Koehler Michael, Fischer Thomas, Kropf Siegfried, Frommer Joerg
Department of Hematology and Oncology, Otto-von-Guericke-University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany,
Support Care Cancer. 2014 Nov;22(11):3089-99. doi: 10.1007/s00520-014-2331-z. Epub 2014 Jul 5.
Although there are several established methods like the Common Terminology Criteria for Adverse Events (CTCAE), heretofore, no objective, quantitative measurement exists for the somatic burden due to chemotherapy-induced adverse events (SB-CHINAE). We developed the Somatic Burden Score (SBS-AE) that combines the severity grade and duration of an AE. This paper describes the development and validation of the SBS-AE.
SBS-AE's calculation was based on the number of days of CTCAE grades of a particular AE. The target value was the weighted, relative duration of an AE grade using CTCAE v3.0. We applied the SBS-AE in 64 patients with hematological malignancies and high-dose chemotherapy (HDC). The ratio measurement scale of the SBS-AE allows all statistical measures using SBS-AE, as all necessary mathematical operations are defined for it. We calculated an overall-SBS-HDC, defined as the total SB-CHINAE of HDC. To determine SBS-AE's criterion and construct validity, three self-rating scales and one clinician rating scale were used (German Clinical Trials Register, Main ID: DRKS00003453).
The SBS-AE's criterion validity could be verified both with statistical significance and at least medium-to-large effects (p < 0.05, Cohen's d > 0.79, f (2) > 0.18). The quantitative measured SB-CHINAE was equally associated with subjectively assessed physical health-related quality of life (0.15 ≤ R (2) ≤ 0.49), objectively evaluated toxicities (0.48 ≤ R (2) ≤ 0.67), transfusion-dependent thrombocytopenia, and anemia (Cohen's d > 0.89). Patients' somatic burden of HDC was 5.8-fold greater compared with standard chemotherapy regimens.
The SBS-AE indicates psychometric and clinical properties and may prove useful in the future design of cancer clinical trials and supportive care interventions inside of the inpatient setting.
尽管有几种既定方法,如不良事件通用术语标准(CTCAE),但迄今为止,尚无针对化疗引起的不良事件所致躯体负担(SB-CHINAE)的客观、定量测量方法。我们开发了结合不良事件严重程度等级和持续时间的躯体负担评分(SBS-AE)。本文描述了SBS-AE的开发与验证过程。
SBS-AE的计算基于特定不良事件CTCAE等级的天数。目标值是使用CTCAE v3.0的不良事件等级的加权相对持续时间。我们将SBS-AE应用于64例血液系统恶性肿瘤和接受大剂量化疗(HDC)的患者。SBS-AE的比率测量量表允许使用SBS-AE进行所有统计测量,因为为其定义了所有必要的数学运算。我们计算了总体SBS-HDC,定义为HDC的总SB-CHINAE。为了确定SBS-AE的标准效度并构建效度,使用了三个自评量表和一个临床医生评定量表(德国临床试验注册中心,主要标识符:DRKS00003453)。
SBS-AE的标准效度在统计学意义上以及至少中等至较大效应方面均得到验证(p < 0.05,科恩d值> 0.79,f(2) > 0.18)。定量测量的SB-CHINAE与主观评估的与身体健康相关的生活质量(0.15≤R(2)≤0.49)、客观评估的毒性(0.48≤R(2)≤0.67)、输血依赖型血小板减少症和贫血(科恩d值> 0.89)同样相关。与标准化疗方案相比,患者接受HDC的躯体负担大5.8倍。
SBS-AE显示出心理测量学和临床特性,未来可能在住院环境下的癌症临床试验设计和支持性护理干预中发挥作用。