Nagel G C, Schmidt S, Strauss B M, Katenkamp D
Comprehensive Cancer Center/Field study, Friedrich-Schiller University, Jena, Germany.
Breast Cancer Res Treat. 2001 Jul;68(1):75-87. doi: 10.1023/a:1017975609835.
Quality of life (QOL) questionnaires are integrated into clinical trials in order to evaluate different treatments, and rarely used in a diagnostic sense. The aim of this study was to identify clinically meaningful subgroups by means of established QOL tools. Since January 1995, a field study funded by the German Ministry of Health was conducted to evaluate quality of care of breast cancer patients in eastern Thuringia. During the follow-up period, the European Organization of Research and Treatment of Cancer (EORTC), Quality of Life C30 and the breast specific module BR23 were mailed. One-hundred-fifty-eight women answered both questionnaires. A cluster analysis was performed to distinguish subgroups on the basis of QOL-BR23 scores. According to the QOL outcomes, four subgroups could be described. There was a strong relation to operative treatment (p < 0.05), while no association with the adjuvant treatment strategy was observed. The subsets identified on the basis of BR23 scores were significantly related to all C30 domains. It was possible to demonstrate the clinical validity in terms of clinical and sociodemographic data. No association was found with the marital status or the highest level of education, while a worsening of the financial situation was associated. It could be shown that a distinction of patient subgroups based on clinically meaningful BR23 data is possible. Subgroups with specific profiles could be identified. In the future, the characterisation of subgroups could provide a possibility to generate indications for specific supportive interventions.
生活质量(QOL)问卷被纳入临床试验以评估不同治疗方法,很少用于诊断目的。本研究的目的是通过既定的QOL工具识别具有临床意义的亚组。自1995年1月起,由德国卫生部资助开展了一项实地研究,以评估图林根州东部乳腺癌患者的护理质量。在随访期间,邮寄了欧洲癌症研究与治疗组织(EORTC)的生活质量C30问卷和乳腺癌特异性模块BR23问卷。158名女性回答了这两份问卷。进行聚类分析以根据QOL-BR23评分区分亚组。根据生活质量结果,可以描述出四个亚组。这与手术治疗有很强的相关性(p < 0.05),而未观察到与辅助治疗策略有关联。基于BR23评分确定的亚组与所有C30领域均显著相关。在临床和社会人口统计学数据方面可以证明其临床有效性。未发现与婚姻状况或最高教育水平有关联,而与财务状况恶化有关联。可以表明,基于具有临床意义的BR23数据区分患者亚组是可行的。可以识别出具有特定特征的亚组。未来,亚组的特征描述可为特定支持性干预措施提供指征。