De Cicco Davide, Tartaro Gianpaolo, Ciardiello Fortunato, Fasano Morena, Rauso Raffaele, Fiore Francesca, Spuntarelli Chiara, Troiano Antonio, Lo Giudice Giorgio, Colella Giuseppe
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy.
Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Cancers (Basel). 2021 Aug 31;13(17):4398. doi: 10.3390/cancers13174398.
health-related quality of life (HRQOL) represents a secondary endpoint of medical interventions in oncological patients. Our aim was to highlight potential sources of bias that could be encountered when evaluating HRQOL in oral cancer patients.
this review followed PRISMA-ScR recommendations.
patients treated for oral cancer.
HRQOL assessed by EORTC QLQ-C30 and QLQ-H&N35/QLQ-H&N43. A critical appraisal of included studies was performed to evaluate the accuracy of data stratification with respect to HRQOL determinants.
overall, 30 studies met the inclusion criteria, totaling 1833 patients. In total, 8 sociodemographic (SDG) and 15 disease/treatment-specific (DT) HRQOL determinants (independent variables) were identified. The mean number of the independent variables was 6.1 (SD, 4.3)-5.0 (SD, 4.0) DT-related and 1.1 (SD, 1.8) SDG-related variables per article. None of the included papers considered all the identified determinants simultaneously.
a substantial lack of evidence regarding HRQOL determinants was demonstrated. This strongly weakens the reliability of the reported findings due to the challenging presence of baseline confounding, selection, and omitted variable biases. The proposed approach recommends the use of further evaluation tools that gather more variables in a single score together with a selection of more homogeneous, reproducible, and comparable cohorts based on the identified baseline confounding.
健康相关生活质量（HRQOL）是肿瘤患者医学干预的次要终点。我们的目的是强调在评估口腔癌患者的HRQOL时可能遇到的潜在偏倚来源。
本综述遵循PRISMA-ScR建议。
接受口腔癌治疗的患者。
通过欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）和头颈部癌特异性问卷（QLQ-H&N35/QLQ-H&N43）评估HRQOL。对纳入研究进行严格评估，以评估关于HRQOL决定因素的数据分层准确性。
总体而言，30项研究符合纳入标准，共计1833例患者。总共确定了8个社会人口统计学（SDG）和15个疾病/治疗特异性（DT）HRQOL决定因素（自变量）。每篇文章中自变量的平均数量为6.1（标准差，4.3）-5.0（标准差，4.0）个与DT相关的变量和1.1（标准差，1.8）个与SDG相关的变量。纳入的论文均未同时考虑所有确定的决定因素。
结果表明，关于HRQOL决定因素的证据严重不足。由于存在具有挑战性的基线混杂、选择和遗漏变量偏倚，这严重削弱了所报告结果的可靠性。所提出的方法建议使用进一步的评估工具，这些工具可以在单个评分中收集更多变量，并根据确定的基线混杂因素选择更同质、可重复和可比的队列。
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