Differences In Quality Of Life Scores Research Articles

Abstract PO2-11-04: Assessing quality of Life in breast cancer patients undergoing mHealth mobile monitoring: A descriptive Analysis

Abstract Background: Breast cancer (BC) can be associated with a significant symptom burden that can be related both to the disease and to administered therapies. In particular, protocol related toxicity has an extreme impact on patient quality of life (QoL), and can lead to lack of adherence and ultimately, compromise therapy success. There is increasing interest in adopting more effective approaches for active/continuous patient-reported symptom monitoring. Emerging evidence, (Denis et al. 2019), shows that this strategy can reduce toxicity, emergency room visits, and improve QoL. Objectives: We aimed to analyze the QoL of women with BC diagnosis who underwent mobile-based continuous monitoring, searching for possible trends and describing the population. Methods: We conducted a retrospective analysis using data from patients with BC undergoing systemic treatment and monitored by a mobile-based application between January 2022 and June 2023 at an outpatient clinic in Brazil. Thummi is a digital platform for remote monitoring of cancer patients which enables them to record symptoms, toxicities and lifestyle variables. Utilizes the data to generate personalized recommendations and advice. It is available in Brazil at no cost. Doctors indicate the use and can monitor their patients in real time. In addition to an algorithm that informs the user if there is a need to go to the emergency room or not, the medical team can exchange real-time messages with patients. Clinicians have access to patient data through a web tool, allowing them to visualize the information, address symptom alerts, and make informed clinical-therapeutic decisions. The evaluated sample is from patients who come from physicians who indicated the use, without control of their origin, indication of treatment or clinical stage. The data were extracted from the platform's total database. Participants were requested to complete the Quality of Life Questionnaire (EORTC EQ-5D) integrated into the app every month. Inclusion criteria comprised a BC diagnosis, age ≥18, and having responded to the QoL questionnaire with at least a one-month interval between scores. Patients who failed to meet these criteria were excluded from the analysis. A comparison of QoL scores was performed between two periods: T0 (the first recorded response) and T1 (the subsequent response with at least a one-month interval between scores). Descriptive statistical analyses were conducted to search for possible trends, describe the population, and comprehensively examine the differences in QoL scores between T0 and T1. Results: There were 134 active patients in the mobile-based platform with a BC diagnosis, but only 86 (64,17%) met the inclusion criteria for the final analysis. The median age of this group was 54 years old (range 22-78). The most common treatments administered were Cyclophosphamide-Doxorubicin (28 patients, 33%) and Trastuzumab-Deruxtecan (18 patients, 21%). The average QoL score in T0 was 0,70 (SD 0,1379) and 1,0 (SD 0,1560) at T1, representing an increase of 30% after using the app for one month. Conclusion: This study suggests that mobile-based monitoring has the potential to improve the QoL for women diagnosed with BC. The difference in average QoL scores between the initial and subsequent periods indicates a positive impact of utilizing the platform. Further research is needed to establish a better correlation and to explore the specific interventions that contribute to these improvements. Implementing mobile-based monitoring in clinical practice could enhance patient well-being, treatment adherence, and survival time and can potentially lessen both burden of disease and resource utilization in BC care. Citation Format: Alessandra Morelle, Carlos Barrios, Carlos Pereira, Vinicius Agibert, Pedhro Lennon Freitas, Matheus Rocha, Paulo Schulze. Assessing quality of Life in breast cancer patients undergoing mHealth mobile monitoring: A descriptive Analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-04.

Psychometric properties of the World Health Organization WHOQOL-AGE Scale in Singapore

WHOQOL-AGE is a promising quality of life (QOL) tool that has not been fully validated in Asia. The present study aimed to verify its factor structure and psychometric properties among community-dwelling older adults in Singapore. This study was cross-sectional and used data (N = 593) from the Community Health and Intergenerational study that interviewed older adults between 2018 and 2021. Confirmatory factor analysis (CFA) was used to examine the factor structure of the WHOQOL-AGE, and Cronbach’s alpha coefficients were employed to examine internal consistency. Spearman’s rho correlations coefficients between WHOQOL-AGE and other related scales (Satisfaction with Life and the Friendship) examined convergent validity. A Pearson’s correlation coefficient between WHOQOL-AGE and compassion scale examined discriminant validity. An independent t test was used to demonstrate known-groups validity, examining differences in QOL scores between individuals with and without chronic medical conditions. Findings supported a bifactor model with more satisfactory goodness-of-fit indices than the original two-factor model and the two-correlated factor model. WHOQOL-AGE showed adequate internal consistency (Cronbach’s alpha coefficients > .70). Good convergent validity was demonstrated by moderate-to-large correlations between WHOQOL-AGE and satisfaction with life (rs = .54) as well as social connectedness (rs = .33). Discriminant validity was shown by low correlations between WHOQOL-AGE and compassion (r = .19). Findings also indicated good known-groups validity (p < 0.01). The WHOQOL-AGE showed promising psychometric properties using an Asian convenience sample and can be useful in large-scale studies or busy clinical settings.

Colchicine in acute myocardial infarction: cardiovascular events at 1-year follow up

ObjectiveIn the COVERT-MI randomised placebo-controlled trial, oral administration of high-dose colchicine at the time of reperfusion and for 5 days in acute ST-elevated myocardial infarction did not reduce infarct size...

Children With Developmental Language Disorder Have Lower Quality of Life Than Children With Typical Development and Children With Cochlear Implants.

The purpose of this study was to examine quality of life (QOL) and its relation to language skills in children with developmental language disorder (DLD). This was examined by comparing QOL to a control group of children with typical development (TD), as well as children with cochlear implants (CIs), who potentially struggle with language for language, although for a different reason than children with DLD. Two groups of children, a group with TD (n = 29) and a group of children with CIs (n = 29), were matched to the DLD group (n = 29) on chronological age, gender, nonverbal IQ, and parental educational level through a propensity matching procedure. A third group consisting of children with CIs was also matched to the DLD group but additionally matched on language abilities. QOL scores were compared across groups, and the association between language skills and QOL was examined in the DLD group. The DLD group was reported by parents to have statistically significantly poorer QOL scores than peers with TD or CIs. When controlling for language skills, either statistically or through an additional CI group matched on language abilities, there were no statistically significant differences in QOL scores across groups. In the DLD group, language skills explained 16% of the variation in QOL. DLD is associated with the children's overall QOL, and the degree of reduced QOL relates to the severity of the language impairment.

Quality of Life Among Family Caregivers of Disabled Children in Saudi Arabia.

The physical and mental health of parents can be adversely affected by their child's disability, leading to a potential decline in their overall Quality of Life (QoL). This research aimed to determine the QoL of family caregivers and compare this based on sociodemographic factors and child characteristics. An analytical cross-sectional design was employed, and data were collected from multiple rehabilitation centers for children with special needs and learning disorders in the Kingdom of Saudi Arabia. The study sample comprised 95 family caregivers who completed a self-structured questionnaire. The questionnaire included sections on sociodemographic characteristics, child characteristics, and caregivers' QoL assessed using the RAND 36-Item Short Form Health Survey (SF-36). The collected data were analyzed using the IBM Corp. Released 2022. IBM SPSS Statistics for Windows, Version 29.0. Armonk, NY: IBM Corp, employing descriptive statistics and multivariate linear regression analysis. Our findings revealed that the overall mean QoL score among caregivers was 57, ranging from 12 to 94. There were no statistically significant differences in QoL scores based on caregivers' age, gender, occupational status, or income. However, further analysis indicated significant associations between certain factors and specific domains of QoL. Specifically, caregiver education was found to be associated with role limitations due to emotional problems, while relationships with disabled children were linked to emotional well-being. The severity of the child's disability and the presence of another child with a disability in the family were associated with the bodily pain domain. Additionally, the presence of another child with a disability had an impact on perceived change in the health domain. The QoL of family caregivers varied, highlighting the significant challenges faced by certain individuals. Factors such as education level, the relationship with the child, the severity of the disability, and the presence of multiple disabled children in the family were identified as influencing caregivers' QoL. These findings emphasize the importance of developing targeted interventions that can address emotional well-being and fatigue management while promoting a supportive society.

Improvement in Quality of Life With the Use of a Technological System Among Patients With Chronic Disease Followed Up in Primary Care (TeNDER Project): Protocol for a Randomized Controlled Trial.

Among chronic diseases, cognitive, neurological, and cardiovascular impairments are becoming increasingly prevalent, generating a shift in health and social needs. Technology can create an ecosystem of care integrated with microtools based on biosensors for motion, location, voice, and expression detection that can help people with chronic diseases. A technological system capable of identifying symptoms, signs, or behavioral patterns could provide notification of the development of complications of disease. This would help the self-care of patients with chronic disease and save health care costs, promoting the autonomy and empowerment of patients and their caregivers, improving their quality of life (QoL), and providing health professionals with monitoring tools. The main objective of this study is to evaluate the effectiveness of a technological system (the TeNDER system) to improve quality of life in patients with chronic diseases: Alzheimer disease, Parkinson disease, and cardiovascular disease. A multicenter, randomized, parallel-group clinical trial will be conducted with a follow-up of 2 months. The scope of the study will be the primary care health centers of the Community of Madrid belonging to the Spanish public health system. The study population will be patients diagnosed with Parkinson disease, Alzheimer disease, and cardiovascular disease; their caregivers; and health professionals. The sample size will be 534 patients (380 in the intervention group). The intervention will consist of the use of the TeNDER system. The system will monitor the patients by means of biosensors, and their data will be integrated into the TeNDER app. With the information provided, the TeNDER system will generate health reports that can be consulted by patients, caregivers, and health professionals. Sociodemographic variables and technological affinity will be measured, as will views on the usability of and satisfaction with the TeNDER system. The dependent variable will be the mean difference in QoL score between the intervention and control groups at 2 months. To study the effectiveness of the TeNDER system in improving QoL in patients, an explanatory linear regression model will be constructed. All analyses will be performed with the 95% CI and robust estimators. Ethics approval for this project was received on September 11, 2019. The trial was registered on August 14, 2020. Recruitment commenced in April 2021, and the expected results will be available during 2023 or 2024. This clinical trial among patients with highly prevalent chronic illnesses and the people most involved in their care will provide a more realistic view of the situation experienced by people with long-term illness and their support networks. The TeNDER system is in continuous development based on a study of the needs of the target population and on feedback during its use from the users: patients, caregivers, and primary care health professionals. ClinicalTrials.gov NCT05681065; https://clinicaltrials.gov/ct2/show/NCT05681065. DERR1-10.2196/47331.

Quality of life of older gynecologic oncology patients at the initiation of chemotherapy.

To evaluate older gynecologic oncology patients' quality of life (QOL) at the initiation of chemotherapy and compare their QOL scores with a female age-matched general population (GP) sample. Cross-sectional. Older (n = 122) gynecologic oncology patients completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) that evaluates global health and five functional scales (range from 0 to 100). Differences in QOL scores between our sample and the GP were evaluated using one-sample t-tests and effect sizes were calculated using Cohen's d. Patients' mean age was 70.7 years (±6.6). Mean scores for the function scales ranged from 58.5 (±31.1) for role function to 86.1 (±17.0) for cognitive function. Compared to the GP, our sample reported significantly lower scores for global health status, social, role and physical functioning, and a significantly higher score for cognitive functioning. No differences were found in emotional functioning scores. No patient or public contribution.

Patient Perspectives and Quality of Life after Breast Reconstruction and the Impact of Subsequent Revisions.

Patients undergoing mastectomy with immediate implant-based or autologous free-flap breast reconstruction from 2008 to 2020 were reviewed. These patients were categorized by revisions (0-1, 2-3, and 4+) and surveyed on QoL metrics using BREAST-Q and Was It Worth It? (WIWI) questionnaires. BREAST-Q QoL, satisfaction, and WIWI metrics between revision groups were evaluated. Among 252 patients, a total of 150 patients (60%) underwent zero to one revisions, 72 patients (28%) underwent two to three revisions, and 30 patients (12%) underwent four or more revisions. Median follow-up was 6 years (range, 1-11 years). BREAST-Q satisfaction among patients with four or more revisions was significantly lower (P = 0.03), while core QoL domains (chest physical, psychosocial, and sexual well-being) did not significantly differ. Analysis of unplanned reoperations due to complications and breast satisfaction showed no significant difference in QoL scores between groups (P = 0.08). Regarding WIWI QoL metrics, four or more revisions were associated with a higher rate of worse QoL (P = 0.035) and worse overall experience (P = 0.001). Most patients in all revision groups felt it was worthwhile to undergo breast reconstruction (86%), would choose breast reconstruction again (83%), and would recommend breast reconstruction to others (79%). Overall, a majority of patients undergoing revisions after breast reconstruction still have a worthwhile experience. Although reoperations after breast reconstruction do not significantly impact long-term BREAST-Q QoL domains, patients undergoing four or more revisions have significantly lower breast satisfaction, worse QoL, and a postoperative experience worse than expected.

Demographic and clinical determinants of the quality of life in adults with inherited and acquired myopathies.

Measuring health-related quality of life (QOL) is vital for understanding the disease impact, but the complex relationship between clinical parameters and QOL remains unclear. The objective was to determine the demographic and clinical factors that influence the QOL in adults with inherited and acquired myopathies. The study was of cross-sectional design. Detailed demographic and clinical details were collected. Patients answered Neuro-QOL and Patient-Reported Outcomes Measurement Information System short-form questionnaires. Data was collected from 100 consecutive in-person patient visits. Mean age of the cohort was 49.5 ± 20.1 (18-85) years, and the majority were male (53, 53%). Bivariate analysis between the various demographic and clinical features with the QOL scales revealed single simple question (SSQ), handgrip strength, Medical Research Council (MRC) sum score, female gender, and age to be nonuniformly associated with the QOL scales. There was no difference between inherited and acquired myopathies for any of the QOL scores, except for the poorer lower limb function domain in inherited myopathies (36.7 ± 7.3 vs. 40.9 ± 11.2, p = 0.049). Linear regression models revealed lower SSQ, lower handgrip strength, and lower MRC sum score to independently predict poor QOL. Handgrip strength and SSQ serve as novel predictors of QOL in myopathies. Handgrip strength has a significant impact on physical, mental, and social domains and deserves special attention with respect to rehabilitation. SSQ correlates well with QOL and can be employed as a quick and global assessment of a patient's well-being. Differences in QOL scores between patients with inherited and acquired myopathies were minimal.

Evaluating the effect of upper-body morbidity on quality of life following primary breast cancer treatment: a systematic review and meta-analysis.

Improvements in breast cancer management continue to increase survival and life expectancy after treatment. Yet the adverse effects of treatment may persist long term, threatening physical, psychological, and social wellbeing, leading to impaired quality of life (QOL). Upper-body morbidity (UBM) such as pain, lymphoedema, restricted shoulder range of motion (ROM), and impaired function are widely reported after breast cancer treatment, but evidence demonstrating its impact on QOL is inconsistent. Therefore, the aim of the study was to conduct a systematic review and meta-analysis evaluating the effect of UBM on QOL following primary breast cancer treatment. The study was prospectively registered on PROSPERO (CRD42020203445). CINAHL, Embase, Emcare, PsycInfo, PubMed/Medline, and SPORTDiscus databases were searched for studies reporting QOL in individuals with and without UBM following primary breast cancer treatment. Primary analysis determined the standardised mean difference (SMD) in physical, psychological, and social wellbeing scores between UBM + /UBM - groups. Secondary analyses identified differences in QOL scores between groups, according to questionnaire. Fifty-eight studies were included, with 39 conducive to meta-analysis. Types of UBM included pain, lymphoedema, restricted shoulder ROM, impaired upper-body function, and upper-body symptoms. UBM + groups reported poorer physical (SMD = - 0.99; 95%CI = - 1.26, - 0.71; p < 0.00001), psychological (SMD = - 0.43; 95%CI = - 0.60, - 0.27; p < 0.00001), and social wellbeing (SMD = - 0.62; 95%CI = - 0.83, - 0.40; p < 0.00001) than UBM - groups. Secondary analyses according to questionnaire showed that UBM + groups rated their QOL poorer or at equal to, UBM - groups across all domains. Findings demonstrate the significant, negative impact of UBM on QOL, pervading physical, psychological, and social domains. Efforts to assess and minimise the multidimensional impact of UBM are warranted to mitigate impaired QOL after breast cancer.

The effect of pain-education nursing based on a mind map on postoperative pain score and quality of life in patients with colorectal cancer.

Mind mapping is a combination of images and logical thinking in the form of pictures and texts. It presents a natural expression process that conforms to the divergent thinking of the brain, helping patients understand memory. This study aimed to investigate the impact of pain-education nursing with the aid of mind maps on postoperative pain scores and quality of life in patients with colorectal cancer. The medical records of 100 colorectal cancer patients treated from July 2020 to July 2022 were selected as retrospective research participants and divided into control and observation groups. The control group received routine pain care, and the observation group was given pain-education nursing based on a mind map. The effects on quality of life, pain, negative emotions, and comfort after nursing were compared between the 2 groups. There was no significant difference in quality of-life scores between the 2 groups before the nursing intervention (P > .05). After nursing, the physical, emotional, cognitive, and social functions of patients in the observation group were significantly higher than those in the control group. However, the overall quality of life and financial difficulties of patients in the observation group were significantly lower than those in the control group (P < .05). The observation group's social, physical, and psychological comfort scores were significantly higher than those in the control group after nursing intervention (P < .05). After nursing, the observation group's visual analog scale scores at different times after the operation were significantly lower than those of the control group. The scores on the self-rating anxiety scale and self-rating depression scale in the observation group were significantly lower than those in the control group (P < .05). Pain-education nursing based on mind maps can effectively improve the daily living ability, pain symptoms, and quality of life of patients after colorectal cancer, and there is a reference value for post-nursing care of patients after colorectal cancer.

Comparison of Postoperative Quality of Life Scores in Women Who Underwent Myomectomy Versus Hysterectomy for Uterine Fibroids [ID: 1379414

INTRODUCTION: Uterine fibroids are highly prevalent and associated with significant effect on quality of life (QOL). The current study compares QOL scores in patients that underwent myomectomy or hysterectomy for management of fibroids. METHODS: After obtaining approval from the Cleveland Clinic IRB, we conducted a retrospective cohort study for patients that underwent hysterectomy or myomectomy for uterine fibroids. Eligible patients were sent validated surveys: 36-Item Short Form Health Survey (SF-36) and Uterine Fibroid Symptom and QOL questionnaire (UFS-QOL). Standard bivariate analyses were used to compare differences in QOL scores between groups, adjusting for age and race. RESULTS: Of the 142 survey respondents, 37 underwent myomectomy and 105 underwent hysterectomy. The median number of days between surgery and survey completion was 1,652 (1,142, 2,328) for myomectomy and 1,022 (740, 1,317) for hysterectomy. For SF-36, hysterectomy patients reported significantly less energy (P=.006) compared to myomectomy. Significant differences were not observed in postoperative physical functioning, role limitations, pain, health perceptions, vitality, social functioning, or mental health. Although there was no statistically significant difference in UFS-QOL scores, patients who underwent hysterectomy experienced significantly lower symptom severity (P=.009) and levels of concern (P&lt;.001), and increased activity tolerance (P=.005) and sense of control (P=.029). CONCLUSION: While patients who underwent hysterectomy reported more fatigue, they experienced lower symptom severity, lower levels of concern, higher activity tolerance, and increased sense of control compared to myomectomy. These findings may help guide counseling for surgical fibroid treatment.

Quality of life by dysmenorrhea severity in young and adult Japanese females: A web-based cross-sectional study.

Dysmenorrhea is a monthly menstrual pain that can limit a woman's quality of life (QOL). The relationship between dysmenorrhea severity and QOL has been reported in several countries; however, the results cannot be generalized because lifestyle and cultural background affect menstrual pain. This study sought to uncover whether 1) different factors, such as emotions and ways of coping with symptoms, vary with the severity of dysmenorrhea and 2) the severity of dysmenorrhea ultimately affects QOL in Japan. A web-based cross-sectional survey was sent to 1000 Japanese females aged 16-30 years. The respondents were divided into two groups: those without dysmenorrhea (n = 24) and those with dysmenorrhea (n = 471). The severity of dysmenorrhea was classified using the Numerical Rating Scale as either mild (1-3), moderate (4-7), or severe (8-10). In total, 156 respondents reported mild dysmenorrhea, 249 reported moderate dysmenorrhea, and 66 reported severe dysmenorrhea. QOL was measured using the 26-item World Health Organization Quality of Life scale. One-way ANOVA and Kruskal-Wallis tests were used to compare QOL across different levels of dysmenorrhea severity, depending on normality. Ultimately, significant differences in QOL scores (p<0.001) were observed based on dysmenorrhea severity, with respondents with severe dysmenorrhea reporting the lowest QOL scores. Meanwhile, significant differences were observed in the physical, psychological, and environmental subscales (p<0.001, p<0.001, p = 0.019) across respondents with different levels of dysmenorrhea severity; notably, respondents with severe dysmenorrhea demonstrated a negative spiral of chronic pain, which may significantly impact QOL, and, relatedly, a relatively low psychological QOL. This study is the first to show the relationship between dysmenorrhea severity and QOL in Japanese females, who are more likely to experience negative feelings during menstruation.

Predictors of quality of life of cancer patients: A psycho-oncological study conducted at Tripura, North-East India.

Cancer is, no doubt, a life-threatening illness, and it has a long-term effect on the physical and mental health of the patients, particularly on their quality of life (QOL). Many factors significantly impact the QOL of cancer patients, and the present article is an attempt to explore the predictors of QOL of cancer patients. More specifically, the article tries to ascertain the role of the area of living, educational status, family income, and type of family on the QOL of cancer patients. We also tried to examine the role of illness duration and spirituality on the QOL of cancer patients. The sample consisted of 200 cancer patients belonging to the state of Tripura, a Northeastern state of India. General Information Schedule, Quality of Life Patient/Cancer Survivor Version (developed by Ferrell, Hassey-Dow, and Grant), and The Spiritual Experience Index-Revised (developed by Genia) were used for data collection. For analysis of data, independent t-test, analysis of variance, and multiple linear regression were computed. The statistical analysis was carried out using IBM SPSS Version 25.0. Out of 200 cancer patients, there were 100 (50%) men and 100 (50%) women patients. Most of the cancer patients (100, 50%) were suffering from oral cancer, followed by lung and breast cancers. They were mostly from the rural areas of Tripura and belonged to nuclear families. Most of them were not much educated, and their monthly family income was below INR (Indian National Rupee) 10,000. A total of 122 (61%) cancer patients were diagnosed less than 1 year before. The results showed no significant difference in QOL scores among the subgroups of cancer patients in socioeconomic and illness factors, except for family income. Further analysis revealed that only spirituality and educational qualification of cancer patients significantly predicted their QOL. The current article can act as a springboard for further studies in this area and provide aids for socioeconomic development while improvising cancer patients' QOL.

Pancreas transplantation improves the quality of life of Japanese type 1 diabetes patients with diabetic kidney disease

Type 1 diabetes mellitus (T1DM) patients with diabetic kidney disease-induced kidney failure have a significantly impaired quality of life (QOL), resulting in a high level of physical, mental, and social anxiety. In this study, we evaluated the QOL of T1DM patients on the list for pancreas transplantation (PTx) at their registration, and determined whether PTx improved their QOL. There were 58 patients (men/women, 22/36; mean age, 42.8±8.0 years) with T1DM and who were registered on the waiting list for PTx. Quantitative QOL assessment was performed using the Medical Health Survey Short Form (SF-36) version 2. Changes in the QOL before and after PTx were also examined in 24 of these patients. The mean value of each endpoint and the summary score of the SF-36 physical (PCS), mental (MCS), and role (RCS) components were all below the national normal level at PTx registration. No significant difference in QOL scores was observed in the intergroup comparison of 35 patients on dialysis, 13 patients without dialysis, and ten patients after kidney transplantation. The 24 patients who underwent PTx showed improvement in PCS, MCS, and most SF-36 scores. T1DM patients waiting for PTx had a decreased QOL, regardless of dialysis, and PTx improved their QOL.

Early integration of palliative care in cervical cancer: Experiences from a pilot study.

Palliative care (PC) has been classically synonymous with end-of-life care offered to patients with advanced incurable cancers with an aim to improve their quality-of-life (QoL). However, there is growing evidence to suggest that early integration of PC (EIPC) along with cancer-directed management improves patient-reported outcomes. In this study, we aim to evaluate the impact of EIPC on QoL of cervical cancer patients treated with curative intent. Patients with locally advanced cervical cancer (stage IB2 to IIIB) having eastern cooperative oncology group (ECOG) performance score 0-2 were randomized into EIPC arm and standard of care arm of concurrent chemoradiation by a computer-generated table of random numbers. QoL was assessed by functional assessment of cancer therapy - general (FACT-G) questionnaire twice in both arms. The first assessment was done prior to starting treatment and second assessment at three months after treatment completion. The mean scores on physical, mental, emotional, social, and functional well-being subscales of FACT-G scale were calculated in both arms, and Wilcoxon test was used to evaluate differences in QoL scores within and in between the arms. This trial was registered with Clinical Trials Registry of India (CTRI) vide CTRI/2017/05/008704. Fifty patients were enrolled in each arm. However, only 42 and 45 patients in EPIC and standard oncological care arm were evaluated in the final analysis. Comparing QoL scores between the two time points in each arm, the mean pre-treatment scores in EIPC arm was significantly higher than post-treatment scores in the domains of physical and emotional well-being, whereas social and functional well-being scores improved significantly after treatment as compared with that as baseline. However, when compared between two arms, the difference of mean scores pre- and post-treatment were almost similar for physical and functional well-being but statistically significant differences were found only in social and emotional well-being scales. Our study is a feasibility study done in an attempt to test the validity of EIPC in cervical cancers. The results are inspiring to conduct robust studies in the future to explore this new domain of integration of palliative services in curable cancers.

Impact of Racial/Ethnic Discrimination on Quality of Life Among Breast Cancer Survivors.

Although racial/ethnic disparities in health-care access, treatment, and cancer outcomes are well documented, the impact of racial/ethnic discrimination on cancer survivorship is unclear. We examined associations between quality of life (QoL) and self-reported discrimination among 3,991 women with breast cancer recruited during 2006-2013 from the Pathways Study in the Kaiser Permanente Northern California integrated health-care system, using linear regression models. Overall, 31% of women reported experiencing racial/ethnic discrimination, with differences by race/ethnicity (82% among non-Hispanic Black women vs. 19% among non-Hispanic White women) and nativity (40% among foreign-born Hispanic women vs. 76% among US-born Asian-American women). Experiencing racial/ethnic discrimination was associated with lower QoL in fully adjusted models. The mean QoL scorewas119.6 (95% confidence interval (CI):102.0, 137.1) for women who did not report discrimination, 115.5 (95% CI: 98.0, 133.0) for those who reported some discrimination/less than the median level, and 110.2 (95% CI: 92.7, 127.7) for those who reported more discrimination/greater than or equal to the median level. Discrimination was associated with lower QoL among women who used passive coping strategies or lived in neighborhoods with high neighborhood socioeconomic status, neighborhoods with high levels of segregation, or non-ethnic enclaves. Among breast cancer survivors, clinically meaningful differences in QoL scores were associated with racial/ethnic discrimination. Additional studies are needed to understand potential pathways through which these social factors affect survivorship outcomes.

Quality of Life Analysis of a Phase II Randomized Controlled Trial Comparing 3D-Conformal Radiotherapy (3D-CRT) and Intensity Modulated Radiotherapy (IMRT) in Locally Advanced Rectal Cancer (TRI-LARC)

<h3>Purpose/Objective(s)</h3> The aim of the study was to compare the use of 3D-CRT and IMRT in pre-operative long course chemo-radiotherapy for locally advanced rectal cancer. We herein evaluate the impact of the two treatment modalities on quality of life (QOL), a secondary objective of the study. <h3>Materials/Methods</h3> 94 patients with rectal adenocarcinoma were enrolled in a prospective randomized phase II trial across three institutions between 2014 and 2020. Eligible patients had stage T3-4, N(any) or circumferential resection margin at risk with no evidence of metastatic disease. All patients were prescribed 50.4Gy in 28 fractions with concomitant 5-fluorouracil or capecitabine. Patients were randomly assigned (1:1) to 3D-CRT and IMRT planning techniques. QOL was assessed using the EORTC QLQ C30 and QLQ CR29 questionnaires at baseline, during the final week of radiotherapy and at six and twelve months after radiotherapy. A paired sample t test was used to compare differences in QOL from baseline to each follow-up. One-way between-group analyses of covariance (ANCOVA) were conducted to compare the effect of the trial arms on each QOL score. <h3>Results</h3> At a median follow-up of 14 months, the trial was terminated early due to failure to establish efficacy in the primary outcome, acute gastrointestinal toxicity. The median age was 59 years and 72/94 (77%) were male. 86/94 (91%) patients completed the baseline and at least one other QOL assessments. QOL data at one year was available in 55/94(58%). At baseline, there was no difference in QOL scores between trial arms. Overall, emotional functioning had improved at six months but physical, cognitive, role and social functioning had declined. At six months, there was a significant improvement in constipation, blood and mucous in stool, bloating, urinary frequency, buttock pain and anxiety scores compared to baseline. There was a significant deterioration in dyspnea, fatigue, nausea/vomiting, taste, hair loss, erectile dysfunction, body image and global health scores from baseline to 6-month follow-up. After adjusting for pre-intervention score, the IMRT arm had better physical functioning (p=0.038) and role functioning (p=0.014) during the final week of radiotherapy compared to the 3DCRT arm. The end of radiotherapy embarrassment score, for those without a stoma, was significantly worse in the IMRT arm (p=0.032). There was no other significant difference in QOL scores between the two arms, at either the final week of radiotherapy or at 6 months, after adjustment for pre-intervention scores. The limitations of the study include its early termination, the potential for type 1 error and the possible influence of other factors on QOL data such as chemotherapy and postoperative complications. <h3>Conclusion</h3> There are limited QOL benefits of IMRT compared to 3D-CRT in the neoadjuvant setting for rectal cancer.

Impact of meibomian gland dysfunction on quality of life and mental health in a clinical sample in Ghana: a cross-sectional study.

ObjectivesThis study aimed to determine the impact of meibomian gland dysfunction (MGD) on quality of life and psychosomatic conditions.DesignThis was a clinic-based cross-sectional study.SettingThis study was conducted at the eye clinic of the University of Cape Coast, Ghana.Participants215 clinical subjects visiting the clinic for a comprehensive eye examination.Primary and secondary outcome measuresSymptomatic MGD, asymptomatic MGD, quality of life scores, depression, anxiety and stress.Results215 clinical subjects consented to participate in the study, but 212 were included in the analysis. The mean age was 21.9 (± 3.8) years, 54 had MGD and 158 did not have MGD served as controls. There was no statistically significant difference in the mean quality of life scores between subjects with MGD and subjects without MGD (t=1.57, p=0.12). The quality of life scores (DEQS) (p=0.022) were significantly higher in the symptomatic MGD group compared with the asymptomatic MGD group. There was no significant difference in quality of life scores (DEQS) (p=0.251) in the asymptomatic MGD group compared with healthy controls. Using Pillai’s trace in the MANOVA, there was a significant effect of MGD on depression, anxiety and stress (V=0.05, F(3,208)=3.76, p=0.012). Furthermore, Pillai’s trace in the MANOVA showed a significant difference between asymptomatic and symptomatic MGDs for depression, anxiety and stress scores stress (V=0.24, F(3, 51)=5.24, p=0.003).ConclusionThe study revealed no difference in the quality of life scores between MGD and non-MGD groups. However, the symptomatic MGD group had worse quality of life and psychosomatic symptoms than the asymptomatic MGD group and non-MGD group.

Identifying quality of life outcome patterns to inform treatment choices in ischemic cardiomyopathy

BackgroundThe Surgical Treatment for Ischemic Heart Failure (STICH) trial found that routine use of coronary artery bypass surgery (CABG) improved mean quality of life (QoL) scores relative to guideline-directed medical therapy (GDMT) in patients with ischemic cardiomyopathy. However, mean differences in QoL scores do not provide what patients want to know when facing a high-risk/high-benefit treatment choice. MethodsWe analyzed Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary scores in CABG and GDMT patients over 36 months using a combination of statistical methods to group QoL data into clinically relevant outcome patterns (phenotype trajectories) and to then identify the main baseline predictors of each phenotype. QoL outcome phenotypes were developed using mixture models to define the dominant phenotype trajectories present in STICH QoL data. Logistic regression models were used to predict each patient's probability of achieving each outcome pattern with each treatment. ResultsIn STICH, 592 patients underwent CABG and 607 were managed with GDMT. Our analyses identified 3 phenotype trajectory patterns in both treatment groups. Two of the 3 trajectories showed improving patterns, and were classified as “good QoL trajectories,” seen in 498 (84.1%) CABG and 449 (73.9%) GDMT patients. Defining a consequential CABG-GDMT treatment difference as a >10% higher absolute predicted probability of belonging to good QoL trajectories, 277 (23.5%) patients were more likely to have good outcome with CABG while 45 (3.8%) patients were more likely to have a good outcome with GDMT. For 644 (54.7%) patients, CABG and GDMT probabilities of a good outcome were within 5% of each other. ConclusionsThe pattern of QoL outcomes after CABG compared with GDMT in STICH followed 3 main phenotypic trajectories, which could be predicted based on individual baseline features. Patient-specific predictions about expected QoL outcomes with different treatment choices provide an intuitive framework for personalizing patient decision making.