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Undergoing Lung Surgery (PSA-Lung) was appropriate for symptom assessment after discharge

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Abstract

Purpose

To examine whether a 7-day or 24-h recall period of Perioperative Symptom Assessment for Patients Undergoing Lung Surgery (PSA-Lung) was appropriate for symptom assessment after discharge.

Methods

A total of 377 patients were recruited in a cohort study of patients who underwent lung surgery. We measured patient symptoms daily and weekly using the two recall period versions of the PSA-Lung scale, respectively. The psychometric properties of both versions were calculated. Spearman rank correlation coefficients and kappa (k) coefficients were used to measure the association between items score measured by the two version scales each week. Cohen’s d effect size and mixed linear model were used to measure responsiveness to change over time.

Results

Spearman rank correlation coefficients between the symptom scores generated by the 7-day and 24-h versions (range 0.48–0.77; all P < 0.05). The correlations increased in patients in stable condition (weekly symptom change < 2). Cronbach’s α coefficients for both ratings were > 0.87 and both had good test–retest reliability. The longitudinal analysis and Cohen’s d effect sizes showed that both ratings had good ability to detect changes in all items.

Conclusion

The 7-day retrospective scale was as effective as the 24-h retrospective scale in terms of psychometric performance. In the stage where the patient’s symptoms change rapidly, it is recommended to use the 24-h retrospective scale for symptom monitoring. On the contrary, in a stable state, it can be considered to use the 7-day retrospective scale for monitoring to reduce the patient’s burden.

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Data availability

The data that support the findings of this study are available on request from the corresponding author [Qiuling Shi].

References

  1. de Koning, H. J., van der Aalst, C. M., de Jong, P. A., Scholten, E. T., Nackaerts, K., Heuvelmans, M. A., Lammers, J. J., Weenink, C., Yousaf-Khan, U., Horeweg, N., et al. (2020). Reduced lung-cancer mortality with volume CT screening in a randomized trial. New England Journal of Medicine, 382(6), 503–513.

    Article  PubMed  Google Scholar 

  2. Fagundes, C. P., Shi, Q., Vaporciyan, A. A., Rice, D. C., Popat, K. U., Cleeland, C. S., & Wang, X. S. (2015). Symptom recovery after thoracic surgery: Measuring patient-reported outcomes with the MD Anderson Symptom Inventory. Journal of Thoracic and Cardiovascular Surgery, 150(3), 613-619.e612.

    Article  PubMed  Google Scholar 

  3. Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced recovery after surgery: A review. JAMA Surgery, 152(3), 292–298.

    Article  PubMed  Google Scholar 

  4. Huang, L., Frandsen, M. N., Kehlet, H., & Petersen, R. H. (2022). Early and late readmissions after enhanced recovery thoracoscopic lobectomy. European Journal of Cardiothoracic Surgery, 62, 3.

    Article  Google Scholar 

  5. Bao, F., Dimitrovska, N. T., Hu, S., Chu, X., & Li, W. (2020). Safety of early discharge with a chest tube after pulmonary segmentectomy. European Journal of Cardio-Thoracic Surgery, 58(3), 613–618.

    Article  PubMed  Google Scholar 

  6. Vandrevala, T., Senior, V., Spring, L., Kelliher, L., & Jones, C. (2016). “Am I really ready to go home?”: A qualitative study of patients’ experience of early discharge following an enhanced recovery programme for liver resection surgery. Supportive Care in Cancer, 24(8), 3447–3454.

    Article  CAS  PubMed  Google Scholar 

  7. Zhang, J., Su, X., Xu, W., Yu, Q., Dai, W., Wang, Y., Zhuang, X., Li, Q., Wang, X. S., & Shi, Q. (2022). Identifying patients who suffered from post-discharge cough after lung cancer surgery. Supportive Care in Cancer, 30(9), 7705–7713.

    Article  PubMed  Google Scholar 

  8. Wang, K. Y., Chang, N. W., Wu, T. H., Hsu, C. C., Lee, Y. H., & Lee, S. C. (2010). Post-discharge health care needs of patients after lung cancer resection. Journal of Clinical Nursing, 19(17–18), 2471–2480.

    Article  PubMed  Google Scholar 

  9. Lowery, A. E., Krebs, P., Coups, E. J., Feinstein, M. B., Burkhalter, J. E., Park, B. J., & Ostroff, J. S. (2014). Impact of symptom burden in post-surgical non-small cell lung cancer survivors. Supportive Care in Cancer, 22(1), 173–180.

    Article  PubMed  Google Scholar 

  10. Dai, W., Feng, W., Zhang, Y., Wang, X. S., Liu, Y., Pompili, C., Xu, W., Xie, S., Wang, Y., Liao, J., Wei, X., Xiang, R., Hu, B., Tian, B., Yang, X., Wang, X., Xiao, P., Lai, Q., Wang, X., … Shi, Q. (2022). Patient-reported outcome-based symptom management versus usual care after lung cancer surgery: A multicenter randomized controlled trial. Journal of Clinical Oncology, 40(9), 988–996.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Guidance for industry: patient-reported outcome measures: Use in medical product development to support labeling claims: draft guidance. (2006). Health and Quality of Life Outcomes, 4, 79.

  12. de Bono, J., Mateo, J., Fizazi, K., Saad, F., Shore, N., Sandhu, S., Chi, K. N., Sartor, O., Agarwal, N., Olmos, D., Thiery-Vuillemin, A., Twardowski, P., Mehra, N., Goessl, C., Kang, J., Burgents, J., Wu, W., Kohlmann, A., Adelman, C. A., & Hussain, M. (2020). Olaparib for metastatic castration-resistant prostate cancer. New England Journal of Medicine, 382(22), 2091–2102.

    Article  PubMed  Google Scholar 

  13. Kallen, M. A., Yang, D., & Haas, N. (2012). A technical solution to improving palliative and hospice care. Supportive Care in Cancer, 20(1), 167–174.

    Article  PubMed  Google Scholar 

  14. Bergman, B., Aaronson, N. K., Ahmedzai, S., Kaasa, S., & Sullivan, M. (1994). The EORTC QLQ-LC13: a modular supplement to the EORTC Core Quality of Life Questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC Study Group on Quality of Life. European Journal of Cancer, 30(5), 635–642.

    Article  Google Scholar 

  15. Cella, D. F., Bonomi, A. E., Lloyd, S. R., Tulsky, D. S., Kaplan, E., & Bonomi, P. (1995). Reliability and validity of the Functional Assessment of Cancer Therapy-Lung (FACT-L) quality of life instrument. Lung Cancer, 12(3), 199–220.

    Article  CAS  PubMed  Google Scholar 

  16. Mendoza, T. R., Wang, X. S., Lu, C., Palos, G. R., Liao, Z., Mobley, G. M., Kapoor, S., & Cleeland, C. S. (2011). Measuring the symptom burden of lung cancer: The validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory. The Oncologist, 16(2), 217–227.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hollen, P. J., Gralla, R. J., Kris, M. G., & Potanovich, L. M. (1993). Quality of life assessment in individuals with lung cancer: Testing the Lung Cancer Symptom Scale (LCSS). European Journal of Cancer, 29A(Suppl 1), S51-58.

    Article  Google Scholar 

  18. Dalziel, K., Li, J., Scott, A., & Clarke, P. (2018). Accuracy of patient recall for self-reported doctor visits: Is shorter recall better? Health Economics, 27(11), 1684–1698.

    Article  PubMed  Google Scholar 

  19. Guidance for industry: Principles for Selecting, Developing, Modifying, and Adapting Patient-Reported Outcome Instruments for Use in Medical Device Evaluation.[8]Food and Drug Administration.pdf. (2020).

  20. Rolstad, S., Adler, J., & Rydén, A. (2011). Response burden and questionnaire length: Is shorter better? A review and meta-analysis. Value Health, 14(8), 1101–1108.

    Article  PubMed  Google Scholar 

  21. Gabrilove, J. L., Perez, E. A., Tomita, D. K., Rossi, G., & Cleeland, C. S. (2007). Assessing symptom burden using the M.D. Anderson symptom inventory in patients with chemotherapy-induced anemia: results of a multicenter, open-label study (SURPASS) of patients treated with darbepoetin-alpha at a dose of 200 microg every 2 weeks. Cancer, 110(7), 1629–1640.

    Article  PubMed  Google Scholar 

  22. Northouse, L. L., Mood, D. W., Schafenacker, A., Montie, J. E., Sandler, H. M., Forman, J. D., Hussain, M., Pienta, K. J., Smith, D. C., & Kershaw, T. (2007). Randomized clinical trial of a family intervention for prostate cancer patients and their spouses. Cancer, 110(12), 2809–2818.

    Article  PubMed  Google Scholar 

  23. Bennett, A. V., Patrick, D. L., Bushnell, D. M., Chiou, C. F., & Diehr, P. (2011). Comparison of 7-day and repeated 24-h recall of type 2 diabetes. Quality of Life Research, 20(5), 769–777.

    Article  CAS  PubMed  Google Scholar 

  24. Schaffer, E. M., Basch, E. M., Schwab, G. M., & Bennett, A. V. (2021). Comparison of weekly and daily recall of pain as an endpoint in a randomized phase 3 trial of cabozantinib for metastatic castration-resistant prostate cancer. Clinical Trials, 18(4), 408–416.

    Article  PubMed  Google Scholar 

  25. Shi, Q., Trask, P. C., Wang, X. S., Mendoza, T. R., Apraku, W. A., Malekifar, M., & Cleeland, C. S. (2010). Does recall period have an effect on cancer patients’ ratings of the severity of multiple symptoms? Journal of Pain and Symptom Management, 40(2), 191–199.

    Article  PubMed  PubMed Central  Google Scholar 

  26. 28th Annual Conference of the International Society for Quality of Life Research. (2021). Quality of Life Research, 30(Suppl 1), 1–177.

  27. El Miedany, Y., El Gaafary, M., Youssef, S., Ahmed, I., & Palmer, D. (2014). The arthritic patients’ perspective of measuring treatment efficacy: Patient Reported Experience Measures (PREMs) as a quality tool. Clinical and Experimental Rheumatology, 32(4), 547–552.

    PubMed  Google Scholar 

  28. Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., Filiberti, A., Flechtner, H., Fleishman, S. B., de Haes, J. C., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376.

    Article  CAS  PubMed  Google Scholar 

  29. Kaasa, S., Bjordal, K., Aaronson, N., Moum, T., Wist, E., Hagen, S., & Kvikstad, A. (1995). The EORTC core quality of life questionnaire (QLQ-C30): validity and reliability when analysed with patients treated with palliative radiotherapy. European Journal of Cancer, 31(13–14), 2260–2263.

    Article  Google Scholar 

  30. Bland, J. M., & Altman, D. G. (1997). Cronbach’s alpha. BMJ, 314(7080), 572.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Bartko, J. J. (1966). The intraclass correlation coefficient as a measure of reliability. Psychological Reports, 19(1), 3–11.

    Article  CAS  PubMed  Google Scholar 

  32. Fayers, P. M., & Machin, D. (2000). Quality of life: Assessment, analysis and interpretation. Sons Ltd.

    Book  Google Scholar 

  33. Juniper, E. F., Guyatt, G. H., & Jaeschke, R. (1996). How to develop and validate a new health-related quality of life instrument. In B. Spilker (Ed.), Quality of Life and Pharmacoeconomics in Clinical Trials. Lippincott-Raven.

    Google Scholar 

  34. Selby, D., Cascella, A., Gardiner, K., Do, R., Moravan, V., Myers, J., & Chow, E. (2010). A single set of numerical cutpoints to define moderate and severe symptoms for the Edmonton Symptom Assessment System. Journal of Pain and Symptom Management, 39(2), 241–249.

    Article  PubMed  Google Scholar 

  35. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174.

    Article  CAS  PubMed  Google Scholar 

  36. Xu, W., Dai, W., Gao, Z., Wang, X. S., Tang, L., Pu, Y., Yu, Q., Yu, H., Nie, Y., Zhuang, W., Qiao, G., Cleeland, C. S., & Shi, Q. (2022). Establishment of minimal clinically important improvement for patient-reported symptoms to define recovery after video-assisted thoracoscopic surgery. Annals of Surgical Oncology, 29(9), 5593–5604.

    Article  PubMed  Google Scholar 

  37. Minton, P. D., & Cohen, J. (1971). Statistical power analysis for the behavioral sciences. Journal of the American Statistical Association, 66, 334.

    Article  Google Scholar 

  38. Boesen, V. B., Feldt-Rasmussen, U., Bjorner, J. B., Cramon, P. K., Grøenvold, M., Rasmussen, Å. K., & Watt, T. (2020). Shorter recall period for the thyroid-related patient-reported outcome measure ThyPRO did not change the accuracy as evaluated by repeated momentary measurements. Thyroid, 30(2), 185–191.

    Article  PubMed  Google Scholar 

  39. Qin, S., Nelson, L., McLeod, L., Eremenco, S., & Coons, S. J. (2019). Assessing test-retest reliability of patient-reported outcome measures using intraclass correlation coefficients: Recommendations for selecting and documenting the analytical formula. Quality of Life Research, 28(4), 1029–1033.

    Article  PubMed  Google Scholar 

  40. Yu, H., Yu, Q., Nie, Y., Xu, W., Pu, Y., Dai, W., Wei, X., & Shi, Q. (2021). Data quality of longitudinally collected patient-reported outcomes after thoracic surgery: Comparison of paper- and web-based assessments. Journal of Medical Internet Research, 23(11), e28915.

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This research was funded by the National Key R&D Plan for Intergovernmental Cooperation, the Ministry of Science and Technology of China (Grant No. 2022YFE0133100).

Author information

Author notes

  1. Xueyao Su and Yanyan Huang have contributed equally to this work.

Authors and Affiliations

  1. School of Public Health, Chongqing Medical University, No.1, Medical School Road, Yuzhong District, Chongqing, 400016, China

    Xueyao Su, Yanyan Huang, Ruoyan Gong, Wei Xu, Yang Pu, Lijun Zhang & Qiuling Shi

  2. Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine,, University of Electronic Science and Technology of China, Chengdu, Sichuan, China

    Wei Dai & Qiuling Shi

  3. State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China

    Jingwen Yu, Jiayuan Zhang & Qiuling Shi

  4. Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China

    Qingsong Yu

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  1. Xueyao Su
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Contributions

Study concept and design: All authors. Acquisition, analysis, or interpretation of data: All authors. Drafting of the abstract: Xueyao Su, Wei Xu, and Qiuling Shi. Revising the article critically for important intellectual content: Qiuling Shi and Wei Dai. Final approval of the version to be published: All authors. Statistical analysis: Xueyao Su, Wei Xu, Yang Pu, and Ruoyan Gong. Obtained funding: Qiuling Shi and Wei Dai. Administrative, technical, or material support: Qiuling Shi and Wei Dai. Study supervision: Qiuling Shi. Xueyao Su, and Qiuling Shi had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Qiuling Shi.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose. The authors have no competing interests to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article. Authors are responsible for correctness of the statements provided in the manuscript.

Ethical approval

This study was approved by the Ethics Committee of Sichuan Cancer Hospital (Approval number: SCCHEC-02-2018-043).

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Informed consent was obtained from all participants included in the study. Each participant was aware that their private personal information would not be disclosed and were educated about the content and purpose of the study.

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Su, X., Huang, Y., Gong, R. et al. Undergoing Lung Surgery (PSA-Lung) was appropriate for symptom assessment after discharge. Qual Life Res (2024). https://doi.org/10.1007/s11136-024-03636-w

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