Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery

Quinten, Chantal; Kenis, Cindy; Decoster, Lore; Debruyne, Philip R.; Groof, Inge De; Focan, C.; Cornélis, Frank; Verschaeve, Vincent; Bachmann, Christian; Bron, Dominique; Luce, Sylvie; Debugne, Gwenaëlle; Bulck, Hilde Van den; Goeminne, Jean-Charles; Baitar, Abdelbari; Geboers, Katrien; Petit, Bénédicte; Langenaeken, Christine; Rijswijk, R. Van; Specenier, Pol; Jérusalem, Guy; Praet, Jean Philippe; Vandenborre, K.; Lycke, Michelle; Flamaing, Johan; Milisen, Koen; Lobelle, Jean-Pierre; Wildiers, Hans

doi:10.1007/s11136-018-2062-6

Cited by 25 publications

(19 citation statements)

References 46 publications

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“…(2019) and Quinten et al. (2019) conducted on a larger cohort of older cancer patients demonstrated the prognostic value of GA, in addition to clinical and socio‐demographic variables, in HRQOL decline, a finding that we were not able to replicate in our study. In addition, our data set was missing values for several of the EORTC QLQ‐C30 scales and the GA measures at follow‐up, but we imputed the missing values for our inferential analysis with a method suitable for the observed missingness pattern.…”

Section: Discussioncontrasting

confidence: 75%

The added value of geriatric assessment in evaluating a patient's Health‐Related Quality‐of‐Life: A study in ≥70‐year‐old early‐stage invasive breast cancer patients

et al. 2020

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Objective: The objective of this study was to assess the relationship between geriatric assessment (GA) and health-related Quality-of-Life (HRQOL) in older patients with breast cancer. Methods: Patients were assigned either to adjuvant chemotherapy (CTG) or to a control group (CG). Spearman rank coefficients (ρ) calculated correlations between HRQOL and GA at baseline, 3 months and 1 year. Multivariate regressions modelled the prognostic value of GA in evaluating of a patient's HRQOL and the accuracy of baseline GA in predicting HRQOL decline (change of ≥10 points). Results: The analysis included 57 patients in the CTG and 52 in the CG. Strong correlations (ρ ≥ 0.5) were reported between the EORTC QLQ-C30 Physical Functioning Scale and Activities of Daily Living (ADL), Instrumental ADL (iADL) and Leuven Oncogeriatric Frailty Score Scale (LOFS). Multivariate models demonstrated that poor iADL, ADL and LOFS (CG) and ADL and iADL (CTG) contributed to a statistically

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Section: Discussioncontrasting

confidence: 75%

The added value of geriatric assessment in evaluating a patient's Health‐Related Quality‐of‐Life: A study in ≥70‐year‐old early‐stage invasive breast cancer patients

et al. 2020

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“…Until a follow-up of 2 months, quality of life declined in 30% of patients with localized advanced prostate cancer and a low prevalence of malnutrition at baseline (2%), but the study did not report adjusted analyses related to its association with baseline MNA [57]. In two studies [45,75] reporting on patients with various types of cancer and a follow-up of 3 months, patients with (risk of) malnutrition had a significantly lower chance for a decline in health-related quality of life compared to well-nourished patients. In one of these studies, this effect was not maintained in in the multivariable analysis in patients receiving chemotherapy [75].…”

Section: (Health-related) Quality Of Lifementioning

confidence: 99%

Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review

et al. 2020

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Background Patients with cancer have an increased risk of malnutrition which is associated with poor outcome. The Mini Nutritional Assessment (MNA®) is often used in older patients with cancer but its relation to outcome is not known. Methods Four databases were systematically searched for studies relating MNA-results with any reported outcome. Two reviewers screened titles/abstracts and full-texts, extracted data and rated the risk of bias (RoB) independently. Results We included 56 studies which varied widely in patient and study characteristics. In multivariable analyses, (risk of) malnutrition assessed by MNA significantly predicts a higher chance for mortality/poor overall survival (22/27 studies), shorter progression-free survival/time to progression (3/5 studies), treatment maintenance (5/8 studies) and (health-related) quality of life (2/2 studies), but not treatment toxicity/complications (1/7 studies) or functional status/decline in (1/3 studies). For other outcomes – length of hospital stay (2 studies), falls, fatigue and unplanned (hospital) admissions (1 study each) – no adjusted results were reported. RoB was rated as moderate to high. Conclusions MNA®-result predicts mortality/survival, cancer progression, treatment maintenance and (health-related) quality of life and did not predict adverse treatment outcomes and functional status/ decline in patients with cancer. For other outcomes results are less clear. The moderate to high RoB calls for studies with better control of potential confounders.

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“…-The ROC: created by plotting the sensitivity of the instrument (the true positive rate) against the specificity (the false positive rate). Some studies [43,51,54,60,76] identified the MCID as the upper corner of the curve, and other studies [45,65] identified the MCID as the point of the receiver operating characteristics curve in which sensitivity and specificity are maximized (Maximum (Sensibility+Specificity-1), Youden index). The area under the curve (AUC) was always calculated to measure the instrument responsiveness, suggesting AUC values upper than 0.…”

Section: Type Of Anchorsmentioning

confidence: 99%

How is the minimal clinically important difference established in health-related quality of life instruments? Review of anchors and methods

Mouelhi

Jouve

Castelli

et al. 2020

Health Qual Life Outcomes

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Background: The aim of this systematic review is to describe the different types of anchors and statistical methods used in estimating the Minimal Clinically Important Difference (MCID) for Health-Related Quality of Life (HRQoL) instruments. Methods: PubMed and Google scholar were searched for English and French language studies published from 2010 to 2018 using selected keywords. We included original articles (reviews, meta-analysis, commentaries and research letters were not considered) that described anchors and statistical methods used to estimate the MCID in HRQoL instruments. Results: Forty-seven papers satisfied the inclusion criteria. The MCID was estimated for 6 generic and 18 diseasespecific instruments. Most studies in our review used anchor-based methods (n = 41), either alone or in combination with distribution-based methods. The most common applied anchors were non-clinical, from the viewpoint of patients. Different statistical methods for anchor-based methods were applied and the Change Difference (CD) was the most used one. Most distributional methods included 0.2 standard deviations (SD), 0.3 SD, 0.5 SD and 1 standard error of measurement (SEM). MCID values were very variable depending on methods applied, and also on clinical context of the study. Conclusion: Multiple anchors and methods were applied in the included studies, which lead to different estimations of MCID. Using several methods enables to assess the robustness of the results. This corresponds to a sensitivity analysis of the methods. Close collaboration between statisticians and clinicians is recommended to integrate an agreement regarding the appropriate method to determine MCID for a specific context.

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Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery

Cited by 25 publications

References 46 publications

The added value of geriatric assessment in evaluating a patient's Health‐Related Quality‐of‐Life: A study in ≥70‐year‐old early‐stage invasive breast cancer patients

The added value of geriatric assessment in evaluating a patient's Health‐Related Quality‐of‐Life: A study in ≥70‐year‐old early‐stage invasive breast cancer patients

Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer – a systematic review

How is the minimal clinically important difference established in health-related quality of life instruments? Review of anchors and methods

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