Goswami Pushpendra, Oliva Esther N, Ionova Tatyana, Else Roger, Kell Jonathan, Fielding Adele K, Jennings Daniel M, Karakantza Marina, Al-Ismail Saad, Collins Graham P, McConnell Stewart, Langton Catherine, Al-Obaidi Magda J, Oblak Metod, Salek Sam
School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.
Hematology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy.
Front Pharmacol. 2020 Oct 20;11:571066. doi: 10.3389/fphar.2020.571066. eCollection 2020.
Patients' experience of symptoms often goes undetected during consultation in an outpatient clinic, and the use of a patient-reported outcome measure (PRO) in such a setting could be useful to aid treatment decision-making. A new PRO measure, the HM-PRO (Hematological Malignancy Specific Patient-Reported Outcome Measure) has been recently developed to evaluate hematological malignancy (HM) patients' health-related quality of life (HRQoL) and their symptom experience in daily clinical practice as well as in research. The objectives of the study were to assess: the internal consistency of the scores for Part A (impact) and its four domains (physical behavior; social well-being; emotional behavior; and eating and drinking habits) and Part B (signs and symptoms); and the test-retest reliability of the individual items of the newly developed hematological malignancy specific composite measure, the HM-PRO.
This was a prospective longitudinal observational study where 150 patients with different HMs and different stage of disease (male n = 98 (65.3%); mean age 64.9 ± 14.4 years, range 17.9-89.2 years; mean time since diagnosis 3.7 ± 4.9 years, range 0.04-25.8 years) completed the HM-PRO at baseline (assessment 1 at t1) and after 7 days (assessment 2 at t2). Data analysis was performed using IBMSPSS 23 statistical software.
The Cronbach's alpha estimates of the HM-PRO for both assessment points (t1 and t2) were above 0.9 for Part A, and above 0.8 for Part B, showing strong stability of the measurement. The level of agreement for the reproducibility between the two assessments, using intra-class correlation coefficients (ICC), was very strong with Part A: ICC = 0.93 (95% CI = 0.90-0.95), and Part B: ICC = 0.91 (0.88-0.93). The ICC for the four domains of Part A ranged from 0.85-0.91. The ICC was greater than 0.8 for overall score of Part A and Part B for all the 10 diagnoses, confirming strong reliability.
This study clearly indicates that the HM-PRO possesses strong test-retest reliability for both Part A and Part B. The Cronbach's alpha confirmed acceptable internal consistency. The extensive reliability testing described in this study supports the generic nature of the HM-PRO for use in hematological malignancies in both routine clinical practice, to aid treatment decisions, as well as in research.
在门诊咨询过程中,患者的症状体验常常未被察觉,在此种情况下使用患者报告结局量表(PRO)可能有助于辅助治疗决策。最近开发了一种新的PRO量表,即血液系统恶性肿瘤特异性患者报告结局量表(HM-PRO),用于评估血液系统恶性肿瘤(HM)患者的健康相关生活质量(HRQoL)以及他们在日常临床实践和研究中的症状体验。本研究的目的是评估:A部分(影响)及其四个领域(身体行为;社会福祉;情绪行为;饮食和饮水习惯)以及B部分(体征和症状)得分的内部一致性;以及新开发的血液系统恶性肿瘤特异性综合量表HM-PRO各个条目的重测信度。
这是一项前瞻性纵向观察性研究,150例患有不同血液系统恶性肿瘤且处于不同疾病阶段的患者(男性n = 98例(65.3%);平均年龄64.9±14.4岁,范围17.9 - 89.2岁;自诊断以来的平均时间3.7±4.9年,范围0.04 - 25.8年)在基线时(t1时的评估1)和7天后(t2时的评估2)完成HM-PRO量表。使用IBM SPSS 23统计软件进行数据分析。
HM-PRO在两个评估点(t1和t2)的克朗巴哈系数估计值,A部分高于0.9,B部分高于0.8,表明测量具有很强的稳定性。使用组内相关系数(ICC)对两次评估之间的再现性一致性水平进行分析,A部分非常强:ICC = 0.93(95%CI = 0.90 - 0.95),B部分:ICC = 0.91(0.88 - 0.93)。A部分四个领域的ICC范围为0.85 - 0.91。对于所有10种诊断,A部分和B部分的总分ICC均大于0.8,证实了很强的信度。
本研究清楚地表明,HM-PRO在A部分和B部分均具有很强的重测信度。克朗巴哈系数证实了可接受的内部一致性。本研究中描述的广泛的信度测试支持了HM-PRO在常规临床实践中用于辅助血液系统恶性肿瘤治疗决策以及在研究中的通用性。