Prospective evaluation of patient reported swallow function with the Functional Assessment of Cancer Therapy (FACT), MD Anderson Dysphagia Inventory (MDADI) and the Sydney Swallow Questionnaire (SSQ) in head and neck cancer patients
Prospective evaluation of patient reported swallow function with the Functional Assessment of Cancer Therapy (FACT), MD Anderson Dysphagia Inventory (MDADI) and the Sydney Swallow Questionnaire (SSQ) in head and neck cancer patients
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DOI：
10.1016/j.oraloncology.2018.05.012
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发表时间：
2018-09-01
期刊：
影响因子：
4.8
通讯作者：
Quon, Harry
中科院分区：
文献类型：
--
作者：
Peng, Luke C.;Hui, Xuan;Quon, Harry
目的：癌症治疗功能评估（FACT）工具由一组相关和重叠的生活质量（QoL）问卷组成，包括核心一般表格、头颈癌（HNC）特定项目和专家选择的指数（FACT-HNSI）。了解这些如何与更多的HNC特定的工具，如MD安德森吞咽困难量表（MDADI）和悉尼吞咽问卷（SSQ）是至关重要的指导他们在临床试验中的使用。材料和方法：HNC患者同时完成MDADI，SSQ，并在放射肿瘤学诊所访视FACT问卷（2015-2016）。计算各FACT仪器与MDADI或SSQ之间的斯皮尔曼相关系数。进行无监督k均值聚类分析，以识别相似QoL反应的聚类。主成分分析（PCA）确定的变异程度解释每个instrument.Results：我们确定了631例（363例患者）的问卷同时完成。各种FACT指标与SSQ或MDADI之间的相关性均显著（p < 0.001），但FACT HNC特定子量表和FACT-HNSI与MDADI和SSQ的相关性最强。当成对或三向组合工具时，聚类确定了3个不同的响应组。PCA显示，MDADI和FACT HNC-特定的子量表提供类似的和可能的冗余information.Conclusion：FACT HNC-子量表和FACT-HNSI可能是优选的，在临床试验中使用的其他FACT措施，患者报告的吞咽功能进行评估。MDADI和FACT提供了对HNC患者QoL的类似见解，而SSQ提供了额外的补充信息，可用于更好地将患者分为高、中和低QoL结局组。
Objectives: The Functional Assessment of Cancer Therapy (FACT) instrument is comprised of a group of related and overlapping quality of life (QoL) questionnaires including a core general form, head and neck cancer (HNC)-specific items, and an expert-selected index (FACT-HNSI). Understanding how these relate to more HNC-specific instruments such as the MD Anderson Dysphagia Inventory (MDADI) and Sydney Swallow Questionnaire (SSQ) is vital for guiding their use in clinical trials.Materials and methods: HNC patients concurrently completed MDADI, SSQ, and FACT questionnaires at radiation oncology clinic visits (2015-2016). Spearman correlation coefficients were calculated between each FACT instrument and MDADI or SSQ. Unsupervised k-means cluster analyses were performed to identify clusters of similar QoL responses. Principal component analysis (PCA) identified the degree of variability explained by each instrument.Results: We identified 631 instances (363 patients) where the questionnaires were completed concurrently. Correlations between the various FACT measures and SSQ or MDADI were all significant (p < 0.001), but FACT HNC-specific subscale and FACT-HNSI showed the strongest correlation with MDADI and SSQ. Clustering identified 3 distinct groups of responses when combining instruments either pairwise or three-way. PCA revealed that MDADI and FACT HNC-specific subscale provide similar and likely redundant information.Conclusion: FACT HNC-subscale and FACT-HNSI may be preferable over other FACT measures for use in clinical trials where patient-reported swallow function is evaluated. MDADI and FACT provide similar insights into HNC patient QoL while SSQ provides additional, complementary information which could serve to better stratify patients into groups with high, medium, and low QoL outcomes.