Needs assessments can identify scores on HRQOL questionnaires that represent problems for patients: an illustration with the Supportive Care Needs Survey and the QLQ-C30.

Needs assessments can identify scores on HRQOL questionnaires that represent problems for patients: an illustration with the Supportive Care Needs Survey and the QLQ-C30.
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DOI:
10.1007/s11136-010-9636-2
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发表时间:
2010-08
期刊:
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
影响因子:
--
通讯作者:
Wu AW
Wu AW
中科院分区:
其他
文献类型:
--
作者:
Snyder CF;Blackford AL;Brahmer JR;Carducci MA;Pili R;Stearns V;Wolff AC;Dy SM;Wu AW

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使用 HRQOL 问卷进行个体患者管理的一个障碍是知道什么分数代表值得关注的问题。我们探索使用需求评估来识别与患者报告的未满足需求相关的 HRQOL 评分。这项横断面研究包括 117 名癌症患者(平均年龄 61 岁;51% 男性;77% 白人),他们完成了支持性护理需求调查 (SCNS) 和 EORTC QLQ-C30。 SCNS 分数分为“没有未满足的需求”与“某些未满足的需求”,并作为识别问题分数的外部标准。我们使用受试者工作特征 (ROC) 分析评估 QLQ-C30 分数的辨别能力。进一步检查 ROC 曲线下面积 (AUC) ≥ .70 的域,以确定 QLQ-C30 分数预测存在/不存在未满足需求的程度。我们发现 14 个 EORTC 领域中的 6 个领域的 AUC ≥ .70:身体、情感、角色、整体生活质量、疼痛、疲劳。所有 6 个域的敏感性 ≥ .85,特异性 ≥ .50。与 SCNS 项目内容密切匹配的 EORTC 域更有可能具有 AUC ≥ .70。适当的截止值取决于假阳性和假阴性的相对重要性。需求评估可以识别需要临床医生关注的 HRQOL 分数。未来的研究应该使用其他 HRQOL 问卷和需求评估来证实这些发现。
A barrier to using HRQOL questionnaires for individual patient management is knowing what score represents a problem deserving attention. We explored using needs assessments to identify HRQOL scores associated with patient-reported unmet needs. This cross-sectional study included 117 cancer patients (mean age 61 years; 51% men; 77% white) who completed the Supportive Care Needs Survey (SCNS) and EORTC QLQ-C30. SCNS scores were dichotomized as “no unmet need” versus “some unmet need” and served as an external criterion for identifying problem scores. We evaluated the discriminative ability of QLQ-C30 scores using receiver operating characteristic (ROC) analysis. Domains with an area under the ROC curve (AUC) ≥ .70 were examined further to determine how well QLQ-C30 scores predicted presence/absence of unmet need. We found AUCs ≥ .70 for 6 of 14 EORTC domains: physical, emotional, role, global QOL, pain, fatigue. All 6 domains had sensitivity ≥ .85 and specificity ≥ .50. EORTC domains that closely matched the content of SCNS item(s) were more likely to have AUCs ≥ .70. The appropriate cut-off depends on the relative importance of false positives and false negatives. Needs assessments can identify HRQOL scores requiring clinicians’ attention. Future research should confirm these findings using other HRQOL questionnaires and needs assessments.
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