Health-related Quality Of Life In Patients Research Articles

Health-Related Quality of Life in a Real-World Cohort of Patients with Advanced Urothelial Carcinoma Treated with Immune Checkpoint Inhibitors.

Health-related quality of life (HRQOL) has been reported in clinical trials of pembrolizumab and avelumab treatment of locally advanced or metastatic urothelial carcinoma. However, few studies have investigated the effect of immune checkpoint inhibitors (ICIs) on HRQOL in patients with urothelial carcinoma in a real-world setting. We included 44 patients with advanced urothelial cancer who were treated with pembrolizumab or avelumab from January 2018 to November 2023. When patients visited our hospital for treatment, we evaluated their HRQOL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care. We retrospectively reviewed the interview sheets. The median time to deterioration in global health status was 19.1 weeks. The mean scores of emotional functioning were improved in weeks 18 and 36 compared with baseline. The mean scores for fatigue and appetite loss were also improved in weeks 18 and 36. ICI treatment for advanced urothelial carcinoma did not worsen HRQOL over time in a real-world setting. Tolerability of ICIs for advanced urothelial carcinoma appears good in those who received long-term treatment.

Transarterial Radioembolisation with Y90 Resin Microspheres and the Effect of Reimbursement Criteria in France: Final Results of the CIRT-FR Prospective Observational Study.

This analysis of the CIRSE Registry for SIR-Spheres Therapy in France, CIRT-FR, reports on real-world outcomes of transarterial radioembolisation (TARE) with Y90 resin microspheres for hepatocellular carcinoma (HCC) and colorectal cancer liver metastases (CRLM) patients in France, focusing on safety, effectiveness and health-related quality of life (HRQoL). Results on patients treated based on national reimbursement criteria are discussed here. Prospective, multicentre, observational study of HCC and CRLM patients treated between August 2017 and July 2020 with TARE Y90 resin microspheres. Patients were assigned to different analysis groups based on reimbursement recommendations. Follow-up period was at least 24months with patient data collected every 3months. In total, 252 (193 HCC, 59 CRLM) patients of CIRT-FR were included in the analysis. No differences in effectiveness, safety and HRQoL were found between analysis groups based on reimbursement recommendations. Median overall survival for HCC and CRLM was 19.0 (95% CI, 16.1-22.4) and 10.8 (95% CI, 8.0-13.5) months, respectively. Serious procedure-related adverse events occurred in 13% of the patients. HRQoL generally remained stable, with some fluctuations in function scores and symptoms. In our cohorts, patients performed similarly regarding clinical outcomes irrespective of their analysis group based on reimbursement recommendations. Our results suggest that instead of restrictive reimbursement criteria, more decision-making power in selecting suitable patient groups could be given to multidisciplinary tumour boards. Results confirm that TARE with Y90 resin microspheres is an effective and safe treatment for liver cancer, with maintained HRQoL in most patients.

The Impact of Non-pharmacologic Traditional Chinese Medicine on Health-Related Quality of Life and Symptom Management in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Background: Breast cancer remains a prevalent malignancy among women globally. Survivors often experience diminished quality of life, pain, and sleep disturbances after treatment and suffer feelings of isolation. Non-pharmacological traditional Chinese medicine (NP-TCM) interventions have been increasingly applied in clinical practice, yet their efficacy requires further clarification. Objective: This meta-analysis aimed to evaluate the impact of NP-TCM interventions (e.g. Qigong, Tai Chi, Baduanjin) on the health-related quality of life (HRQOL) in breast cancer patients. Methods: Randomized controlled trials published between 1999 and 2024 were retrieved from various databases. Studies comparing NP-TCM and control groups in quality of life and other outcomes were included. Meta-analysis was performed using RevMan 5.4 software. 14 RCTs with 688 patients were included. Results: NP-TCM interventions significantly improved overall quality of life (SMD=0.13, 95%CI 0.24~0.51, P<0.001). Specifically, Baduanjin demonstrated substantial benefits (SMD=0.82, P<0.001). NP-TCM also enhanced sleep (SMD=1.16, P=0.04) and alleviated anxiety (SMD=-0.46, P<0.05). Conclusion: NP-TCM interventions effectively improved the HRQOL and certain symptoms for breast cancer patients, providing practical adjunctive therapies. However, study qualities require optimization.

Long‑term physical and mental Health-Related Quality of Life in Italian patients post COVID-19 hospitalisation.

Prior evidence suggests that patients' Health Related Quality of Life (HRQoL) worsens after COVID-19. This study aimed to investigate HRQoL in Italian patients post-hospitalization for COVID-19, focusing on changes in physical and mental HRQoL over time since COVID-19 diagnosis. A cohort of patients hospitalized for COVID-19 at Molinette Hospital in Turin, Italy, was contacted post-discharge to assess HRQoL using the SF-36 questionnaire. Patients completed the questionnaire only once at a different time since diagnosis. This design allowed for the analysis of responses up to three years after diagnosis. Measured scores were compared with normative data from the Italian population using z-scores. HRQoL differences by gender, comorbidities, and self-perception of health status before and after COVID-19 were tested. The effect of time since diagnosis on physical (PCS) and mental (MCS) SF-36 scores was analysed using multiple linear models and stratified analyses. A total of 601 patients completed the questionnaire. HRQoL was significantly lower compared to the normative Italian population. Men and individuals without comorbidities had better HRQoL, and self-perceptions of health status before and after COVID-19 influenced HRQoL. Time since diagnosis was associated with improved PCS, but MCS remained unaffected. Mental health declined in patients using anxiolytics post-COVID-19, and increasing age negatively affected physical health. Our findings highlight the impact of time since diagnosis on HRQoL post-COVID-19 in an Italian population and suggest the need for further investigation into the pandemic's effects on HRQoL. Physicians should implement measures to improve mental HRQoL post-COVID-19.

The Role of Atrial Fibrillation and Oral Anticoagulation Status in Health-Related Quality of Life 12 Months After Ischemic Stroke or TIA.

Atrial fibrillation (AF) accounts for about 20% of all ischemic strokes worldwide. It is known that AF impairs health-related quality of life (HRQOL) in the general population, but data on HRQOL in stroke patients with newly diagnosed AF are sparse. Post hoc analysis of the prospective, investigator-initiated, multicenter MonDAFIS study (NCT02204267) to analyze whether AF-related oral anticoagulation (OAC), and/or AF-symptom severity are associated with HRQOL after ischemic stroke or transient ischemic attack (TIA). HRQOL was measured using the EQ-5D-3L-questionnaire (including EQ-index/EQ-VAS) at baseline and after 12 months using multivariable linear mixed models. AF symptom severity was assessed using the European Heart Rhythm Association classification and symptom severity score (EHRA score) categorizing patients with no/mild/severe/disabling AF-related symptoms. A first episode of AF was detected in 261/2927 (8.9%) patients within 12 months after the index stroke and 227/2920 (7.8%) patients had AF and were anticoagulated at 12 months. HRQOL (measured by EQ-index, n = 2495 patients) was higher in AF patients on OAC compared to AF patients without OAC at 12 months after stroke (mean difference: MD: -16.8, 95% CI: 5.6 to 28.0), and similar in AF patients under OAC compared with patients without AF (MD: 2.0, 95% CI: -2.2 to 6.3). AF-related symptoms were negatively associated with HRQOL (measured by EQ-index) indicating that stroke patients with AF-related symptoms had a lower HRQOL compared to asymptomatic AF patients (mild vs. asymptomatic: MD: -9.0, 95% CI: -17.7 to -0.3; severe/disabling vs. asymptomatic: MD: -19.1, 95% CI: -34.7 to -3.4). Stroke patients with newly diagnosed AF are at risk of lower quality of life at 12 months, depending on OAC status and AF symptom severity.

Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple – an explorative and comparative single-centre study

BackgroundThe introduction of enhanced recovery programmes (ERP) in pancreatic surgery has significantly improved clinical outcomes by decreasing the length of hospital stay, cost and complications without increasing readmissions and reoperations. To complement evidence on these outcomes, there is a need to explore patients’ perspectives of a structured ERP. Therefore, this study aimed to explore the health-related quality of life (HRQoL) of patients before and after implementing ERP in pancreaticoduodenectomy ad modum Whipple (PD) at a regional surgical centre.MethodThis was an explorative and comparative single-centre study in Sweden. A prospective cohort receiving ERP was included between October 2019 and December 2022 (n = 73) and was compared with a retrospective pre-ERP cohort between October 2011 and December 2013 (n = 65). EQ-5D, the European Organization for Research and Treatment of Cancer (EORCT) Quality of Life Questionnaire Cancer 30 items (QOL-C30), and EORCT Quality of Life Questionnaire pancreatic cancer module (QOL-PAN26) were collected preoperatively and at three and six months postoperatively. Demographic and clinical variables were collected from patient charts. Complications were expressed using the Clavien-Dindo Classification and the Comprehensive Complications Index (CCI).ResultsThere were no significant differences in general health, cancer- or disease-specific HRQoL between the pre-ERP and ERP cohorts. Length of stay was significantly shorter in the ERP cohort (16 vs. 11 days; p < 0.001). There was no significant difference in CCI.ConclusionNo significant differences were found in the HRQoL of patients who participated in an ERP compared to those who did not. However, a significant decrease in LoS was found when ERP was applied.Trial registrationNot applicable.

Muscle atrophy and organ enlargement associated with quality of life during systemic therapy for melanoma: findings from an AI-based body composition analysis.

Health-related quality of life (HRQoL) is emerging as an endpoint, adjunct to survival, in cancer treatment. For this reason, the European Organization for Research and Treatment of Cancer (EORTC) has developed standardized quality-of-life questionnaires to collect patient-reported outcome measurement (PROM), which so far have been widely used in clinical trials to evaluate the impact of new drugs on cancer patients. However, while these questionnaires comprehensively describe patient functions, little is known about their association with patient characteristics. This study aims to bridge this gap and investigate the association between patient body composition and HRQoL. A retrospective cohort of melanoma patients treated with systemic therapy who completed HRQoL questionnaires and had regular imaging follow-ups was included. The primary endpoint was the association between n = 116 AI-measured longitudinal volumes of thoracic and abdominal organs, subcutaneous and visceral fat, skeleton and muscles (estimated by TotalSegmentator), and physical functioning (PF), role functioning (RF) and fatigue (FA) (estimated by the EORTC-QLQ-C30). The n = 358 patients were included. Our findings show larger liver, spleen, and gallbladder volumes associated with decreased PF and RF and an increase in FA (p < 0.05). Furthermore, larger muscle volumes were associated with an increase in PF and RF and a decrease in FA (p < 0.01). Our findings show significant associations between AI-measured body and organ analysis and HRQoL in patients with melanoma on systemic treatment. Future research is needed to understand the underlying cause and determine the possible predictive ability of these imaging features. Question Are changes in body composition associated with changes in HRQoL in melanoma patients undergoing systemic therapy? Findings AI-based body composition analysis shows that larger muscle volumes are linked to improved HRQoL, while organ enlargement is associated with a decline in it. Clinical relevance Our findings indicate new imaging biomarkers that can help monitor patients and evaluate treatment responses. These biomarkers link patient function to physical changes during treatment, offering insights for creating response evaluation criteria that also consider improvements in quality of life.

Impact of FESS on symptomatology and quality of life of patients with CRSsNP.

Chronic rhinosinusitis (CRS) has an impact on health related quality of life (HRQOL). The objective of this study was to examine generic and disease specific HRQOL and symptoms in CRS patients before and 6 months after sinus surgery. This prospective, observational study consisted of 30 patients with chronic sinusitis. Generic and disease specific HRQOL were measured using the Short Form Health Survey (SF 36) and Sino Nasal Outcome Test (SNOT 22). The results revealed that chronic sinusitis has a significant impact on a person's quality of life reflected in the vitality, mental health, social activities, physical pain and perceived health status of patients also a positive correlation emerged between functional endoscopic sinus surgery (FESS) and improvement not only in symptomatology but also overall quality of life. FESS turns out to be a useful and necessary intervention for the improvement of symptomatology related to chronic sinusitis but also for the improvement of the quality of life of individuals who appear to be severely affected by the condition.

Health-related quality of life outcomes between non-steroid and steroid aromatase inhibitors and switching hormone therapy in postmenopausal women with ER+ breast cancer

Adjuvant hormone therapy can affect the quality of life of postmenopausal breast cancer patients with the estrogen receptor (ER+). This study aimed to measure the outcomes of health-related quality of life (HRQoL) in postmenopausal women with ER+ breast cancer receiving non-steroidal aromatase inhibitors (NSAI), steroidal aromatase inhibitors (SAI), and hormone change therapy (Switch). This cross-sectional study was conducted by interviewing women with postmenopausal ER+ breast cancer. The EQ-5D-5L instrument was used to measure and compare utility scores among patients who received NSAI, SAI, and switch therapy. As a result, the average utility score EQ-5D-5L for NSAI is 0.864 (SD = 0.117), significantly different (p = 0.025) from SAI 0.777 (SD = 0.211) and switch 0.776 (SD = 0.071). The conclusion is that NSAI, SAI, and Switch significantly affected HRQoL in postmenopausal breast cancer patients with ER+. NSAI has a better quality of life compared to SAI and Switch.

Health-related quality of life in 62 patients with diffuse low-grade glioma during a non-therapeutic and progression-free phase: a cross-sectional study.

Few studies have evaluated the health-related quality of life (HRQoL) of patients with diffuse low-grade glioma (LGG) during a clinical and radiological monitoring period. We report a cross sectional cohort study of HRQoL in patients with LGG and compare the results with normative population data. We then explore factors associated with HRQoL. We used the European Organisation for Research and Treatment of Cancer QLQ-C30, BN-20 and the Hospital Anxiety and Depression Scale (HADS) to evaluate HRQoL. Averaged QLQC30 and HADS scores were compared with scores of a normative population. A general linear model multivariate analysis of variance was used to investigate the association between HRQoL and independent factors. A total of 62 patients with LGG completed HRQoL questionnaires. Compared with a normative population, LGG patients reported statistical and clinically significant lower cognitive, emotional, role and social functioning. Fatigue, anxiety, depression and sleep disturbances were frequently reported. Awake surgery and preserved high Karnofsky Performance Status were found to be independent prognostic factors for better global HRQoL, while radiotherapy was associated with worsened HRQoL. Despite a non-therapeutic and progression free phase, LGG patients report noticeable limitations in several HRQoL subscales. Our study highlights the importance of HRQoL assessment not only at diagnosis or during active therapeutic stage. Further studies are needed to develop better adapted tools of HRQoL assessment.

Relationship Between Psychological Factors and Health-Related Quality of Life in Patients with Chronic Low Back Pain.

Low back pain has frequently been mentioned as the most common sort of chronic pain, and numerous studies have confirmed its influence on the health-related quality of life (HRQoL). Despite a great deal of research demonstrating the important part that psychological factors play in explaining HRQoL, a therapeutic setting that prioritizes the physical domain still predominates. For this reason, the aim of this study is to assess the relationship between age, pain intensity, pain catastrophizing, depression, anxiety, pain-related anxiety, chronic pain acceptance and the psychological and physical dimensions of HRQoL in patients with chronic low back pain (CLBP). Data were collected from 201 patients with CLBP using sociodemographic data, the SF-36 Health Status Questionnaire (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Pain Anxiety Symptoms Scale Short Form 20 (PASS-20), the Pain Catastrophizing Scale (PCS), the Chronic Pain Acceptance Questionnaire (CPAQ-8) and the Numeric Pain Rating Scale (NRS). The linear regression model for the dependent variable of Physical Health (SF-36 PhyH) was statistically significant (F (7, 201) = 38.951, p < 0.05), explaining 57.6% of the variance regarding the Physical Health dimension of HRQL in patients with CLBP. The linear regression model for the dependent variable of Psychological Health (SF-36 PsyH) was statistically significant (F (7, 200) = 39.049, p < 0.05), explaining 57.7% of the variance regarding the Psychological Health dimension of HRQL in patients with CLBP. The findings of this study confirm that age, pain intensity, depression, pain-related anxiety and chronic pain acceptance are significant predictors of the physical dimension of HRQoL, while pain intensity, anxiety and depression proved to be significant predictors of the psychological dimension of HRQoL in patients with CLBP.

The Impact of Cardiac Telerehabilitation on Health-Related Quality of Life in Patients Undergoing Percutaneous Coronary Intervention (PCI): A Systematic Review Protocol.

Cardiac rehabilitation (CR) is an intervention to improve health and quality of life in patients undergoing percutaneous coronary intervention (PCI). The use of digital technology for healthcare promotion, such as telemedicine, has received growing attention in recent years due to the possibility of offering remote and individualized cardiac rehabilitation to patients undergoing coronary interventions. However, the impact of cardiac telerehabilitation on health-related quality of life (HRQoL) is not fully understood. This systematic review aims to analyze through meta-analyses and synthesized comments the current knowledge on the effectiveness of cardiac telerehabilitation in improving HRQoL in patients undergoing PCI. This manuscript presents a protocol for a systematic review to assess the effects of cardiac telerehabilitation on HRQoL in cardiac patients after PCI. Furthermore, the systematic review will explore the different modalities of remote rehabilitation documented in scientific literature. The literature review protocol was developed according to the PRISMA guidelines for systematic reviews. Search terms were structured according to the PIO (Population-Intervention-Outcome) framework. All relevant available studies will be identified using the main databases (PubMed, Scopus, CINAHL, Web of Science, and the Cochrane Library) and included in the review. Methodological quality and risk of bias will be evaluated using the Crowe Critical Appraisal Tool (CCAT). This review protocol has been registered on PROSPERO (No. CRD42024582933). This systematic review will comprehensively investigate the effects of cardiac telerehabilitation on QoL improvements in patients after PCI.

Health-Related Quality of Life among Patients with Ventricular Assist Devices in Saudi Arabia

Background: End-stage heart failure patients awaiting heart transplant often require Ventricular Assisted Devices (VAD) to support systemic and pulmonary circulation and to improve ventricular function, symptoms, and Health-Related Quality of Life (HRQoL). This study evaluates the health-related quality of life in patients with VAD and was conducted at the Cardio Ventricular Assisted Devices Clinic at King Faisal Specialist Hospital and Research Centre, Riyadh. Methods: This retrospective cohort study design included all eligible VAD patients who were still attending the cardio ventricular assisted devices clinic at KFSHRC, Riyadh. Each study participant was assigned a detailed questionnaire to assess and evaluate HRQoL outcomes measured in physical limitations, emotional stress, sexual activity, and social function from the date of device insertion to the time of data collection. Data were analyzed using the Statistical Package for Social Studies (SPSS 22; IBM Corp., New York, NY, USA). Results: Between February 2016 until June 2020, 26 patients were eligible for the study. The patients' support scores were moderate to high, indicating a positive effect on their HRQoL, with a mean score of 57.69 in emotional activity, a mean score of 34.07 in physical activity, and a mean score of 83.17 in social activity. The study's results show that the level of HRQoL varies among patients with VADs. Conclusion: Participating patients with VAD reported excellent health-related quality of life in all domains, with moderate to high support scores indicating a positive effect on their HRQoL. There is currently a lack of study on HRQoL in patients with VADs in Saudi Arabia. Therefore, this study may provide a baseline understanding of current challenges in the care of heart failure patients with VAD awaiting a heart transplant.

Remote Symptom Monitoring of Patients With Advanced Lung Cancer (The ProWide Study): A Randomized Controlled Trial.

Remote symptom monitoring of patients with cancer has previously shown potential for improving clinical outcomes. This study aimed to evaluate the effects of remote symptom monitoring in patients with lung cancer after palliative induction treatment. In a Danish multicenter randomized controlled trial, patients were randomly assigned 1:1 to remote symptom monitoring (intervention arm) added to standard of care versus standard of care (control arm). Key eligibility criteria were stage III-IV lung cancer (small cell lung cancer and non-small cell lung cancer), Eastern Cooperative Oncology Group performance status ≤2, and no sign of disease progression after initial induction treatment. Patients in the intervention arm completed a weekly electronic questionnaire, assessing 14 common symptoms related to lung cancer. When a patient reported a severity exceeding a predefined threshold, the patient was subsequently contacted by phone to address potential clinical needs. Symptom monitoring was discontinued after progression. The primary outcome was overall survival (OS). Secondary measures included assessment of health-related quality of life (HRQoL). Of 494 randomly assigned patients, 240 were assigned to the intervention arm and 254 were assigned to the control arm. At a median follow-up of 3.5 years, symptom monitoring did not significantly improve OS compared with standard care (hazard ratio [HR], 0.93 [95% CI, 0.75 to 1.16]; P = .53). Exploratory subgroup analyses indicated improved survival for patients treated with carboplatin/vinorelbine (HR, 0.67 [95% CI, 0.45 to 0.98]; P = .04) and in departments with previous implementation of patient-reported outcomes (HR, 0.66 [95% CI, 0.44 to 0.98]; P = .04). HRQoL analyses did not reveal clinically meaningful effects. In the Danish health care system, remote symptom monitoring did not improve OS but led to modest improvements in HRQoL for patients with advanced lung cancer.

TELEPROM Psoriasis: Enhancing patient-centered care and health-related quality of life (HRQoL) in moderate-to-severe plaque psoriasis

Background and purposePsoriasis is a chronic, immune-mediated inflammatory skin disease that significantly impacts patients’ quality of life. The integration of telepharmacy has the potential to enhance patient care by providing flexible and personalized pharmaceutical follow-up. This study (TELEPROM Psoriasis) evaluates a telepharmacy model for evaluating electronic Patient-Reported outcomes (ePROMs) for individuals with moderate to severe plaque psoriasis in Spain with biological treatment.Experimental approachThis multicenter prospective quasi-experimental study included 258 adult patients initiating or switching biological/immunomodulatory therapy for moderate to severe plaque psoriasis. Patients were recruited from public hospitals in Spain and monitored through the NAVETA telepharmacy platform over a six-month period. PROMs assessed were the Psoriasis Symptoms and Signs Diary and the Dermatology Life Quality Index at baseline, 1 month, 3 months, and 6 months. Data were analyzed using ANOVA, Student’s t-test, multiple regression, and machine learning algorithms to evaluate ePROMs evolution and response and satisfaction with Telepharmacy follow up.Key resultsThe analysis revealed significant influences of gender, employment status, educational level, and daily activity, but no effect of age, on responses to Patient-Reported Outcomes questionnaires. Machine learning models, particularly Random Forest (AUC = 0.98) and Support Vector Machine (AUC = 0.96), effectively predicted patient engagement. DLQI scores significantly decreased from 9.33 ± 7.75 at baseline to 4.34 ± 5.86 at 6 months. Similarly, the PSSD - 7 Days questionnaire showed major reductions, with scores dropping from 55.43 ± 29.94 to 30.73 ± 30.66 at 6 months, and 53% of patients reaching a score of 20 or less. Notably, women reported worse scores at all time points compared to men. Regression analysis explained only 13.2% of the variance in PROMs scores, identifying Employment Status and BMI Range as key contributors.ConclusionThis study demonstrates the efficacy of biologic treatments in significantly improving HRQoL for psoriasis patients. Addressing demographic variables, such as gender, is key for optimizing treatment outcomes and improving ePROMs response rates. Tailored strategies and ML techniques can help identify low-engagement patients and mitigate disparities. Integrating sociodemographic factors into clinical decision-making and patient engagement strategies is fundamental for delivering equitable and comprehensive care.

Understanding preoperative health-related quality of life in rotator cuff tear patients: role of patients’ characteristics

BackgroundAssessing health-related quality of life (HRQoL) is a widely employed method in orthopedics to evaluate patient well-being and measure the effectiveness of surgical interventions. Understanding the relationship between specific baseline factors and preoperative HRQoL can help clinicians identify patients at risk for low quality of life and thus, develop preventive strategies that adequately address individual patient needs. The objective was to assess associations between baseline factors and preoperative HRQoL in patients undergoing arthroscopic rotator cuff repair (ARCR).MethodsThis study is part of a multicenter prospective Swiss cohort study that included patients undergoing ARCR between June 2020 and November 2021. Data were derived from baseline and surgery forms. HRQoL was assessed using the European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) questionnaire to calculate EQ-5D index and EQ VAS scores. Univariable and multivariable linear regression models examined associations between the 21 factors and preoperative HRQoL. Final models were determined using stepwise backward regression.ResultsA total of 973 included patients (mean age [SD], 57.3 [9.4] years; 611 men [63%]) had a mean [SD] EQ-5D index and EQ VAS of 0.70 [0.23] and 68.7 [19.8], respectively. Being male (regression coefficient (β), 0.05; 95% CI [0.02–0.08]), having a higher age (β, 0.02; 95% CI [0.01–0.03]) and higher education levels (e.g., university, college: β, 0.11; 95% CI [0.06–0.16]) were associated with a higher EQ-5D index. Increased body mass index (β, -0.02; 95% CI [-0.04 to -0.01]) and worse sleep quality (β, -0.03; 95% CI [-0.04 to -0.03]) were associated with a lower EQ-5D index. Factors negatively associated with overall EQ VAS health were depression (e.g., moderate: β, -12.70; 95% CI [-16.18 to -9.21]), presence of at least one comorbidity (β, -3.71; 95% CI [-5.91 to -1.52]), and pain (β, -1.81; 95% CI [-2.36 to -1.26]).ConclusionOur results suggest that preoperative HRQoL is highly associated with sociodemographic and patient-related factors. Specifically addressing these factors may improve orthopedic care.

Handgrip strength is independently associated with physical quality of life in patients undergoing maintenance hemodialysis: a cross-sectional study.

We aimed to identify the association between Health-related quality of life (HRQoL) and muscle strength in patients undergoing maintenance hemodialysis (MHD). In this cross-sectional study from March 2021 to December 2021, 110 MHD patients with a mean age of 63.9 ± 13.0 years and a median dialysis vintage of 25.5 (12.0-52.3) months, were enrolled at a hemodialysis center in Guangzhou city, China. HRQoL was assessed using the Short Form 36 Health Survey (SF-36) and converted into the Physical Component Summary (PCS) and the Mental Component Summary (MCS). The groups were assigned according to the mean score of PCS and MCS, and those with higher PCS/MCS scores (high-PCS/MCS) were compared with those with lower PCS/MCS scores (low-PCS/MCS). Independent factors were evaluated using multivariate analysis. Muscle strength was estimated by handgrip strength (HGS). The mean HGS was 23.7 ± 9.60 kg in men and 14.3 ± 5.30 kg in women. Compared to the high-PCS group, the low-PCS group had older age, higher levels of creatinine, total cholesterol, high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6), and had lower HGS (all p < 0.05). After adjusting for confounding factors in different models, the five-model multivariate binary logistic regression analyses revealed that HGS was the only independent factor in PCS domain, but not in MCS. HGS may be an independent factor of poor HRQoL in MHD patients, particularly in relation to physical health. The management of muscle strength may improve the HRQoL in MHD patients. The study was registered at https://www.chictr.org.cn/ as ChiCTR2100053790.

Textbook Outcomes and Quality of Life Assessment Following Liver Resection for Colorectal Metastasis.

It is unknown if textbook outcomes (TBOs) correlate with patient-reported health-related quality of life (HRQoL) parameters in patients undergoing hepatic resection for colorectal liver metastasises. Understanding this relationship is required to inform treatment decisions and optimise patient care. This single-centre analysis aims to assess this correlation and provide insight into the impact of liver resection on patient well-being in this population. Single-centre analysis of all liver resections performed for colorectal liver metastases (CRLM) at our centre from 2018 to 2023. The EuroQol-5D (EQ-5D) validated telephone questionnaire was used to assess HRQoL. The impact of a TBO on overall survival and recurrence-free survival was investigated using Kaplan-Meier curve analysis. A Cox model was used to determine factors associated with improved survival. 185 patients underwent liver resection for CRLM between 2018 and 2023. 55% of eligible patients completed the EQ-5D telephone questionnaire. TBOs were achieved in 68.2% of CRLM at our institution. Achieving TBOs in this cohort was associated with improved HRQoL (p = 0.061). This study demonstrates excellent long-term HRQoL in patients who undergo resection for CRLM. Achieving TBO in this cohort is associated with improved patient-reported HRQoL. Our findings strengthen the utility of the previously defined textbook outcomes in CRLM.

Prospective changes in financial toxicity and health-related quality of life in patients with gynecologic cancer.

Financial toxicity impacts the treatment choices, daily life, and health-related quality of life (HRQoL) of cancer patients. We investigated future variations in financial toxicity and HRQoL of patients with gynecologic cancer, evaluated using the COmprehensive Score for financial Toxicity (COST) questionnaire. This multicenter study enrolled patients with gynecologic cancer incurring co-payments for anti-cancer drug treatment for over 2months. Questionnaires were administered at baseline and at the end of follow-up. Patients completed the COST, EORTC-QLQ-C30, EORTC-QLQ-OV28, EORTC-QLQ-CX24, EORTC-QLQ-EN24, and EQ-5D-5L. Paired t-tests were used to compare the initial and follow-up responses. Spearman's rank test was used to examine correlations between COST and HRQoL scores. Ninety-one patients (ovarian, 40; cervical, 18; endometrial, 33) completed the questionnaires at baseline and follow-up. The mean COST score was not significantly different between baseline and end of follow-up (19.56 ± 6.63 and 19.97 ± 7.47, respectively; p = 0.439). Significant correlations were found between COST scores and emotional functioning (r = 0.251, p = 0.023), cognitive functioning (r = 0.254, p = 0.020), and financial difficulties (r = - 0.298, p = 0.006), attitude toward disease/treatment (r = 0.356, p = 0.033), poor body image (r = - 0.362, p = 0.042), back and pelvis pain (r = - 0.451, p = 0.010), and taste change (r = - 0.359, p = 0.040). During anticancer drug therapy for gynecologic cancer, the COST score remained stable and did not correlate with overall HRQoL, although higher scores were associated with worse HRQoL for specific functions and symptoms.

Electronic and paper delivery of parent proxy and children's report of two scar-specific patient-reported outcome measures (Brisbane Burn Scar Impact Profile and Patient and Observer Scar Assessment Scale): An equivalence study.

The Brisbane Burn Scar Impact Profile (BBSIP) and the Patient and Observer Scar Assessment Scale (POSAS) are used in burn scar assessment to quantify patient health-related quality of life (HR-QoL). These questionnaires were developed using pen-and-paper delivery methods; however, there is a push towards electronic delivery of these questionnaires in both clinical practice and research. Equivalence testing is required to ensure that validity of these paper questionnaires is maintained electronically. Participants were presented with a survey containing the BBSIP and POSAS, which was completed twice during a single outpatient appointment using either pen-and-paper or a tablet. Completion order was randomised to: 1) paper-paper; 2) paper-tablet; 3) tablet-paper; and 4) tablet-tablet. Comparison of intraclass correlation coefficients (ICCs), calculated for each BBSIP and POSAS subscale, was conducted with the ICC of the paper-paper group. Participants (n = 104) included 55 caregiver proxies of children aged 8 years or less, 26 caregiver proxies of children aged 8-18 years, and 23 children aged 8-18 years. The majority but not all BBSIP (61 %) and POSAS (81 %) subscales were equivalent. The acceptability of electronic delivery was supported. Findings generally support electronic delivery of the BBSIP and POSAS, likely supporting their use in outpatient clinics, telehealth clinics, and remote monitoring. Additional testing is required for subscales that did not demonstrate equivalence.