Symptom Burden in Long-Term Survivors of Head and Neck Cancer: Patient-Reported Versus Clinical Data

G. Pocobelli, Rebecca A. Ziebell, M. Fujii, K. Hutcheson, Steven S. Chang, J. McClure, Jessica Chubak
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引用次数: 3

Abstract

Introduction: The symptom burden faced by long-term head and neck cancer survivors is not well understood. In addition, the accuracy of clinical data sources for symptom ascertainment is not clear. Objective: To 1) describe the prevalence of symptoms in 5-year survivors of head and neck cancer, and 2) to evaluate agreement between symptoms obtained via self-report and symptoms obtained from clinical data sources. Methods: We recruited 5-year survivors of head and neck cancer enrolled at Kaiser Permanente Washington (n = 54). Symptoms were assessed using the MD Anderson Symptom Inventory head and neck cancer module. For each symptom, we assessed the agreement of the patient’s survey response (“gold standard”) with the 1) medical chart and 2) administrative health care claims data. We computed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value, along with their 95 percent confidence intervals, for each clinical data source. Results: Eighty percent of patients responded. Nearly all participants (95 percent) reported experiencing at least one symptom from the MDASI-HN, and 93 percent reported two or more symptoms. Among patients reporting a given symptom, there was generally no evidence of the symptom from either clinical data source (i.e., sensitivity was generally no greater than 40 percent). The specificity and PPV of the clinical data sources were generally higher than the sensitivity. Conclusion: Relying only on medical chart review and/or administrative health data would substantially underestimate symptom burden in long-term head and neck cancer survivors.
头颈癌长期幸存者的症状负担:患者报告与临床数据对比
简介:长期头颈癌症幸存者所面临的症状负担尚不清楚。此外,用于确定症状的临床数据来源的准确性尚不清楚。目的:1)描述癌症5年幸存者的症状患病率,2)评估通过自我报告获得的症状与从临床数据来源获得的症状之间的一致性。方法:我们招募了在华盛顿凯萨永久医院登记的癌症5年幸存者(n=54)。使用MD Anderson症状量表癌症头颈部模块评估症状。对于每种症状,我们评估了患者的调查反应(“金标准”)与1)医疗图表和2)行政医疗索赔数据的一致性。我们计算了每个临床数据源的敏感性、特异性、阳性预测值(PPV)和阴性预测值,以及它们的95%置信区间。结果:80%的患者有反应。几乎所有参与者(95%)都报告至少经历过一种MDASI-HN症状,93%的参与者报告有两种或两种以上症状。在报告特定症状的患者中,通常没有来自任何临床数据来源的症状证据(即,敏感性通常不超过40%)。临床数据来源的特异性和PPV通常高于敏感性。结论:仅依赖医学图表审查和/或管理健康数据会大大低估长期头颈部癌症幸存者的症状负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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