A barrier to using HRQOL questionnaires for individual patient management is knowing what score represents a problem deserving attention. We explored using needs assessments to identify HRQOL scores associated with patient-reported unmet needs.
This cross-sectional study included 117 cancer patients (mean age 61 years; 51% men; 77% white) who completed the Supportive Care Needs Survey (SCNS) and EORTC QLQ-C30. SCNS scores were dichotomized as “no unmet need” versus “some unmet need” and served as an external criterion for identifying problem scores. We evaluated the discriminative ability of QLQ-C30 scores using receiver operating characteristic (ROC) analysis. Domains with an area under the ROC curve (AUC) ≥ .70 were examined further to determine how well QLQ-C30 scores predicted presence/absence of unmet need.
We found AUCs ≥ .70 for 6 of 14 EORTC domains: physical, emotional, role, global QOL, pain, fatigue. All 6 domains had sensitivity ≥ .85 and specificity ≥ .50. EORTC domains that closely matched the content of SCNS item(s) were more likely to have AUCs ≥ .70. The appropriate cut-off depends on the relative importance of false positives and false negatives.
Needs assessments can identify HRQOL scores requiring clinicians’ attention. Future research should confirm these findings using other HRQOL questionnaires and needs assessments.
Health-related quality of life Needs assessment Clinical practice Cancer Interpretation
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The authors would like to thank David Ettinger, MD, and Charles Rudin, MD, for assistance in recruiting patients and Danetta Hendricks, MA, and Kristina Weeks, BA, BS, for assistance in coordinating the study. Drs. Snyder, Carducci, and Wu and Ms. Blackford are supported by a Mentored Research Scholar Grant from the American Cancer Society (MRSG-08-011-01-CPPB). This research was also supported by the Aegon International Fellowship in Oncology.
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