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Systematic review reveals limitations of studies evaluating health-related quality of life after potentially curative treatment for esophageal cancer

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Abstract

Purpose

To (1) assess the quality of studies evaluating Health-Related Quality of Life (HRQL) after potentially curative treatment for esophageal cancer, and (2) to identify high-quality studies that provide robust HRQL results.

Methods

A systematic literature search is to identify studies evaluating HRQL with a validated multidimensional patient-reported outcome measure. Study quality focused on study design, risk of bias, HRQL outcome reporting, and additional issues of reporting and methodology. A study was deemed high-quality if criteria for robust study methodology and robust HRQL outcome reporting were met.

Results

Six RCTs, 12 cohort studies, 13 case-series, and 31 cross-sectional studies were identified. Overall risk of bias was high. Reporting of HRQL concept (e.g., a priori hypothesis), methodology (e.g., reasons for missing data), and interpretation (e.g., clinical significance) was often absent or unclear. Additional issues of reporting (e.g., unclear treatment descriptions) and methodology (e.g., no control for multiple testing) were identified. Four studies (6 %) met the criteria for robust study methodology, and 26 studies (42 %) met the criteria for robust HRQL outcome reporting. We identified three high-quality studies (5 %)—two RCTs and one case-series—capable of providing robust results.

Conclusions

Current evidence is restricted in its ability to inform practice on HRQL after potentially curative treatment for esophageal cancer.

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Notes

  1. the electronic search strategy is available electronically as Supplementary Material 1 .

  2. nonrandomized prospective studies with a comparison group.

  3. nonrandomized prospective studies with no comparison group.

  4. scoring criteria are available electronically as Supplementary Material 2.

  5. results are available electronically as Supplementary Material 3.

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Acknowledgments

We would like to extend our gratitude to Maureen Marck for her help in the assessment of study quality. We would also like to thank Pythia T. Nieuwkerk for her insightful comments on an early draft. Presented in part as a poster at the 18th Annual Conference of the International Society for Quality of Life Research, Denver, USA, 26–29 October 2011, and as an oral presentation at the 1st conference of the Association for Researchers in Psychology and Health (ARPH), Utrecht, The Netherlands, 1–2 December 2011.

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Authors and Affiliations

  1. Department of Medical Psychology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands

    Marc Jacobs, Hanneke C. J. M. de Haes, Ellen M. Smets & Mirjam A. G. Sprangers

  2. School of Social and Community Medicine, University of Bristol, Bristol, UK

    Rhiannon C. Macefield & Jane M. Blazeby

  3. Division of Surgery Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, UK

    Jane M. Blazeby

  4. Department of Public Health, University Medical Center Rotterdam, Rotterdam, The Netherlands

    Ida J. Korfage

  5. Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Mark I. van Berge Henegouwen

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  1. Marc Jacobs
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Correspondence to Marc Jacobs.

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Jacobs, M., Macefield, R.C., Blazeby, J.M. et al. Systematic review reveals limitations of studies evaluating health-related quality of life after potentially curative treatment for esophageal cancer. Qual Life Res 22, 1787–1803 (2013). https://doi.org/10.1007/s11136-012-0290-8

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