Division of Cancer, Surgery and Transplantation, Oslo University Hospital, P.O. Box 4956, Oslo, 0424, Norway.
Support Care Cancer. 2013 Jun;21(6):1677-84. doi: 10.1007/s00520-012-1713-3. Epub 2013 Jan 13.
Patient-reported outcomes are important for clinical practice and research, and should reflect what patients perceive as important. The objective of this study was to develop and preliminarily validate a brief, patient-derived, disease-specific tool, the pancreatic cancer disease impact (PACADI) score.
The development was performed in two phases. Forty-one patients with confirmed pancreatic cancer (PC) selected dimensions of health related to the impact of the disease. A weighting of the eight most frequently reported dimensions was performed in a second sample of 80 PC patients who also rated the impact on eight numeric rating scales (NRS, range 0 to 10). The relative weights and the scores from the NRS were used to compute the PACADI score (range 0 to 10). The patients also completed Edmonton Symptom Assessment System (ESAS) and EQ-5D.
Dimensions reported by more than 20% of the patients were included in the PACADI score (relative weights in parenthesis): pain/discomfort (0.16), fatigue (0.16), anxiety (0.15), bowel/digestive problems (0.14), loss of appetite (0.13), dry mouth (0.11), itchiness (0.08), and nausea (0.07). The PACADI score in the 80 PC patients had a mean (SD) value of 3.26 (2.06) (95% CI 2.80, 3.71), was moderately to strongly correlated to ESAS sense of well-being (r = 0.69) and EQ-5D (r = -0.52), and discriminated significantly between patients with and without PC.
The PACADI score is a new eight-item, patient-derived, disease-specific measure. Preliminary validation regarding construct validity and discrimination encourages further validation in independent patient samples.
患者报告的结局对于临床实践和研究很重要，应该反映患者认为重要的内容。本研究的目的是开发并初步验证一种简短的、源自患者的、针对特定疾病的工具，即胰腺癌疾病影响（PACADI）评分。
该研究分两个阶段进行。41 名确诊为胰腺癌（PC）的患者选择了与疾病影响相关的健康维度。在第二组 80 名 PC 患者中，对这 8 个最常报告的维度进行了加权，这些患者还对 8 个数字评定量表（NRS，范围 0 到 10）的影响进行了评分。NRS 的相对权重和评分用于计算 PACADI 评分（范围 0 到 10）。患者还完成了埃德蒙顿症状评估系统（ESAS）和 EQ-5D 量表。
超过 20%的患者报告的维度被纳入 PACADI 评分（括号中为相对权重）：疼痛/不适（0.16）、疲劳（0.16）、焦虑（0.15）、肠道/消化问题（0.14）、食欲减退（0.13）、口干（0.11）、瘙痒（0.08）和恶心（0.07）。80 名 PC 患者的 PACADI 评分均值（SD）为 3.26（2.06）（95%CI 2.80,3.71），与 ESAS 幸福感（r=0.69）和 EQ-5D（r=-0.52）中度至高度相关，并且能够显著区分有和无 PC 的患者。
PACADI 评分是一种新的八项、源自患者的、针对特定疾病的测量工具。初步验证了其结构有效性和区分能力，鼓励在独立患者样本中进一步验证。
