Patients’ reported outcome measures and clinical scales in brain tumor surgery: results from a prospective cohort study
This study aims to assess surgical outcome in brain tumor surgery using patient reported outcome measures (PROMs) and to compare their results with traditional clinical outcome measurements.
Neuro-oncological patients undergoing surgical removal for the lesion were enrolled; MOCA test, PROMs (EUROHIS-QoL, PGWB-S, WHODAS-12), and the clinical scale Karnofsky Performance Status (KPS) were administered to evaluate respectively cognitive status, quality of life, well-being, disability, and functional status before surgery and at 3-month follow-up. Wilcoxon test was performed to evaluate the longitudinal change of test scores, the smallest detectable difference to classify the change of patients in PROMs, the Cohen kappa to investigate the concordance between KPS and PROMs in classifying the patients’ change, and Mann-Whitney U test to compare patients with complications and no complications.
A total of 101 patients were enrolled (54 woman, mean age 50.2 ± 14.1, range 20–85): psychological well-being improved at follow-up; 95 patients (94.1%) were improved/unchanged and 6 (5.9%) were worsened according to PROMs; functional status measured with KPS had a slight agreement with quality of life and disability and no agreement with psychological well-being questionnaires; patients with complications had a greater worsening in KPS.
According to PROMs measuring QoL, disability, and psychological well-being, most of the patients were improved/unchanged after surgery. Since PROMs and KPS detect different aspects of the patients’ health status, PROMs should be integrated in surgical outcome evaluation. Furthermore, their association with complications and with other clinical and subjective variables that could influence patient’s perception of health status should be investigated.
KeywordsBrain tumor Neurosurgery Clinical outcome Patient reported outcomes
This study was an independent examination on the presence of complications and quality of life in patients candidate to neurosurgical procedures (CQ-NCH), sponsored by the Neurological Institute C. Besta IRCCS Foundation.
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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