LONGITUDINAL QUALITY OF LIFE AFTER MARROW TRANSPLANT

描述：本项目将采用改进的纵向方法 多维生命质量过程的评价分析 (QOL)在骨髓移植(BMT)后的四年内， 更好地描述了BMT后生活质量的变化，从而 允许患者在竞争对手中做出更明智的选择 治疗。这些方法提供的更高的精密度和准确度 可能使临床医生能够前瞻性地进行干预，以尽量减少 这可能会导致并发症，并为康复铺平道路。解决这些问题的新方法 纵向评估是一般性的，并将延伸到其他癌症 人口。 基于现有的125个极端(6-18年)长期调查 幸存者和对新的一年幸存者进行广泛的试点工作， 每年将招募约150名新患者(总计600名) 在四年内每隔6个月进行一次QOL评估，产生 比之前研究的任何纵向BMT样本都要大得多。这个 问卷组评估身体、角色、 情感、认知和社交领域，包括一般 情感和健康认知的心理测量学评估。在……里面 此外，电池还包括BMT特定库存，由 项目人员，评估晚期医疗并发症和需求 受经济复苏的影响。参与的患者将完成所有 在他们的住处进行问卷调查，接收和退还信息包 邮寄的。 为该项目收集的新的纵向数据将增强 通过(A)开发一种更简单的现有形式的心理测量学发展 适用于更频繁管理的文书，以及(B)使用 结构方程建模技术的建立和完善 电池内关键指标变化的敏感度。因为 大样本投影，标准纵向分析将精确地 描述有条件的患者的预期生活质量 每一次评估都要存活下来。然而，幸存的亚样本可能 选择性地高估了#年总体人口的预期趋势 新患者；因此，本研究的一个主要重点是发展 对不受此影响的生活质量趋势的无条件估计 自然减员偏向。获得对生活质量的无条件估计 趋势，作者将a)使用混合效应模型，如下所述 以及b)开发形式上类似于Q twist的端点， 使用心理测量学常模衡量生活质量经历的生存时间 在BMT恢复期间。

DESCRIPTION: This project will use improved methods of longitudinal analysis to evaluate the multidimensional course of quality of life (QOL) in the four years following bone marrow transplantation (BMT), providing better descriptions of how QOL changes following BMT, thereby allowing patients to make more informed choices among competing treatments. The increased precision and accuracy offered by these methods may enable clinicians to intervene prospectively to minimize complications and smooth the path to recovery. The new methods for longitudinal evaluation are general, and will extend to other cancer populations. Building on an existing survey of 125 extreme (6 18 years) long term survivors and on extensive pilot work with new one year survivors, approximately 150 new patients will be recruited each year (600 total) for QOL assessments at 6 month intervals over four years, yielding a much larger longitudinal BMT sample than any previously studied. The questionnaire battery assesses functioning in the physical, role, emotional, cognitive, and social domains, and includes general psychometric assessments of affective and health perceptions. In addition, the battery includes BMT specific inventories, developed by project personnel, assessing late medical complications and demands imposed by recovery. Participating patients will complete all questionnaires in their residences, receiving and returning the packets by mail. The new longitudinal data collected for this project will enhance psychometric development by a (a) developing a briefer form of existing instruments amenable to more frequent administration, and (b) using structural equation modeling techniques to establish and improve the sensitivity to change of key indicators in the battery. Because of the large projected sample, standard longitudinal analyses will precisely describe the expected quality of life for patients conditional on survival to each assessment. Surviving subsamples, however, may selectively overestimate expected trends for the general population of new patients; thus a major focus of this study is the development of unconditional estimates of QOL trends that are not subject to this attrition bias. To obtain unconditional estimates of quality of life trends, the authors will a) employ mixed effects models as discussed by Donaldson; and b) develop endpoints, formally similar to Q TWIST, that use psychometric norms to weight survival times for QOL experienced during BMT recovery.