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Patient reported outcomes can improve performance status assessment: a pilot study
BACKGROUND: Patient performance status is routinely used in oncology to estimate physical functioning, an important factor in clinical treatment decisions and eligibility for clinical trials. However, validity and reliability data for ratings of performance status have not been optimal. This study r...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635569/ https://www.ncbi.nlm.nih.gov/pubmed/31313047 http://dx.doi.org/10.1186/s41687-019-0136-z |
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author | Broderick, Joan E. May, Marcella Schwartz, Joseph E. Li, Ming Mejia, Aaron Nocera, Luciano Kolatkar, Anand Ueno, Naoto T. Yennu, Sriram Lee, Jerry S. H. Hanlon, Sean E. Cozzens Philips, Frankie A. Shahabi, Cyrus Kuhn, Peter Nieva, Jorge |
author_facet | Broderick, Joan E. May, Marcella Schwartz, Joseph E. Li, Ming Mejia, Aaron Nocera, Luciano Kolatkar, Anand Ueno, Naoto T. Yennu, Sriram Lee, Jerry S. H. Hanlon, Sean E. Cozzens Philips, Frankie A. Shahabi, Cyrus Kuhn, Peter Nieva, Jorge |
author_sort | Broderick, Joan E. |
collection | PubMed |
description | BACKGROUND: Patient performance status is routinely used in oncology to estimate physical functioning, an important factor in clinical treatment decisions and eligibility for clinical trials. However, validity and reliability data for ratings of performance status have not been optimal. This study recruited oncology patients who were about to begin emetogenic palliative or adjuvant chemotherapy for treatment of solid tumors. We employed actigraphy as the gold standard for physical activity level. Correspondences between actigraphy and oncologists’ and patients’ ratings of performance status were examined and compared with the correspondences of actigraphy and several patient reported outcomes (PROs). The study was designed to determine feasibility of the measurement approaches and if PROs can improve the accuracy of assessment of performance status. METHODS: Oncologists and patients made performance status ratings at visit 1. Patients wore an actigraph and entered weekly PROs on a smartphone app. Data for days 1–14 after visit 1 were analyzed. Chart reviews were conducted to tabulate all unexpected medical events across days 1–150. RESULTS: Neither oncologist nor patient ratings of performance status predicted steps/hour (actigraphy). The PROMIS® Physical Function PRO (average of Days 1, 7, 14) was associated with steps/hour at high (for men) and moderate (for women) levels; the PROMIS® Fatigue PRO predicted steps for men, but not for women. Unexpected medical events occurred in 57% of patients. Only body weight in female patients predicted events; oncologist and patient performance status ratings, steps/hour, and other PROs did not. CONCLUSIONS: PROMIS® Physical Function and Fatigue PROs show good correspondence with steps/hour making them easy, useful tools for oncologists to improve their assessment of performance status, especially for male patients. Female patients had lower levels of steps/hour than males and lower correlations among the predictors, suggesting the need for further work to improve performance status assessment in women. Assessment of pre-morbid sedentary behavior alongside current Physical Functioning and Fatigue PROs may allow for a more valid determination of disease-related activity level and performance status. |
format | Online Article Text |
id | pubmed-6635569 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-66355692019-08-01 Patient reported outcomes can improve performance status assessment: a pilot study Broderick, Joan E. May, Marcella Schwartz, Joseph E. Li, Ming Mejia, Aaron Nocera, Luciano Kolatkar, Anand Ueno, Naoto T. Yennu, Sriram Lee, Jerry S. H. Hanlon, Sean E. Cozzens Philips, Frankie A. Shahabi, Cyrus Kuhn, Peter Nieva, Jorge J Patient Rep Outcomes Research BACKGROUND: Patient performance status is routinely used in oncology to estimate physical functioning, an important factor in clinical treatment decisions and eligibility for clinical trials. However, validity and reliability data for ratings of performance status have not been optimal. This study recruited oncology patients who were about to begin emetogenic palliative or adjuvant chemotherapy for treatment of solid tumors. We employed actigraphy as the gold standard for physical activity level. Correspondences between actigraphy and oncologists’ and patients’ ratings of performance status were examined and compared with the correspondences of actigraphy and several patient reported outcomes (PROs). The study was designed to determine feasibility of the measurement approaches and if PROs can improve the accuracy of assessment of performance status. METHODS: Oncologists and patients made performance status ratings at visit 1. Patients wore an actigraph and entered weekly PROs on a smartphone app. Data for days 1–14 after visit 1 were analyzed. Chart reviews were conducted to tabulate all unexpected medical events across days 1–150. RESULTS: Neither oncologist nor patient ratings of performance status predicted steps/hour (actigraphy). The PROMIS® Physical Function PRO (average of Days 1, 7, 14) was associated with steps/hour at high (for men) and moderate (for women) levels; the PROMIS® Fatigue PRO predicted steps for men, but not for women. Unexpected medical events occurred in 57% of patients. Only body weight in female patients predicted events; oncologist and patient performance status ratings, steps/hour, and other PROs did not. CONCLUSIONS: PROMIS® Physical Function and Fatigue PROs show good correspondence with steps/hour making them easy, useful tools for oncologists to improve their assessment of performance status, especially for male patients. Female patients had lower levels of steps/hour than males and lower correlations among the predictors, suggesting the need for further work to improve performance status assessment in women. Assessment of pre-morbid sedentary behavior alongside current Physical Functioning and Fatigue PROs may allow for a more valid determination of disease-related activity level and performance status. Springer International Publishing 2019-07-16 /pmc/articles/PMC6635569/ /pubmed/31313047 http://dx.doi.org/10.1186/s41687-019-0136-z Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Broderick, Joan E. May, Marcella Schwartz, Joseph E. Li, Ming Mejia, Aaron Nocera, Luciano Kolatkar, Anand Ueno, Naoto T. Yennu, Sriram Lee, Jerry S. H. Hanlon, Sean E. Cozzens Philips, Frankie A. Shahabi, Cyrus Kuhn, Peter Nieva, Jorge Patient reported outcomes can improve performance status assessment: a pilot study |
title | Patient reported outcomes can improve performance status assessment: a pilot study |
title_full | Patient reported outcomes can improve performance status assessment: a pilot study |
title_fullStr | Patient reported outcomes can improve performance status assessment: a pilot study |
title_full_unstemmed | Patient reported outcomes can improve performance status assessment: a pilot study |
title_short | Patient reported outcomes can improve performance status assessment: a pilot study |
title_sort | patient reported outcomes can improve performance status assessment: a pilot study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635569/ https://www.ncbi.nlm.nih.gov/pubmed/31313047 http://dx.doi.org/10.1186/s41687-019-0136-z |
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