Quality-of-life assessment in the symptom management trials of the National Cancer Institute - Supported Community Clinical Oncology Program
Quality-of-life assessment in the symptom management trials of the National Cancer Institute - Supported Community Clinical Oncology Program
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DOI：
10.1200/jco.2005.12.181
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发表时间：
2005-01-20
影响因子：
45.3
通讯作者：
Minasian, LM
中科院分区：
文献类型：
--
作者：
Buchanan, DR;O'Mara, AM;Minasian, LM
目的探讨美国国家癌症研究所社区临床肿瘤学项目（CCOP）支持的症状管理临床试验中生活质量（QOL）的前瞻性概念化、定义和测量。提取并分析了临床试验CCOP症状管理组合中的干预措施类型。结果提出了QOL评估自1987年以来开始的130项CCOP症状管理试验中有68项（52%）。共确定了22个全球QOL工具。随着时间的推移，症状管理试验的频率和QOL评估的频率都显着增加。癌症治疗功能评估和Uniscale工具是最广泛使用的QOL工具，包括在55%的评估QOL的试验中。QOL纳入的概念框架仅限于症状缓解与QOL总体改善之间的单变量关系。没有一致的协会被发现之间的生活质量评估和针对的症状或类型的interventions.Conclusion推进国家的科学，研究方案需要提供更明确的理由，用于评估生活质量的症状管理试验和选择的生活质量工具（S）使用。还需要更精确地描述概念框架，该框架规定了所管理的特定症状之间的假设联系、与其他症状的相互作用、QCL的不同领域以及整体QOL。QOL症状管理试验的方法和概念的进步对于实现减轻癌症患者痛苦和改善QOL的承诺至关重要。
Purpose To examine how quality of life (QOL) is prospectively conceptualized, defined, and measured in the symptom management clinical trials supported by the National Cancer Institute Community Clinical Oncology Program (CCOP).Methods All QOL research objectives, rationales, assessment instruments, symptoms treated, and types of interventions from the CCOP symptom management portfolio of clinical trials were extracted and analyzed.Results QOL assessments were proposed in 68 (52%) of the 130 total CCOP symptom management trials initiated since 1987. A total of 22 global QOL instruments were identified. Both the frequency of symptom management trials and the frequency of QOL assessment have increased significantly over time. The Functional Assessment of Cancer Therapy and Uniscale instruments were the most widely used QOL instruments, included in 55% of trials assessing QOL. The conceptual framework for QOL inclusion was limited to univariate relationships between symptom relief and global improvements in QOL. No consistent associations were found between QOL assessment and either the symptoms targeted or types of interventions.Conclusion To advance the state of the science, research protocols need to provide more explicit rationales for assessing QOL in symptom management trials and for the selection of the QOL instrument(s) to be used. Conceptual frameworks that specify the hypothesized links between the specific symptom(s) being managed, interactions with other symptoms, different domains of QCL, and global QOL also need to be more precisely described. Methodologic and conceptual advances in QOL symptom management trials are critical to fulfill the promise of alleviating suffering and improving the QOL of cancer patients.