Clinician Perceptions of Care Difficulty, Quality of Life, and Symptom Reports for Lung Cancer Patients An Analysis from the Symptom Outcomes and Practice Patterns (SOAPP) Study
Clinician Perceptions of Care Difficulty, Quality of Life, and Symptom Reports for Lung Cancer Patients An Analysis from the Symptom Outcomes and Practice Patterns (SOAPP) Study
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DOI：
10.1097/01.jto.0000437501.83763.5d
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发表时间：
2013-12-01
影响因子：
20.4
通讯作者：
Fisch, Michael J.
中科院分区：
文献类型：
--
作者：
Hamann, Heidi A.;Lee, Ju-Whei;Fisch, Michael J.
导读：尽管最近的治疗进展，肺癌是一种难以控制的疾病。本研究评估了临床医生对肺癌患者与乳腺癌、前列腺癌和结肠癌患者的护理难度、生活质量（QOL）和症状报告的看法。方法：本报告重点分析了东部肿瘤合作组（ECOG）症状结局和实践模式（SOAPP）研究（E2Z02）的二次分析；结果测量包括3106例实体瘤患者的临床医生评分。单变量分析侧重于疾病特异性认知模式；多变量分析检查了协变量纳入后疾病特异性差异是否持续存在。结果：在单变量比较中，临床医生认为肺癌患者比其他实体瘤患者更难治疗，生活质量较差，症状报告较多。调整协变量后，临床医生认为肺癌患者生活质量较低的几率是其他实体肿瘤患者的3.6倍（优势比= 3.6[95%置信区间，2.0-6.6];p < 0.0001）。此外，临床医生认为肺癌患者体重困难的几率是前者的3.2倍（优势比= 3.2[95%可信区间，1.7-6.0];p = 0.0004）。在多变量模型中，没有其他结果显示肺癌与其他癌症之间有显著差异。结论：与其他实体肿瘤患者相比，临床医生对肺癌患者的健康状况更为悲观。即使在控制了分期、表现状态和患者报告的结果等变量后，临床医生对患者生活质量和体重困难的看法仍然存在差异。这些持续的差异表明可能存在认知偏差。需要更多的研究来证实这种差异并探索其基础。
Introduction: Despite recent therapeutic advances, lung cancer is a difficult disease to manage. This study assessed clinicians' perceptions of care difficulty, quality of life (QOL), and symptom reports for their lung cancer patients compared with their patients with breast, prostate, and colon cancer.Methods: This report focused on secondary analyses from the Eastern Cooperative Oncology Group (ECOG) Symptom Outcomes and Practice Patterns (SOAPP) study (E2Z02); outcome measures included clinician ratings of 3106 solid tumor patients. Univariate analyses focused on patterns of disease-specific perceptions; multivariable analyses examined whether disease-specific differences persisted after covariate inclusion.Results: In univariate comparisons, clinicians rated lung cancer patients as more difficult to treat than other solid tumor patients, with poorer QOL and higher symptom reports. After covariates were adjusted, the odds of clinicians perceiving lower QOL for their lung cancer patients were 3.6 times larger than for patients with other solid tumors (odds ratio = 3.6 [95% confidence interval, 2.0-6.6]; p < 0.0001). In addition, the odds of clinicians perceiving weight difficulties for their lung cancer patients were 3.2 times larger (odds ratio = 3.2 [95% confidence interval, 1.7-6.0]; p = 0.0004). No other outcome showed significant differences between lung versus other cancers in multivariable models.Conclusion: Clinicians were more pessimistic about the well-being of their lung cancer patients compared with patients with other solid tumors. Differences remained for clinician perceptions of patient QOL and weight difficulty, even after controlling for such variables as stage, performance status, and patient-reported outcomes. These continuing disparities suggest possible perception bias. More research is needed to confirm this disparity and explore the underpinnings.