: Optimal cancer care increasingly incorporates the patient's perspective, yet clinicians are not routinely taught how to measure patient-reported symptoms and health status. The advent of computerized adaptive testing (CAT) using item response theory (IRT) provides a unique opportunity to integrate health-related quality of life (HRQL) and symptom management research into individual clinical practice. Efficient and precise individual patient measurement paired with symptom management recommendations has the potential to improve patient satisfaction, communication and HRQL outcomes. In our currently funded project CA60068, we have developed brief-yet-accurate and user-friendly assessments of symptoms and function in individual cancer patients. We now propose to refine and broaden our current item banking program in fatigue (F), physical function (PF), pain (P), emotional distress (ED), illness impact (II), current HRQL model (Aim 1); and to test the efficacy of routine and targeted symptom monitoring (SyMon) and management for advanced cancer patients (Aim 2). We will refine and administer existing items to sufficient numbers of patients (n=2000) to evaluate measurement equivalence across gender, race and, where possible, disease type. Additionally, we will fully explore the dimensionality of the items and the usefulness of 1-PL and 2-PL IRT models. We will create CAT applications, incorporating patient-and clinician-derived estimates of clinically meaningful changes in scores to be used in Aim 2. Additionally, we propose to create four new item pools (spiritual well-being, appetite, pulmonary symptoms, and nausea) to ultimately create operational item banks.
For Aim 2, we propose a 4-month efficacy study with a modified crossover design (n=140) to evaluate whether routine and targeted CAT-derived assessments of F, PF, P and ED paired with management recommendations can improve satisfaction, communication and HRQL outcomes for advanced cancer patients receiving chemotherapy. Patients will be randomized to two groups: 1) SyMon intervention for 4 months, or 2) control for 2 months and SyMon intervention for 2 months. All patients will complete CAT-based symptom measures in F, PF, P and ED before each physician visit for the 4-month study period. The intervention will consist of providing CAT-derived scores to patients, and scores with specific guideline-driven recommendations to clinicians. We will also monitor treatment/management changes, and evaluate acceptability of computer assessments and the perceived benefits of the recommendations.
|Cook, Karon F; Jensen, Sally E; Schalet, Benjamin D et al. (2016) PROMIS measures of pain, fatigue, negative affect, physical function, and social function demonstrated clinical validity across a range of chronic conditions. J Clin Epidemiol 73:89-102|
|Askew, Robert L; Cook, Karon F; Revicki, Dennis A et al. (2016) Evidence from diverse clinical populations supported clinical validity of PROMIS pain interference and pain behavior. J Clin Epidemiol 73:103-11|
|Cella, David; Lai, Jin-Shei; Jensen, Sally E et al. (2016) PROMIS Fatigue Item Bank had Clinical Validity across Diverse Chronic Conditions. J Clin Epidemiol 73:128-34|
|Schalet, Benjamin D; Pilkonis, Paul A; Yu, Lan et al. (2016) Clinical validity of PROMIS Depression, Anxiety, and Anger across diverse clinical samples. J Clin Epidemiol 73:119-27|
|Schalet, Benjamin D; Hays, Ron D; Jensen, Sally E et al. (2016) Validity of PROMIS physical function measured in diverse clinical samples. J Clin Epidemiol 73:112-8|
|Wagner, Lynne I; Schink, Julian; Bass, Michael et al. (2015) Bringing PROMIS to practice: brief and precise symptom screening in ambulatory cancer care. Cancer 121:927-34|
|Lai, Jin-Shei; Wagner, Lynne I; Jacobsen, Paul B et al. (2014) Self-reported cognitive concerns and abilities: two sides of one coin? Psychooncology 23:1133-41|
|Eberhart, Nicole K; Sherbourne, Cathy D; Edelen, Maria Orlando et al. (2014) Development of a measure of asthma-specific quality of life among adults. Qual Life Res 23:837-48|
|Peipert, John D; Beaumont, Jennifer L; Bode, Rita et al. (2014) Development and validation of the functional assessment of chronic illness therapy treatment satisfaction (FACIT TS) measures. Qual Life Res 23:815-24|
|Cella, David; Choi, Seung; Garcia, Sofia et al. (2014) Setting standards for severity of common symptoms in oncology using the PROMIS item banks and expert judgment. Qual Life Res 23:2651-61|
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