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Using the EORTC-QLQ-C30 in clinical practice for patient management: identifying scores requiring a clinician’s attention

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Abstract

Purpose

Patient-reported outcomes (PROs) are used increasingly for individual patient management. Identifying which PRO scores require a clinician’s attention is an ongoing challenge. Previous research used a needs assessment to identify EORTC-QLQ-C30 cutoff scores representing unmet needs. This analysis attempted to replicate the previous findings in a new and larger sample.

Methods

This analysis used data from 408 Japanese ambulatory breast cancer patients who completed the QLQ-C30 and Supportive Care Needs Survey-Short Form-34 (SCNS-SF34). Applying the methods used previously, SCNS-SF34 item/domain scores were dichotomized as no versus some unmet need. We calculated area under the receiver operating characteristic curve (AUC) to evaluate QLQ-C30 scores’ ability to discriminate between patients with no versus some unmet need based on SCNS-SF34 items/domains. For QLQ-C30 domains with AUC ≥ 0.70, we calculated the sensitivity, specificity, and predictive value of various cutoffs for identifying unmet needs. We hypothesized that compared to our original analysis, (1) the same six QLQ-C30 domains would have AUC ≥ 0.70, (2) the same SCNS-SF34 items would be best discriminated by QLQ-C30 scores, and (3) the sensitivity and specificity of our original cutoff scores would be supported.

Results

The findings from our original analysis were supported. The same six domains with AUC ≥ 0.70 in the original analysis had AUC ≥ 0.70 in this new sample, and the same SCNS-SF34 item was best discriminated by QLQ-C30 scores. Cutoff scores were identified with sensitivity ≥0.84 and specificity ≥0.54.

Conclusion

Given these findings’ concordance with our previous analysis, these QLQ-C30 cutoffs could be implemented in clinical practice and their usefulness evaluated.

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Abbreviations

AUC:

Area under the curve

ECOG:

Eastern Cooperative Oncology Group

EORTC-QLQ-C30:

European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30

NPV:

Negative predictive value

PPV:

Positive predictive value

PRO:

Patient-reported outcome

ROC:

Receiver operating characteristic

SCNS-SF34:

Supportive Care Needs Survey-Short Form-34

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Acknowledgments

This analysis was supported by the American Cancer Society (MRSG-08-011-01-CPPB). The original data collection was supported in part by Grants-in-Aid for Cancer Research and the Third Term Comprehensive 10-Year Strategy for Cancer Control from the Ministry of Health, Labour and Welfare, Japan. Drs. Snyder and Carducci are members of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins (P30CA006973). The funding sources had no role in study design, data collection, analysis, interpretation, writing, or decision to submit the manuscript for publication.

Conflict of interest

The authors report no conflict of interest.

Author information

Authors and Affiliations

  1. Division of General Internal Medicine, Johns Hopkins School of Medicine, 624 N. Broadway, Room 657, Baltimore, MD, 21205, USA

    Claire F. Snyder & Albert W. Wu

  2. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Claire F. Snyder & Albert W. Wu

  3. Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA

    Claire F. Snyder, Amanda L. Blackford & Michael A. Carducci

  4. Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan

    Toru Okuyama

  5. Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Toru Okuyama & Tatsuo Akechi

  6. Breast and Endocrine Surgery, Hokkaido University Hospital, Hokkaido, Japan

    Hiroko Yamashita

  7. Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Tatsuya Toyama

Authors
  1. Claire F. Snyder
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  2. Amanda L. Blackford
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  3. Toru Okuyama
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  4. Tatsuo Akechi
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  5. Hiroko Yamashita
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  6. Tatsuya Toyama
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  7. Michael A. Carducci
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  8. Albert W. Wu
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Corresponding author

Correspondence to Claire F. Snyder.

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Snyder, C.F., Blackford, A.L., Okuyama, T. et al. Using the EORTC-QLQ-C30 in clinical practice for patient management: identifying scores requiring a clinician’s attention. Qual Life Res 22, 2685–2691 (2013). https://doi.org/10.1007/s11136-013-0387-8

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  • DOI: https://doi.org/10.1007/s11136-013-0387-8

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