Quinten_et_al_2019.docx (43.41 kB)
Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery
journal contributionposted on 2023-08-30, 16:33 authored by Chantal Quinten, Cindy Kenis, Lore Decoster, Philip R. Debruyne, Inge De Groof, Christian Focan, Frank Cornélis, Vincent Verschaeve, Christian Bachmann, Dominique Bron, Sylvie Luce, Gwenaëlle Debugne, Heidi Van den Bulck, Jean-Charles Goeminne, Abdelbari Baitar, Katrien Geboers, Benedicte Petit, Christine Langenaeken, Ruud Van Rijswijk, Pol Specenier, Guy Jerusalem, Jean-Philippe Praet, Katherine Vandenborre, Michelle Lycke, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers
PURPOSE: Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes. METHODS: Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes. RESULTS: The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment. CONCLUSION: The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.
Publication titleQuality of Life Research
- Accepted version