Khan Luluel, Cramarossa Gemma, Chen Emily, Nguyen Janet, Zhang Liying, Tsao May, Danjoux Cyril, Barnes Elizabeth, Sahgal Arjun, Holden Lori, Jon Flo, Culleton Shaelyn, Chow Edward
Rapid Response Radiotherapy Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada.
World J Oncol. 2012 Feb;3(1):23-32. doi: 10.4021/wjon403w. Epub 2012 Feb 19.
To determine whether symptom clusters in patients with bone metastases vary when extracted using three different statistical methods. To compare the temporal composition of symptom clusters in responders versus non-responders to palliative radiation treatment.
A previous dataset of 518 bone metastases patients who completed the Edmonton Symptom Assessment System (ESAS) was used in this study. Clusters derived using Principal Component Analysis (PCA) in our previous study were compared to symptom clusters extracted using Hierarchical Cluster Analysis (HCA) and Exploratory Factor Analysis (EFA). Clusters were derived at baseline, and 1, 2, 4, 8 and 12 weeks after radiation treatment. The patient sample was further divided into responders versus non-responders to radiotherapy. The three statistical methods were performed to identify clusters in the subgroups at each time point.
A complete consensus between HCA, EFA and PCA for the number and composition of symptom clusters was not reached at any time point. Furthermore, little correlation in clusters was found between the three statistical methods despite the use of an identical data set. As expected, different symptom clusters were observed in the responders and non-responders with all three statistical methods. In addition, clusters varied at each time point within each subgroup. Depression and anxiety were consistently found in the same cluster.
The quantity, composition, and occurrence of symptom clusters varied based on which statistical method was employed. The use of a common analytical method is necessary for consistency and comparison purposes in future symptom cluster research.
确定使用三种不同统计方法提取骨转移患者的症状群时是否存在差异。比较姑息性放射治疗有反应者与无反应者症状群的时间构成。
本研究使用了之前一个包含518例完成埃德蒙顿症状评估系统（ESAS）的骨转移患者的数据集。将我们之前研究中使用主成分分析（PCA）得出的症状群与使用层次聚类分析（HCA）和探索性因子分析（EFA）提取的症状群进行比较。在放疗前基线以及放疗后1、2、4、8和12周得出症状群。患者样本进一步分为放疗有反应者和无反应者。在每个时间点对亚组使用这三种统计方法来识别症状群。
在任何时间点，HCA、EFA和PCA在症状群数量和构成上均未达成完全一致。此外，尽管使用的是相同数据集，但三种统计方法之间的症状群相关性很小。正如预期的那样，使用所有三种统计方法在有反应者和无反应者中均观察到不同的症状群。此外，每个亚组内的症状群在每个时间点都有所不同。抑郁和焦虑始终出现在同一症状群中。
症状群的数量、构成和出现情况因所采用的统计方法而异。为了未来症状群研究的一致性和比较目的，使用通用分析方法是必要的。
