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Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery
OBJECTIVE: Although recent studies have improved understanding of quality of life (QOL) outcomes of breast conserving surgery, few have used longitudinal data for more than two time points, and few have examined predictors of QOL over two years. Additionally, the longitudinal data analyses in such s...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589455/ https://www.ncbi.nlm.nih.gov/pubmed/26422018 http://dx.doi.org/10.1371/journal.pone.0139252 |
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author | Kao, Hao-Yun Wu, Wen-Hsiung Liang, Tyng-Yeu Lee, King-The Hou, Ming-Feng Shi, Hon-Yi |
author_facet | Kao, Hao-Yun Wu, Wen-Hsiung Liang, Tyng-Yeu Lee, King-The Hou, Ming-Feng Shi, Hon-Yi |
author_sort | Kao, Hao-Yun |
collection | PubMed |
description | OBJECTIVE: Although recent studies have improved understanding of quality of life (QOL) outcomes of breast conserving surgery, few have used longitudinal data for more than two time points, and few have examined predictors of QOL over two years. Additionally, the longitudinal data analyses in such studies rarely apply the appropriate statistical methodology to control for censoring and inter-correlations arising from repeated measures obtained from the same patient pool. This study evaluated an internet-based system for measuring longitudinal changes in QOL and developed a cloud-based system for managing patients after breast conserving surgery. METHODS: This prospective study analyzed 657 breast cancer patients treated at three tertiary academic hospitals. Related hospital personnel such as surgeons and other healthcare professionals were also interviewed to determine the requirements for an effective cloud-based system for surveying QOL in breast cancer patients. All patients completed the SF-36, Quality of Life Questionnaire (QLQ-C30) and its supplementary breast cancer measure (QLQ-BR23) at baseline, 6 months, 1 year, and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation before and after surgery. RESULTS: All breast cancer surgery patients had significantly improved QLQ-C30 and QLQ-BR23 subscale scores throughout the 2-year follow-up period (p<0.05). During the study period, QOL generally had a negative association with advanced age, high Charlson comorbidity index score, tumor stage III or IV, previous chemotherapy, and long post-operative LOS. Conversely, QOL was positively associated with previous radiotherapy and hormone therapy. Additionally, patients with high scores for preoperative QOL tended to have high scores for QLQ-C30, QLQ-BR23 and SF-36 subscales. Based on the results of usability testing, the five constructs were rated on a Likert scale from 1–7 as follows: system usefulness (5.6±1.8), ease of use (5.6±1.5), information quality (5.4±1.4), interface quality (5.5±1.4), and overall satisfaction (5.5±1.6). CONCLUSIONS: The current trend in clinical medicine is applying therapies and interventions that improve QOL. Therefore, a potentially vast amount of internet-based QOL data is available for use in defining patient populations that may benefit from therapeutic intervention. Additionally, before undergoing breast conserving surgery, patients should be advised that their postoperative QOL depends not only on the success of the surgery, but also on their preoperative functional status. |
format | Online Article Text |
id | pubmed-4589455 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-45894552015-10-02 Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery Kao, Hao-Yun Wu, Wen-Hsiung Liang, Tyng-Yeu Lee, King-The Hou, Ming-Feng Shi, Hon-Yi PLoS One Research Article OBJECTIVE: Although recent studies have improved understanding of quality of life (QOL) outcomes of breast conserving surgery, few have used longitudinal data for more than two time points, and few have examined predictors of QOL over two years. Additionally, the longitudinal data analyses in such studies rarely apply the appropriate statistical methodology to control for censoring and inter-correlations arising from repeated measures obtained from the same patient pool. This study evaluated an internet-based system for measuring longitudinal changes in QOL and developed a cloud-based system for managing patients after breast conserving surgery. METHODS: This prospective study analyzed 657 breast cancer patients treated at three tertiary academic hospitals. Related hospital personnel such as surgeons and other healthcare professionals were also interviewed to determine the requirements for an effective cloud-based system for surveying QOL in breast cancer patients. All patients completed the SF-36, Quality of Life Questionnaire (QLQ-C30) and its supplementary breast cancer measure (QLQ-BR23) at baseline, 6 months, 1 year, and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation before and after surgery. RESULTS: All breast cancer surgery patients had significantly improved QLQ-C30 and QLQ-BR23 subscale scores throughout the 2-year follow-up period (p<0.05). During the study period, QOL generally had a negative association with advanced age, high Charlson comorbidity index score, tumor stage III or IV, previous chemotherapy, and long post-operative LOS. Conversely, QOL was positively associated with previous radiotherapy and hormone therapy. Additionally, patients with high scores for preoperative QOL tended to have high scores for QLQ-C30, QLQ-BR23 and SF-36 subscales. Based on the results of usability testing, the five constructs were rated on a Likert scale from 1–7 as follows: system usefulness (5.6±1.8), ease of use (5.6±1.5), information quality (5.4±1.4), interface quality (5.5±1.4), and overall satisfaction (5.5±1.6). CONCLUSIONS: The current trend in clinical medicine is applying therapies and interventions that improve QOL. Therefore, a potentially vast amount of internet-based QOL data is available for use in defining patient populations that may benefit from therapeutic intervention. Additionally, before undergoing breast conserving surgery, patients should be advised that their postoperative QOL depends not only on the success of the surgery, but also on their preoperative functional status. Public Library of Science 2015-09-30 /pmc/articles/PMC4589455/ /pubmed/26422018 http://dx.doi.org/10.1371/journal.pone.0139252 Text en © 2015 Kao et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Kao, Hao-Yun Wu, Wen-Hsiung Liang, Tyng-Yeu Lee, King-The Hou, Ming-Feng Shi, Hon-Yi Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery |
title | Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery |
title_full | Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery |
title_fullStr | Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery |
title_full_unstemmed | Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery |
title_short | Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery |
title_sort | cloud-based service information system for evaluating quality of life after breast cancer surgery |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589455/ https://www.ncbi.nlm.nih.gov/pubmed/26422018 http://dx.doi.org/10.1371/journal.pone.0139252 |
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