was used as PRO item library. Selected symptoms were transformed into corresponding PRO-CTCAE questions. The questionnaire was tested by patients in a pilot test (n = 12). Patients for interviews and pilot testing were included by purposive sampling. Results: A method for constructing a PRO questionnaire was developed, and a questionnaire of 25 PRO-CTCAE symptoms with 46 questions including an open write-in space for additional adverse events was constructed and tested. Conclusion: This study demonstrates a systematic method to select questions on adverse events for a PRO questionnaire in a specific cancer population receiving oncologic treatment. The present study reveals that audit of patient files and patient interviews in our setting only add little to the information on adverse events obtained from FDA, EMA and RCT. The obtained questionnaire was found useful and acceptable by patients.
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Affiliation(s)
- Aase Nissen
- Documentation and Quality, Danish Cancer Society, Copenhagen, Denmark
| | - Louise Bager
- Department of Oncology, The Finsen Centre, Rigshospitalet, Copenhagen, Denmark
| | - Helle Pappot
- Documentation and Quality, Danish Cancer Society, Copenhagen, Denmark
- Department of Oncology, The Finsen Centre, Rigshospitalet, Copenhagen, Denmark
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22
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Cho J, Yoon J, Kim Y, Oh D, Kim SJ, Ahn J, Suh GY, Nam SJ, Mitchell SA. Linguistic Validation of the US National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events in Korean. J Glob Oncol 2019; 5:1-10. [PMID: 30917069 PMCID: PMC6449075 DOI: 10.1200/jgo.18.00193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this study was to translate and linguistically validate a Korean-language version of the US National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). METHODS All 124 PRO-CTCAE items were translated into Korean (PRO-CTCAE-Korean) using International Society for Pharmacoeconomics and Outcomes Research best practices and linguistically validated in a diverse sample of patients undergoing cancer treatment (n = 120) to determine whether the Korean translation captured the original concepts. During the cognitive interviews, participants first completed approximately 60 PRO-CTCAE-Korean questions and were then interviewed to evaluate the conceptual equivalence of the translation to the original PRO-CTCAE English-language source. Interview probes addressed comprehension, clarity, and ease of judgement. Three rounds of interviews were conducted. Items that met the a priori threshold of 10% or more of respondents with comprehension difficulties were considered for rephrasing and retesting. RESULTS A majority of PRO-CTCAE-Korean items were well comprehended in round 1; 14 items posed comprehension difficulties for at least 10% of respondents in round 1. Four symptom terms (mouth and throat sores, feeling like nothing could cheer you up, frequent urination, and pain, swelling, redness at drug injection or intravenous insertion site) were revised and retested in rounds 2 and 3. For the other 10 symptom terms, no suitable alternative phrasing was identified, and the terms were retested in rounds 2 and 3. After rounds 2 and 3, no item presented difficulties in 20% or more of participants. CONCLUSION PRO-CTCAE-Korean has been linguistically validated for use in Korean-speaking populations. Quantitative evaluation of this new measure to establish its measurement properties and responsiveness in Korean speakers undergoing cancer treatment is in progress.
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Affiliation(s)
- Juhee Cho
- Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.,Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Junghee Yoon
- Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.,Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Youngha Kim
- Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Dongryul Oh
- Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Seok Jin Kim
- Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Jinseok Ahn
- Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Gee Young Suh
- Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
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23
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Tolstrup LK, Bastholt L, Zwisler AD, Dieperink KB, Pappot H. Selection of patient reported outcomes questions reflecting symptoms for patients with metastatic melanoma receiving immunotherapy. J Patient Rep Outcomes 2019; 3:19. [PMID: 30900035 PMCID: PMC6515745 DOI: 10.1186/s41687-019-0111-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 03/15/2019] [Indexed: 12/12/2022] Open
Abstract
Context Toxicity-monitoring plays an important role in all cancer treatment,
however, early recognition is vital for detecting and treating immune-related
symptoms. Preparing a Patient Reported Outcomes tool and including melanoma
patients receiving immunotherapy in the reporting of symptoms, may optimize
toxicity-monitoring. Objectives The objective of this study was to identify the symptoms and their
equivalent questions to include from the Patient-Reported Outcomes Common
Terminology Criteria for Adverse Events (PRO-CTCAE) library for melanoma patients,
receiving immunotherapy and, further, to evaluate if all relevant symptoms are
covered by this tool. Methods To establish the relevant symptoms, three measures were taken.
First, a literature search was carried out in three databases. Second, a chart
audit was performed including medical records from melanoma patients receiving
immunotherapy. Finally, the product information for the relevant immunotherapies
was studied. Results Ten articles were included as a result of the literature search. As
for the chart audit, a total of 37 patients (48 treatments with immunotherapy)
were included. Overall, the reported symptoms from the literature review aligned
with those identified in the chart audit. The examination of the product
information supported the findings from review and chart audit, revealing only one
additional symptom. In total, 28 PRO-CTCAE symptoms were selected comprising of 56
PRO-questions plus an additional question on blood in stool. Conclusion When preparing a Patient Reported Outcomes tool it is important that
the preparatory work of selecting questions is done properly. By going through the
literature, performing a chart audit, and examining the product information, the
most important and relevant symptoms have been uncovered, facilitating the design
of a PROquestionnaire, based on PRO-CTCAE, that fits the patient population under
investigation.
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Affiliation(s)
- Lærke K Tolstrup
- Department of Oncology, Odense University Hospital, Odense, Denmark. .,REHPA -The Danish Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark, Odense, Denmark. .,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ann-Dorthe Zwisler
- Department of Oncology, Odense University Hospital, Odense, Denmark.,REHPA -The Danish Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karin B Dieperink
- Department of Oncology, Odense University Hospital, Odense, Denmark.,REHPA -The Danish Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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24
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Pappot H, Baeksted C, Knoop A, Mitchell SA, Nissen A, Johansen C. Routine surveillance for symptomatic toxicities with real-time clinician reporting in Danish breast cancer patients-Organization and design of the first national, cluster randomized trial using the Patient-Reported Outcomes version of Common Terminology C. Breast J 2019; 25:269-272. [DOI: 10.1111/tbj.13204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/31/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Helle Pappot
- Department of Oncology; The Finsen Centre, Rigshospitalet; Copenhagen Denmark
| | - Christina Baeksted
- Department of Oncology; The Finsen Centre, Rigshospitalet; Copenhagen Denmark
- Documentation & Quality; Danish Cancer Society; Copenhagen Denmark
| | - Ann Knoop
- Department of Oncology; The Finsen Centre, Rigshospitalet; Copenhagen Denmark
| | - Sandra A. Mitchell
- Outcomes Research Branch, Division of Cancer Control and Population Sciences; National Cancer Institute; Rockville Maryland
| | - Aase Nissen
- Documentation & Quality; Danish Cancer Society; Copenhagen Denmark
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25
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Galizia D, Milani A, Geuna E, Martinello R, Cagnazzo C, Foresto M, Longo V, Berchialla P, Solinas G, Calori A, Grasso B, Volpone C, Bertola G, Parola G, Tealdi G, Giuliano PL, Ballari AM, Aglietta M, Montemurro F. Self-evaluation of duration of adjuvant chemotherapy side effects in breast cancer patients: A prospective study. Cancer Med 2018; 7:4339-4344. [PMID: 30030895 PMCID: PMC6144000 DOI: 10.1002/cam4.1687] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
Background We recently reported that self‐evaluation of the incidence and severity of treatment‐related side effects (TSEs) using a National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v4.0‐based questionnaire was feasible and more informative than doctor reports in patients undergoing standard adjuvant chemotherapy for operable breast cancer. Here, we compare self‐ and doctor‐evaluated day of onset and duration of TSEs in the same population. Patients and methods Six hundred and four patients were enrolled at 11 sites in Italy. CTCAE v4.0 definitions of grade of severity of nausea, vomiting, constipation, anorexia, dysgeusia, diarrhea, fatigue, pain, paresthesia, and dyspnea were translated into Italian and rephrased. Questionnaires were administered after the first and third chemotherapy cycles. At each time‐point, information on TSEs was extracted from the medical charts and compared to patient questionnaires. Results A total of 594 and 573 paired patient and doctor questionnaires were collected after cycles one and three, respectively. TSE duration was significantly longer when reported by patients compared to doctors for six and seven of ten items after cycles one and three, respectively. Due to the combined effect of doctor underreporting of TSE incidence and duration, the mean percentages of cycle days with TSEs were significantly higher for all ten items when based on patient reports. Day of onset could not be evaluated because of insufficient numbers of complete records. Conclusions Self‐reporting TSE duration is feasible using a CTCAE‐derived questionnaire. As doctors tend to underestimate TSE incidence and duration, patient‐reported outcomes should be incorporated into clinical practice, perhaps using eHealth technologies, to harness their potential to better estimate total TSE burden.
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Affiliation(s)
- Danilo Galizia
- Investigational and Clinical Oncology (INCO), Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Andrea Milani
- Investigational and Clinical Oncology (INCO), Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Elena Geuna
- Investigational and Clinical Oncology (INCO), Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Rossella Martinello
- Investigational and Clinical Oncology (INCO), Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Celeste Cagnazzo
- Clinical Research Office, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
| | - Manuela Foresto
- Multidisciplinary Day Hospital, Candiolo Cancer Institute-FPO, IRCS, Candiolo, Italy
| | - Virginia Longo
- AOU Città della Salute e della Scienza di Torino - Presidio Sant' Anna, Turin, Italy
| | | | | | | | - Bruna Grasso
- Azienda Sanitaria Locale ASL CN2-Alba-Bra, Alba, Italy
| | - Chiara Volpone
- Azienda Sanitaria Locale Verbano Cusio Ossola - Verbania, Verbania, Italy
| | | | | | - Giancarla Tealdi
- AOU Città della Salute e della Scienza di Torino - Presidio Molinette COES, Turin, Italy
| | | | | | - Massimo Aglietta
- Medical Oncology, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy.,Department of Medical Oncology, University of Turin, Turin, Italy
| | - Filippo Montemurro
- Investigational and Clinical Oncology (INCO), Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy
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Tolstrup LK, Pappot H, Zangger G, Bastholt L, Zwisler AD, Dieperink KB. Danish translation, cultural adaption and initial psychometric evaluation of the patient feedback form. Health Qual Life Outcomes 2018; 16:77. [PMID: 29703191 PMCID: PMC5921302 DOI: 10.1186/s12955-018-0900-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/16/2018] [Indexed: 01/05/2023] Open
Abstract
AIM No suitable Danish questionnaire exists to evaluate patient satisfaction with various patient reported outcome measures. Thus, the aim of this research project was to conduct a study on the translation and cultural adaption of an American patient reported experience measures questionnaire, "Patient Feedback Form", among Danish patients, and to examine selected psychometric properties within reliability. MATERIAL AND METHODS In the first phase of the study, the Patient Feedback Form was forward and backward translated following the methodology of existing guidelines. Subsequently, cognitive interviewing was performed with seven cancer patients and seven healthy persons (19-86 years old/6 men and 8 women) to ensure that questions were easy to understand and made sense to Danish interviewees. In the second phase, phone interviews were carried out with 95 prostate cancer patients after they had responded to the same Patient Feedback Form. Missing data was imputed using the Expectation-Maximization technique. To examine the structure of the questionnaire, an exploratory factor analysis was conducted. Cronbach's alpha was calculated to investigate internal consistency. RESULTS There were only minor disagreements in the translation process, and the reconciliation went smoothly (phase 1). With regard to one item, however, it was difficult to reach a consensus. Through the qualitative validation process, the right solution was found. The results from the psychometric testing (phase 2) showed that four factors had an Eigen value > 1, but only one factor was extracted as the Scree plot had a clear "elbow", showing a one factor structure that explained 46.1% of the variance. The internal consistency was high as Cronbach's alpha was 0.89. CONCLUSION The translated, culturally adapted, and validated version of the Patient Feedback Form seems to be suitable for measuring satisfaction with patient reported outcome measures in a Danish setting. While the results should be treated with caution due to the small sample size, psychometric testing indicates that the questionnaire is a valid instrument. However, additional psychometric testing such as hypotheses testing, responsiveness, and test-retest on a larger and more diverse sample size is required to further verify the validity of the instrument.
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Affiliation(s)
- Lærke K Tolstrup
- Department of Oncology, Odense University Hospital, Odense, Denmark. .,University of Southern Denmark, Odense, Denmark.
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Graziella Zangger
- The Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, and Odense University Hospital, Odense, Denmark
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Ann-Dorthe Zwisler
- The Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, and Odense University Hospital, Odense, Denmark
| | - Karin B Dieperink
- Department of Oncology, Odense University Hospital, Odense, Denmark.,The Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, and Odense University Hospital, Odense, Denmark
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Gastrointestinal toxicity of immune checkpoint inhibitors: from mechanisms to management. Nat Rev Gastroenterol Hepatol 2018; 15:222-234. [PMID: 29512649 DOI: 10.1038/nrgastro.2018.14] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Immune checkpoint inhibitor therapies are a novel group of monoclonal antibodies with proven effectiveness in a wide range of malignancies, including melanoma, renal cell carcinoma, non-small-cell lung cancer, urothelial carcinoma and Hodgkin lymphoma. Their use in a range of other indications, such as gastrointestinal and head and neck cancer, is currently under investigation. The number of agents included in this drug group is increasing, as is their use. Although they have the potential to improve the treatment of advanced malignancies, they are also associated with a substantial risk of immune-related adverse events. The incidence of gastrointestinal toxicity associated with their use is second only in frequency to dermatological toxicity. Thus, gastroenterologists can expect to be increasingly frequently consulted by oncologists as part of a multidisciplinary approach to managing toxicity. Here, we describe this novel group of agents and their mechanisms of action. We review the manifestations of gastrointestinal toxicity associated with their use so that it can be recognized early and diagnosed accurately. We also discuss the proposed mechanisms underlying this toxicity and describe an algorithmic and, wherever possible, evidence-based approach to its management.
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28
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Kawaguchi T, Azuma K, Sano M, Kim S, Kawahara Y, Sano Y, Shimodaira T, Ishibashi K, Miyaji T, Basch E, Yamaguchi T. The Japanese version of the National Cancer Institute's patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE): psychometric validation and discordance between clinician and patient assessments of adverse events. J Patient Rep Outcomes 2018; 2:2. [PMID: 29757309 PMCID: PMC5934922 DOI: 10.1186/s41687-017-0022-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 09/21/2017] [Indexed: 11/10/2022] Open
Abstract
Background The Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) was developed by the National Cancer Institute as an adverse event assessment system to evaluate patients' symptoms, which tend to be underestimated in cancer clinical trials. The aim of this study was to assess the psychometric properties of the Japanese version of the PRO-CTCAE and the degree of adverse event assessment discordance between clinicians and patients. Methods A total of 187 cancer patients receiving systemic therapy were enrolled. Reproducibility, criterion validity, and responsiveness of the Japanese version of PROCTCAE were assessed. The EORTC QLQ-C30 was used as an external anchor. Discordance of assessment of adverse events between clinician and patients were also assessed using the CTCAE and PRO-CTCAE. Results A total of 187 participants (187 for criterion validity, 80 for reproducibility, and 100 for responsiveness), were analyzed (Mage = 62.4 years). All patients responded to at least one symptom item (M = 16). The mean (SD) intra-class correlation coefficients of overall reproducibility for the Japanese PRO-CTCAE was 0.63 (0.02). The correlation coefficient for the corresponding items in the EORTC QLQ-C30 and the Japanese PRO-CTCAE was high (Pearson r = 0.56-0.76). The analysis of responsiveness revealed significant dose-response trends (Jonckheere-Terpstra test, ps < 0.001). Depending on the adverse events, a discrepancy was observed in evaluation between the clinician and patient. Conclusions These results revealed that there is underestimation in the assessment of adverse events in Japan, and that the Japanese version of the PRO-CTCAE had acceptable reliability and validity for common and clinically important symptoms.
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Affiliation(s)
- Takashi Kawaguchi
- 1Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, Japan
| | - Kanako Azuma
- 2Department of Pharmacy, Tokyo Medical University Hospital, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | - Motohiko Sano
- 3Department of Pharmacy Services, Saitama Medical Center, Saitama Medical University, 1981, Kamoda, Kawagoe-city, Saitama, Japan
| | - Soan Kim
- 4Department of Pharmacy, Juntendo University Nerima Hospital, 3-1-10, Takanodai, Nerima-ku, Tokyo, Japan
| | - Yosuke Kawahara
- 5Department of Pharmacy, Toshiba General Hospital, 6-3-22, Higashioi, Shinagawa-ku, Tokyo, Japan
| | - Yoko Sano
- 2Department of Pharmacy, Tokyo Medical University Hospital, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | - Tomohide Shimodaira
- 2Department of Pharmacy, Tokyo Medical University Hospital, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | - Keiichiro Ishibashi
- 6Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981, Kamoda, Kawagoe-city, Saitama, Japan
| | - Tempei Miyaji
- 7Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.,8Division of Health Care Research, QOL Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Tokyo, Japan
| | - Ethan Basch
- 9Department of Medicine, University of North Carolina, Chapel Hill, NC USA
| | - Takuhiro Yamaguchi
- 8Division of Health Care Research, QOL Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Tokyo, Japan.,10Division of Biostatistics, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi Japan
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Miyaji T, Iioka Y, Kuroda Y, Yamamoto D, Iwase S, Goto Y, Tsuboi M, Odagiri H, Tsubota Y, Kawaguchi T, Sakata N, Basch E, Yamaguchi T. Japanese translation and linguistic validation of the US National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). J Patient Rep Outcomes 2017; 1:8. [PMID: 29757296 PMCID: PMC5934908 DOI: 10.1186/s41687-017-0012-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 09/12/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The US National Cancer Institute (NCI) has developed the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) to capture patients' self-reported symptomatic adverse events in cancer clinical trials. The aim of this study was to develop and linguistically validate a Japanese translation of PRO-CTCAE. Forward- and back-translations were produced, and an independent review was performed by the Japan Clinical Oncology Group (JCOG) Executive Committee and the US NCI. We then conducted cognitive interviews with 21 patients undergoing cancer treatment. Participants were asked to complete the PRO-CTCAE and were interviewed using semi-structured scripts and predetermined probes to investigate whether any items were difficult to understand or answer. The interviews were recorded and transcribed, and a thematic analysis was performed. The data were split into two categories: 1) remarks on the items and 2) remarks on the questionnaire in general. RESULTS Twenty-one cancer patients undergoing chemotherapy or hormone therapy were interviewed at the University of Tokyo Hospital and the Kansai Medical University Hirakata Hospital during 2011 and 2012. Thirty-three PRO-CTCAE items were evaluated as "difficult to understand," and 65 items were evaluated as "difficult to answer" by at least one respondent. However, on further investigation, only 24 remarks were categorized as "comprehension difficulties" or "clarity" issues. Most of these remarks concerned patients' difficulties with rating their experience of individual symptomatic events. CONCLUSIONS The study provides preliminary evidence supporting the linguistic validity of the Japanese version of PRO-CTCAE. Further cognitive interviewing is warranted for PRO-CTCAE items relating to sexuality and anxiety and for response options on severity attribute items.
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Affiliation(s)
- Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
- Division of Health Care Research, QOL Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan
| | - Yukiko Iioka
- Adult Nursing, Chronic Illness and Conditions Nursing, St. Luke’s College of Nursing, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044 Japan
- Graduate School of Health and Social Services, Saitama Prefectural University, 820 San-Nomiya, Koshigaya-shi, Saitama, 343-8540 Japan
| | - Yujiro Kuroda
- Department of Public Health, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295 Japan
| | - Daigo Yamamoto
- Breast unit, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi-city, Osaka 570-8507 Japan
| | - Satoru Iwase
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639 Japan
| | - Yasushi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan
| | - Masahiro Tsuboi
- Division of Thoracic Surgery, National Cancer Center East Hospital, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577 Japan
| | - Hiroki Odagiri
- Division of Breast Surgery, Hirosaki National Hospital, 1 Tomino-cho, Hirosaki, Aomori, 036-8545 Japan
| | - Yu Tsubota
- Department of Surgery, Kansai Medical University, 10-15 Fumizonochō, Moriguchi-shi, Osaka, 570-0074 Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji-city, Tokyo, 192-0392 Japan
| | - Naoko Sakata
- Department of Palliative Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Ethan Basch
- Department of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC 27516 USA
| | - Takuhiro Yamaguchi
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
- Division of Health Care Research, QOL Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan
- Division of Biostatistics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
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Baeksted C, Pappot H, Nissen A, Hjollund NH, Mitchell SA, Basch E, Bidstrup PE, Dalton SO, Johansen C. Feasibility and acceptability of electronic symptom surveillance with clinician feedback using the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in Danish prostate cancer patients. J Patient Rep Outcomes 2017; 1:1. [PMID: 29757324 PMCID: PMC5934932 DOI: 10.1186/s41687-017-0005-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 07/27/2017] [Indexed: 11/10/2022] Open
Abstract
Background The aim was to examine the feasibility, acceptability and clinical utility of electronic symptom surveillance with clinician feedback using a subset of items drawn from the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in a cancer treatment setting. Methods Danish-speaking men with castration-resistant metastatic prostate cancer receiving treatment at the Department of Oncology, Rigshospitalet, Copenhagen between March 9, 2015 and June 8, 2015 were invited to participate (n = 63 eligible). Participants completed the PRO-CTCAE questionnaire on tablet computers using AmbuFlex software at each treatment visit in the outpatient clinic. In total, 22 symptomatic toxicities (41 PRO-CTCAE items), corresponding to the symptomatic adverse-events profile associated with the regimens commonly used for prostate cancer treatment (Docetaxel, Cabazitaxel, Abiraterone, Alpharadin), were selected. Participants' PRO-CTCAE responses were presented graphically to their treating oncologists via an AmbuFlex dashboard, for real-time use to enhance the patient-clinician dialogue that occurs during the consultation prior to each treatment cycle. Technical and clinical barriers and acceptability were evaluated through semi-structured interviews with both patients and oncologists. Patients receiving active treatment at the end of the study period completed an evaluation questionnaire. Results Fifty-four out of sixty-three (86%) eligible patients were enrolled. The PRO-CTCAE questionnaire was completed a total of 168 times by 54 participants (median number per patient was 3, range 1-5). Eight surveys were missed, resulting in a compliance rate of 97%. At the end of the study period, 35 patients (65%) were still receiving active treatment and completed the evaluation questionnaire. Patients reported that their PRO-CTCAE responses served as a communication tool. Oncologists stated that the availability of the PRO-CTCAE self-reports during the consultation improved patient-clinician communication about side effects. Conclusion Electronic capture of symptomatic toxicities using PRO-CTCAE and the submission of self-reports to clinicians prior to consultation were feasible among metastatic prostate cancer patients receiving chemotherapy in an outpatient setting, and this procedure was acceptable to both patients and clinicians. Continued research, including a cluster-randomized trial, will evaluate the effects of submitting patients' PRO-CTCAE results to clinicians prior to consultation on the quality of side-effects management and resultant clinical outcomes.
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Affiliation(s)
- Christina Baeksted
- 1Documentation & Quality, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.,2Department of Oncology, The Finsen Centre, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Helle Pappot
- 2Department of Oncology, The Finsen Centre, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Aase Nissen
- 1Documentation & Quality, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Niels Henrik Hjollund
- 3Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, DK-8200 Aarhus, Denmark.,4WestChronic, Department of Occupational Medicine, University Clinic, Health, Aarhus University, Gl. Landevej 61, DK-7400 Herning, Denmark
| | - Sandra A Mitchell
- 5Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, 3 East Suite 448, Rockville, MD 20850 USA
| | - Ethan Basch
- 6Cancer Outcomes Research Program, UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr, Chapel Hill, NC 27514 USA
| | - Pernille Envold Bidstrup
- 7Unit of Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- 7Unit of Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Christoffer Johansen
- 2Department of Oncology, The Finsen Centre, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.,7Unit of Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
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