Peeters Marthe C M, Zwinkels Hanneke, Koekkoek Johan A F, Vos Maaike J, Dirven Linda, Taphoorn Martin J B
Department of Neurology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Department of Neurology, Haaglanden Medical Center, 2262 BA The Hague, The Netherlands.
Cancers (Basel). 2020 Aug 5;12(8):2172. doi: 10.3390/cancers12082172.
The aim of this study was to explore the impact of the timing of Health-Related Quality of Life (HRQoL) measurements in clinical care on the obtained HRQoL scores in glioma patients, and the association with feelings of anxiety or depression.
Patients completed the European Organisation for Research and Treatment of Cancer (EORTC)'s Quality of Life Questionnaires (QLQ-C30 and QLQ-BN20), and the Hospital Anxiety and Depression Scale (HADS) twice. All patients completed the first measurement on the day of the Magnetic Resonance Imaging (MRI) scan ( = 0), but the second measurement ( = 1) depended on randomization; Group 1 ( = 49) completed the questionnaires before and Group 2 ( = 51) after the consultation with the physician.
median HRQoL scale scores on t0/t1 and change scores were comparable between the two groups. Between 8-58% of patients changed to a clinically relevant extent (i.e., ≥10 points) on the evaluated HRQoL scales in about one-week time, in both directions, with only 3% of patients remaining stable in all scales. Patients with a stable role functioning had a lower HADS anxiety change score. The HADS depression score was not associated with a change in HRQoL.
Measuring HRQoL before or after the consultation did not impact HRQoL scores on a group level. However, most patients reported a clinically relevant difference in at least one HRQoL scale between the two time points. These findings highlight the importance of standardized moments of HRQoL assessments, or patient-reported outcomes in general, during treatment and follow-up in clinical trials.
本研究旨在探讨临床护理中健康相关生活质量(HRQoL)测量时间对胶质瘤患者获得的HRQoL评分的影响,以及与焦虑或抑郁情绪的关联。
患者两次完成欧洲癌症研究与治疗组织(EORTC)的生活质量问卷(QLQ-C30和QLQ-BN20)以及医院焦虑抑郁量表(HADS)。所有患者在磁共振成像(MRI)扫描当天(t = 0)完成首次测量,但第二次测量(t = 1)取决于随机分组;第1组(n = 49)在与医生会诊前完成问卷,第2组(n = 51)在会诊后完成。
两组在t0/t1时的HRQoL量表中位数评分及变化评分相当。在大约一周时间内,8 - 58%的患者在评估的HRQoL量表上在临床上有显著变化(即≥10分),变化方向不一,所有量表中仅有3%的患者保持稳定。角色功能稳定的患者HADS焦虑变化评分较低。HADS抑郁评分与HRQoL变化无关。
会诊前或会诊后测量HRQoL在组水平上对HRQoL评分没有影响。然而,大多数患者报告在两个时间点之间至少一个HRQoL量表上有临床显著差异。这些发现凸显了在临床试验的治疗和随访期间,HRQoL评估或一般患者报告结局的标准化时间点的重要性。