Identifying health-related quality of life cut-off scores that indicate the need for supportive care in young adults with cancer
Identifying health-related quality of life cut-off scores that indicate the need for supportive care in young adults with cancer
Purpose: Using patient-reported outcomes in routine cancer care may improve health outcomes. However, a lack of information about which scores are problematic in specific populations can impede use. To facilitate interpretation of the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30), we identified cut-off scores that indicate need for support by comparing each scale to relevant items from the Supportive Care Needs Survey (SCNS-LF59) in a young adult (YA) population. Methods: We conducted a cross-sectional survey amongst YAs with cancer ages 25–39 at diagnosis. Participants completed the EORTC QLQ-C30 and SCNS-LF59. Patient, clinician and research experts matched supportive care needs from the SCNS-LF59 to quality of life domains of the EORTC QLQ-C30. We evaluated the EORTC QLQ-C30 domain score’s ability to detect patients with need using receiver operator characteristic (ROC) analysis, calculating the area under the ROC curve and sensitivity and specificity for selected cut-offs. Cut-offs were chosen by maximising Youden’s J statistic and ensuring sensitivity passed 0.70. Sensitivity analyses were conducted to examine the variability of the cut-off scores by treatment status. Results: Three hundred and forty-seven YAs took part in the survey. Six experts matched SCNS-LF59 items to ten EORTC QLQ-C30 domains. The AUC ranged from 0.78 to 0.87. Cut-offs selected ranged from 8 (Nausea and Vomiting and Pain) to 97 (Physical Functioning). All had adequate sensitivity (above 0.70) except the Financial Difficulties scale (0.64). Specificity ranged from 0.61 to 0.88. Four of the cut-off scores differed by treatment status. Conclusion: Cut-offs with adequate sensitivity were calculated for nine EORTC QLQ-C30 scales for use with YAs with cancer. Cut-offs are key to interpretability and use of the EORTC QLQ-C30 in routine care to identify patients with supportive care need.
Oncology, Patient-reported outcomes, Quality of life, Routine care, Supportive care needs, Young adult
2717-2727
Lidington, Emma
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Giesinger, Johannes M.
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Janssen, Silvie H. M.
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Tang, Suzanne
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Beardsworth, Sam
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Darlington, Anne-sophie
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Starling, Naureen
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Szucs, Zoltan
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Gonzalez, Michael
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Sharma, Anand
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Sirohi, Bhawna
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Van Der Graaf, Winette T. A.
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Husson, Olga
37964f59-bb82-46c7-8f67-88c45ba50463
September 2022
Lidington, Emma
df6cf457-cdde-4439-90c8-a7122e5615e5
Giesinger, Johannes M.
71e4f064-9f9a-4c34-a666-df0c3056a93f
Janssen, Silvie H. M.
958e8186-8f35-4d40-8926-3e283f35acb9
Tang, Suzanne
5aae072b-2fa4-4875-aeb0-35327be41c1f
Beardsworth, Sam
ebe78a60-8dc1-4c27-879f-248596cbba52
Darlington, Anne-sophie
472fcfc9-160b-4344-8113-8dd8760ff962
Starling, Naureen
5ea2ce97-d3f9-465f-a91a-79798a0c9b74
Szucs, Zoltan
d6ceedbd-1839-44ed-a51e-b934724de7c6
Gonzalez, Michael
0ebc5ee8-757e-4fa3-88a7-e3e3984426df
Sharma, Anand
a56f46e7-b293-4dfb-a680-2d53ff8fe8cc
Sirohi, Bhawna
2fb05e7b-744c-4561-8052-148908f6d851
Van Der Graaf, Winette T. A.
b8cb948f-78af-4f2e-bc7e-aa268509dcde
Husson, Olga
37964f59-bb82-46c7-8f67-88c45ba50463
Lidington, Emma, Giesinger, Johannes M., Janssen, Silvie H. M., Tang, Suzanne, Beardsworth, Sam, Darlington, Anne-sophie, Starling, Naureen, Szucs, Zoltan, Gonzalez, Michael, Sharma, Anand, Sirohi, Bhawna, Van Der Graaf, Winette T. A. and Husson, Olga
(2022)
Identifying health-related quality of life cut-off scores that indicate the need for supportive care in young adults with cancer.
Quality of Life Research, 31 (9), .
(doi:10.1007/s11136-022-03139-6).
Abstract
Purpose: Using patient-reported outcomes in routine cancer care may improve health outcomes. However, a lack of information about which scores are problematic in specific populations can impede use. To facilitate interpretation of the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30), we identified cut-off scores that indicate need for support by comparing each scale to relevant items from the Supportive Care Needs Survey (SCNS-LF59) in a young adult (YA) population. Methods: We conducted a cross-sectional survey amongst YAs with cancer ages 25–39 at diagnosis. Participants completed the EORTC QLQ-C30 and SCNS-LF59. Patient, clinician and research experts matched supportive care needs from the SCNS-LF59 to quality of life domains of the EORTC QLQ-C30. We evaluated the EORTC QLQ-C30 domain score’s ability to detect patients with need using receiver operator characteristic (ROC) analysis, calculating the area under the ROC curve and sensitivity and specificity for selected cut-offs. Cut-offs were chosen by maximising Youden’s J statistic and ensuring sensitivity passed 0.70. Sensitivity analyses were conducted to examine the variability of the cut-off scores by treatment status. Results: Three hundred and forty-seven YAs took part in the survey. Six experts matched SCNS-LF59 items to ten EORTC QLQ-C30 domains. The AUC ranged from 0.78 to 0.87. Cut-offs selected ranged from 8 (Nausea and Vomiting and Pain) to 97 (Physical Functioning). All had adequate sensitivity (above 0.70) except the Financial Difficulties scale (0.64). Specificity ranged from 0.61 to 0.88. Four of the cut-off scores differed by treatment status. Conclusion: Cut-offs with adequate sensitivity were calculated for nine EORTC QLQ-C30 scales for use with YAs with cancer. Cut-offs are key to interpretability and use of the EORTC QLQ-C30 in routine care to identify patients with supportive care need.
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Identifying health-related quality of life cut-off scores that indicate the need for supportive
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Lidington2022_Article_IdentifyingHealth-relatedQuali
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Accepted/In Press date: 30 March 2022
e-pub ahead of print date: 27 April 2022
Published date: September 2022
Additional Information:
Funding Information:
The National Institute for Health Research (NIHR) Clinical Research Network provided funding and support and the Dutch Cancer Society supported salary and data collection costs (#KUN2015-7527). This study represents independent research supported by the NIHR Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2022, The Author(s).
Keywords:
Oncology, Patient-reported outcomes, Quality of life, Routine care, Supportive care needs, Young adult
Identifiers
Local EPrints ID: 457752
URI: http://eprints.soton.ac.uk/id/eprint/457752
ISSN: 0962-9343
PURE UUID: 013c542a-70c8-4149-a880-cbc2907e86c9
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Date deposited: 16 Jun 2022 00:31
Last modified: 17 Mar 2024 07:19
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Contributors
Author:
Emma Lidington
Author:
Johannes M. Giesinger
Author:
Silvie H. M. Janssen
Author:
Suzanne Tang
Author:
Sam Beardsworth
Author:
Naureen Starling
Author:
Zoltan Szucs
Author:
Michael Gonzalez
Author:
Anand Sharma
Author:
Bhawna Sirohi
Author:
Winette T. A. Van Der Graaf
Author:
Olga Husson
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