Proxy Perspective on Quality of Life in Prostate Cancer

描述(由申请人提供)： 在局限性前列腺癌中，对于哪种治疗方案最有利于生存，目前还没有明确的共识，每种治疗方法都以不同的方式影响着与健康相关的生活质量。在前列腺癌患者的管理中，家庭照顾者通常在与患者和医生分享决策方面发挥重要作用。在癌症的晚期，家庭照顾者可能成为患者健康信息的主要来源。 护理者在HRQL评估中的一个关键问题是，护理者可能会从护理者那里获得不同的观点，即要求代理做出他们认为患者会[代理-患者]或从代理自己的角度[代理-代理]做出的反应，并且每个观点都可以提供重要的、有效的信息。然而，据我们所知，没有关于前列腺癌或其他方面的研究比较了每种替代视角提供的HRQL信息，也不清楚它们是否系统地不同。这项研究建议检验前列腺癌患者从代理和代理患者的角度进行的HRQL评估是否存在差异，并比较患者自我评估与每种代理角度的一致性程度。100名前列腺癌患者及其家庭照顾者代理将被招募来完成EORTC QLQ C-30和EQ-5D的HRQL评估，使用横断面研究设计，代理完成2项评估(从代理-代理和代理-患者的角度)。通过评估患者和代理人视角差异的一致性、统计学意义和临床意义，研究结果将有助于确定代理人视角对代理人提供的信息的影响程度，并将有助于为临床决策以及在代理人受试者重要的前列腺癌等疾病的临床试验中设计和应用标准化代理人特有的HRQL测量提供信息。

DESCRIPTION (provided by applicant): In localized prostate cancer, there is no clear consensus on the treatment alternative that is most advantageous for survival, and each treatment affects health-related quality of life in different ways. In the management of prostate cancer patients, family caregivers often have a major role in shared decision making with the patient and physician. In more advanced stages of the cancer, a family caregiver may become the primary source of information on the health of patient. A crucial issue in HRQL assessment by caregivers is that different perspectives may be elicited from the caregiver, i.e., ask the proxy to respond as they think the patient would [proxy-patient] or from the proxy's own perspective [proxy-proxy], and that each viewpoint can provide important, valid information. However, we are aware of no studies in prostate cancer or otherwise that have compared the HRQL information provided by each of the proxy perspectives, and it is unclear whether they are systematically different. This study proposes to examine whether there is a difference in HRQL assessments made from the proxy-proxy and proxy-patient perspectives in prostate cancer patients, and to compare the extent to which patient self-assessment agrees with each of the proxy perspectives. One hundred prostate cancer patients and their family caregiver proxies will be recruited to complete HRQL assessments of the EORTC QLQ C-30 and EQ-5D using a cross-sectional study design, with the proxy completing 2 assessments (from the proxy-proxy and proxy-patient perspective). By evaluating concordance, statistical significance and clinical meaningfulness of differences between patient and proxy perspectives, the study results will be important in identifying the extent to which the perspective of the proxy influences the information provided by proxy, and will help to inform clinical decision-making and the design and application of standardized proxy-specific HRQL measures in clinical trials for conditions such as prostate cancer where proxy respondents are important.