Using the EORTC-QLQ-C30 in clinical practice for patient management: identifying scores requiring a clinician’s attention

Abstract

Purpose Patient-reported outcomes (PROs) are used increasingly for individual patient management. Identifying which PRO scores require a clinician’s attention is an ongoing challenge. Previous research used a needs assessment to identify EORTC-QLQ-C30 cut-off scores representing unmet needs. This analysis attempted to replicate the previous findings in a new and larger sample. Methods This analysis used data from 408 Japanese ambulatory breast cancer patients who completed the QLQ-C30 and Supportive Care Needs Survey-Short Form-34 (SCNS-SF34). Applying the methods used previously, SCNS-SF34 item/domain scores were dichotomized as no vs. some unmet need. We calculated area under the receiver operating characteristic curve (AUC) to evaluate QLQ-C30 scores’ ability to discriminate between patients with no vs. some unmet need based on SCNS-SF34 items/domains. For QLQ-C30 domains with AUC≥0.70, we calculated the sensitivity, specificity, and predictive value of various cut-offs for identifying unmet needs. We hypothesized that compared to our original analysis (1) the same six QLQ-C30 domains would have AUC≥0.70, (2) the same SCNS-SF34 items would be best discriminated by QLQ-C30 scores, and (3) the sensitivity and specificity of our original cut-off scores would be supported. Results The findings from our original analysis were supported. The same six domains with AUC≥0.70 in the original analysis had AUC≥0.70 in this new sample, and the same SCNS-SF34 item was the best discriminated by QLQ-C30 scores. Cut-off scores were identified with sensitivity≥0.84 and specificity≥0.54. Conclusion Given these findings’ concordance with our previous analysis, these QLQ-C30 cut-offs could be implemented in clinical practice and their usefulness evaluated.

Prognostic features for quality of life after radical cystectomy and orthotopic neobladder

“…In recent years, many efforts have been made to define certain cut-off values in order to select those patients with unmet needs for further support. Snyder et al evaluated more than 500 oncologic patients and found a QLQ-C30 global health status cut-off value of 70 to have a sensitivity of up to 86% and a negative predictive value of up to 94% (14, 28). The aim of the current study was to evaluate various potential prognostic features on patients QoL after orthotopic urinary diversion, focusing on preoperative, perioperative as well as postoperative features.…”

“…The aim of the current study was to evaluate various potential prognostic features on patients QoL after orthotopic urinary diversion, focusing on preoperative, perioperative as well as postoperative features. To allow a better comparison with existing literature, we analysed the postoperative QLQ-C30 global health status as a continuous parameter as well as following Snyder et al (14). …”

“…Secondary endpoints were above-mentioned prognostic features. Analysis was performed using the global health status as a continuous variable as well as using a cut-off score of 70 as recently described by Snyder et al (14). Hereby, a QLQ-C30 score of less than 70 is associated with a poor quality of life, a score of at least 70 is considered to be associated with a good quality of life.…”

Planning for future success in pediatric heart failure and cardiac transplantation

“…General tools for capturing patient-reported outcomes and disease-specific tools are increasingly being used in other disease states [18][19][20]. These assessments aid in identifying disease burden or treatment effects that are most important or bothersome to the patient in everyday life.…”

New options in the management of intractable ALK(+) metastatic non-small-cell lung cancer

“…Both the Phase II and Phase III trials used the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and the lung cancer module (QLQ-LC13) 14,51. The QLQ-C30 includes five functional domains, eight symptoms, global health, and financial impact 52,53. Patient reported outcomes are based on their responses in accordance with a four-point scale from “not at all” to “very much”.…”