Dataset Information

Congruence of patient- and clinician-reported toxicity in women receiving chemotherapy for early breast cancer.

ABSTRACT:

Background

The National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events, collected alongside the clinician-reported Common Terminology Criteria for Adverse Events, enables comparisons of patient and clinician reports on treatment toxicity.

Methods

In a multisite study of women receiving chemotherapy for early-stage breast cancer, symptom reports were collected on the same day from patients and their clinicians for 17 symptoms; their data were not shared with each other. The proportions of moderate, severe, or very severe patient-reported symptom severity were compared with the proportions of clinician-rated grade 2, 3, or 4 toxicity. Patient-clinician agreement was assessed via ? statistics. Chi-square tests investigated whether patient characteristics were associated with patient-clinician agreement.

Results

Among 267 women, the median age was 58 years (range, 24-83 years), and 26% were nonwhite. There was moderate scoring agreement (? = 0.413-0.570) for 53% of symptoms, fair agreement for 41% (? = 0.220-0.378), and slight agreement for 6% (? = 0.188). For example, patient-reported and clinician-rated percentages were 22% and 8% for severe or very severe fatigue, 41% and 46% for moderate fatigue, 32% and 39% for mild fatigue, and 6% and 7% for none. Clinician severity scores were lower for nonwhite patients in comparison with white patients for peripheral neuropathy, nausea, arthralgia, and dyspnea.

Conclusions

Although clinician reporting of symptoms is common practice in oncology, there is suboptimal agreement with the gold standard of patient self-reporting. These data provide further evidence supporting the integration of patient-reported outcomes into oncological clinical research and clinical practice to improve monitoring of symptoms as well as timely interventions for symptoms.

SUBMITTER: Nyrop KA

PROVIDER: S-EPMC7931261 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Congruence of patient- and clinician-reported toxicity in women receiving chemotherapy for early breast cancer.

Nyrop Kirsten A KA Deal Allison M AM Reeve Bryce B BB Basch Ethan E Chen Yi Tang YT Park Ji Hye JH Shachar Shlomit S SS Carey Lisa A LA Reeder-Hayes Katherine E KE Dees Elizabeth C EC Jolly Trevor A TA Kimmick Gretchen G GG Karuturi Meghan S MS Reinbolt Raquel E RE Speca JoEllen C JC Lee Jordan T JT Wood William A WA Muss Hyman B HB

Cancer 20200421 13

<h4>Background</h4>The National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events, collected alongside the clinician-reported Common Terminology Criteria for Adverse Events, enables comparisons of patient and clinician reports on treatment toxicity.<h4>Methods</h4>In a multisite study of women receiving chemotherapy for early-stage breast cancer, symptom reports were collected on the same day from patients and their clinicians for 17 sympt ...[more]

PMID: 32315091

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Project description:ImportanceThe variability in individual symptom and adverse event reporting between pediatric patient-reports and proxy-reports is widely reported. However, the question of whether symptom profiles based on reports from children with cancer and their caregivers are similar or disparate have not yet been studied.ObjectiveTo compare proxy symptom reports with patient self-reports to assess alignment.Design, setting, and participantsA multicenter cohort study was conducted from October 2016 to December 2018 from data collected at 9 pediatric cancer centers. Participants were a convenience sample of family caregivers or proxies of children aged 7 to 18 years who had received disease-directed oncology treatment in the form of chemotherapy for at least 1 month. Data were analyzed identifying clusters of individuals (ie, latent profiles) based on various responses (ie, indicators) in August 2021.ExposuresThe children of proxy participants received upfront chemotherapy. Children and proxies completed Patient-Reported Outcomes Measurement Information System (PROMIS) surveys at 2 time points: within 72 hours preceding treatment initiation and following the course of chemotherapy.Main outcomes and measuresThe latent profile analysis methods were applied to caregiver-proxy reports of PROMIS Pediatric symptom and function measures (anxiety, depressive symptoms, pain interference, fatigue, psychological stress, and physical function-mobility). The instrument categorized respondents as high symptom suffering, medium symptom suffering, and low symptom suffering (hereafter, high, medium, and low symptom groups, respectively).ResultsOf 580 approached proxies, 431 (368 [85.00%] were female) identified as legal guardians of children aged 7 to 18 years with a first cancer diagnosis (mean [SD] age, 13.03 [3.40] years; 235 [54.65%] were male). Proxy reports of children's experiences based on the 5 proxy PROMIS measures comprised 3 distinct symptom profiles. The most common proxy assessments of children's experiences were the moderate symptom groups (45.7% [197 of 431]) and the low symptom groups profiles (40.1% [173 of 431]). A high symptom groups profile emerged which represented 14.2% (61 of 431) of proxy assessments. The number of profiles and observed distribution of profile membership was similar between child and proxy reports. Proxy reports of individual symptoms generally recorded higher scores than child reports; however, no significant difference was observed between proxies and child profile model results for the PROMIS measures.Conclusions and relevanceResults of this cohort study suggest that, at the level of symptom severity profile, proxy caregiver reports may approximate the children's reports and may serve as a guide to care when the child is not able to self-report.

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Dataset Information

Congruence of patient- and clinician-reported toxicity in women receiving chemotherapy for early breast cancer.

Background

Methods

Results

Conclusions

Publications

Congruence of patient- and clinician-reported toxicity in women receiving chemotherapy for early breast cancer.

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