Quality of Life Research

, Volume 22, Issue 10, pp 2685–2691

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

  • Claire F. Snyder
  • Amanda L. Blackford
  • Toru Okuyama
  • Tatsuo Akechi
  • Hiroko Yamashita
  • Tatsuya Toyama
  • Michael A. Carducci
  • Albert W. Wu
Article

DOI: 10.1007/s11136-013-0387-8

Cite this article as:
Snyder, C.F., Blackford, A.L., Okuyama, T. et al. Qual Life Res (2013) 22: 2685. doi:10.1007/s11136-013-0387-8

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.

Keywords

EORTC-QLQ-C30Patient-reported outcomesClinical practiceCancer

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

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Claire F. Snyder
    • 1
    • 2
    • 3
  • Amanda L. Blackford
    • 3
  • Toru Okuyama
    • 4
    • 5
  • Tatsuo Akechi
    • 5
  • Hiroko Yamashita
    • 6
  • Tatsuya Toyama
    • 7
  • Michael A. Carducci
    • 3
  • Albert W. Wu
    • 1
    • 2
  1. 1.Division of General Internal MedicineJohns Hopkins School of MedicineBaltimoreUSA
  2. 2.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsBaltimoreUSA
  4. 4.Division of Palliative Care and Psycho-oncologyNagoya City University HospitalNagoyaJapan
  5. 5.Department of Psychiatry and Cognitive-Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
  6. 6.Breast and Endocrine SurgeryHokkaido University HospitalHokkaidoJapan
  7. 7.Department of Oncology, Immunology and SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan