Rothmund Maria, Pilz Micha J, Egeter Nathalie, Lidington Emma, Piccinin Claire, Arraras Juan I, Grønvold Mogens, Holzner Bernhard, van Leeuwen Marieke, Petersen Morten Aa, Schmidt Heike, Young Teresa, Giesinger Johannes M
University Hospital of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria.
Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
Psychooncology. 2023 Apr;32(4):628-639. doi: 10.1002/pon.6109. Epub 2023 Feb 19.
Cancer and its treatment can have substantial impact on patients' emotional functioning. Several patient-reported outcome measures (PROMs) assessing emotional functioning are available, but differences in content limit the comparability of results. To better understand conceptual (dis)similarities, we conducted a content comparison of commonly used PROMs.
We included emotional functioning items, scales, and item banks from the EORTC CAT Core, EORTC QLQ-C30, FACT-G, Hospital anxiety and depression scale (HADS), SF-36, PRO-CTCAE, and PROMIS (item banks for anxiety, depression, and anger). Item content was linked to the International Classification of Functioning, Disability, and Health (ICF) and a hierarchical framework established for PROMIS. Single items could be coded with more than one ICF category but were solely assigned to one facet within the PROMIS framework.
The measures comprise 132 unique items covering the ICF components 'Body functions' (136/153 codings, 88.9%) and 'Activities and participation' (15/153, 9.8%). Most ICF codings (112/153, 73.2%) referred to the third-level category 'b1528 Emotional functions, other specified'. According to the PROMIS framework 48.5% of the items assessed depression (64/132 items), followed by anxiety (41/132, 31.1%) and anger (26/132, 19.7%). The EORTC measures covered depression, anxiety, and anger in a single measure, while the PROMIS inventory provides separate item banks for these concepts. The FACT-G, SF-36, PRO-CTCAE and HADS covered depression and anxiety, but not anger.
Our results provide an in-depth conceptual understanding of selected PROMs and important qualitative information going beyond psychometric evidence. Such information supports the identification of PROMs for which scores can be meaningfully linked with quantitative methods.
癌症及其治疗会对患者的情绪功能产生重大影响。目前有几种评估情绪功能的患者报告结局指标（PROMs），但内容差异限制了结果的可比性。为了更好地理解概念上的（不）相似性，我们对常用的PROMs进行了内容比较。
我们纳入了欧洲癌症研究与治疗组织（EORTC）CAT核心量表、EORTC QLQ-C30量表、FACT-G量表、医院焦虑抑郁量表（HADS）、SF-36量表、PRO-CTCAE量表以及PROMIS（焦虑、抑郁和愤怒项目库）中的情绪功能条目、量表和项目库。项目内容与《国际功能、残疾和健康分类》（ICF）相关联，并为PROMIS建立了一个层次框架。单个项目可能与多个ICF类别编码，但在PROMIS框架中仅被分配到一个方面。
这些指标包含132个独特项目，涵盖ICF组件“身体功能”（136/153个编码，88.9%）和“活动与参与”（15/153，9.8%）。大多数ICF编码（112/153，73.2%）涉及第三级类别“b1528 其他特定的情绪功能”。根据PROMIS框架，48.5%的项目评估抑郁（64/132个项目），其次是焦虑（41/132，31.1%）和愤怒（26/132，19.7%）。EORTC量表在一个单一量表中涵盖了抑郁、焦虑和愤怒，而PROMIS量表为这些概念提供了单独的项目库。FACT-G量表、SF-36量表、PRO-CTCAE量表和HADS量表涵盖了抑郁和焦虑，但不包括愤怒。
我们的结果提供了对所选PROMs的深入概念理解以及超越心理测量证据的重要定性信息。这些信息有助于确定哪些PROMs的分数可以与定量方法进行有意义的关联。
