TY - JOUR
T1 - Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery
AU - Quinten, C.
AU - Kenis, C.
AU - Decoster, L.
AU - Debruyne, P. R.
AU - De Groof, I.
AU - Focan, C.
AU - Cornelis, F.
AU - Verschaeve, V.
AU - Bachmann, C.
AU - Bron, D.
AU - Luce, S.
AU - Debugne, G.
AU - Van den Bulck, H.
AU - Goeminne, J. C.
AU - Baitar, A.
AU - Geboers, K.
AU - Petit, B.
AU - Langenaeken, C.
AU - Van Rijswijk, R.
AU - Specenier, P.
AU - Jerusalem, G.
AU - Praet, J. P.
AU - Vandenborre, K.
AU - Lycke, M.
AU - Flamaing, J.
AU - Milisen, K.
AU - Lobelle, J. P.
AU - Wildiers, H.
N1 - Publisher Copyright:
© 2018, Springer Nature Switzerland AG.
PY - 2019/3/15
Y1 - 2019/3/15
N2 - Purpose: Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes. Methods: Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes. Results: The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment. Conclusion: The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.
AB - Purpose: Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes. Methods: Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes. Results: The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment. Conclusion: The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.
KW - Cancer
KW - Elderly patients with cancer
KW - Geriatric assessment
KW - Minimal important differences
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85061988830&partnerID=8YFLogxK
U2 - 10.1007/s11136-018-2062-6
DO - 10.1007/s11136-018-2062-6
M3 - Article
C2 - 30511255
AN - SCOPUS:85061988830
SN - 0962-9343
VL - 28
SP - 663
EP - 676
JO - Quality of Life Research
JF - Quality of Life Research
IS - 3
ER -