Abstract
Functional assessment is at the heart of understanding how a chronic disease and its therapy impact on patients. It puts into tangible terms what the patient is capable of and brings an understandable ‘human context’ to the patient burden. Functional status can be a prognostic indicator. It may also have a role in treatment selection for individual patients and be used to enter and stratify patients in clinical trials. It remains to be seen whether it will be possible and practical to use end-points such as function (and other related end-points such as ‘quality of life’) to direct individual patient management. Using cancer cachexia as a paradigm, this chapter sets out to discuss some of the broader issues in functional patient assessment. New approaches to assessing function and preliminary experience with an emerging technology are also presented.
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References
Simons JP, Aaronson NK, Vansteenkiste JF et al (1996) Effects of medroxyprogesterone acetate on appetite, weight, and quality of life in advancedstage non-hormone-sensitive cancer: a placebo-controlled multicenter study. J Clin Oncol 14:1077–1084
Maloney FI, Barthel DW (1965) Functional evaluation: the Barthel Index. MD St Med J 14:61–65
Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186
Rueben DB, Laliberte L, Hiris J, Mor V (1990) A hierarchical exercise scale to measure function at the advanced activities of daily living (AADL) level. J Am Geriatr Soc 38:855–861
Trentini M, Semeraro S, Motta M (2001) Italian Study Group for Geriatric Assessment and Management. Effectiveness of geriatric evaluation and care. One-year results of a multicenter randomized clinical trial. Aging (Milan) 13:395–405
Karnofsky DA, Burchenal JH (1949) The clinical evaluation of chemotherapeutic agents in cancer. In: Macleod CM (ed) Evaluation of chemotherapeutic agents. Columbia University Press, New York, pp 199–205
Anonymous (1979) WHO Handbook for Reporting Results of Cancer Treatment. World Health Organisation, Geneva
Slevin ML, Plant H, Lynch D et al (1988) Who should measure quality of life, the doctor or the patient? Br J Cancer 57:109–112
Blagden SP, Charman SC, Sharpies LD et al (2003) Performance status score: do patients and their oncologists agree? Br J Cancer 89:1022–1027
Zubrod GC, Schneiderman M, Frei E et al (1960) Appraisal of methods for study of chemotherapy of cancer in man: comparative therapeutic trial of nitrogen mustard and triethylene thiophosphamide. J Chron Dis 11:7–33
Schaafsma J, Osoba D (1994) The Karnofsky Performance Status Scale re examined: a cross-validation with the EORTC-C30. Qual Life Res 3:413–424
Schag CC, Heinrich RL (1984) Karnofsky Performance Status revisited: reliability, validity and guidelines. J Clin Oncol 2:193–197
Jatoi A, Hillman S, Stella PJ et al (2003) Daily activities: exploring their spectrum and prognostic impact in older, chemotherapy-treated lung cancer patients. Support Care Cancer 11:460–464
Osoba D (1999) What has been learned from measuring health-related quality of life in clinical oncology. EurJ Cancer 35:1565–1570
Anonymous (1949) World Health Organisation. Constitution in Basic Documents. World Health Organisation, Geneva
McHorney CA, Ware JE, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263
Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organisation for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376
Cella DF, Tulsky DS, Gray G et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin One 11:570–579
Cohen SR, Leis A (2002) What determines the quality of life of terminally ill cancer patients from their own perspective? J Palliat Care 18:48–58
Greisinger AJ, Lorimor RJ, Aday LA et al (1997) Terminally ill cancer patients. Their most important concerns. Cancer Pract 5:147–154
Steinhauser KE, Christakis NA, Clipp EC et al (2000) Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 284:2476–2482
Cella D, Chang CH, Lai JS, Webster K (2002) Advances in quality of life measurements in oncology patients. Semin Oncol 29(Suppl 8):60–68
Waldron D, O’Boyle CA, Kearney M et al (1999) Quality-of-life measurement in advanced cancer: assessing the individual. J Clin Oncol 17:3603–3611
Gough IR, Furnival CM, Schilder L, Grove W (1983) Assessment of the quality of life of patients with advanced cancer. Eur J Cancer Clin Oncol 19:1161–1165
Nordin K, Steel J, Hoffman K, Glimelius B (2001) Alternative methods of interpreting quality of life data in advanced gastrointestinal cancer patients. Br J Cancer 85:1265–1272
Ballatori E (2001) Unsolved problems in evaluating the quality of life of cancer patients. Ann Oncol 12(Suppl 3):S11–S13
Holzner B, Kemmler G, Sperner-Unterweger B et al (2001) Quality of life measurement in oncology—a matter of the assessment instrument? Eur J Cancer 37:2349–2356
Hakamies-Blomqvist L, Luoma ML, Sjostrom J et al (2001) Timing of quality of life (QoL) assessments as a source of error in oncological trials. J Adv Nurs 35:709–716
Conroy T, Bleiberg H, Glimelius B (2003) Quality of life in patients with advanced colorectal cancer: what has been learnt? Eur J Cancer 39:287–294
Wasson J, Keller A, Rubenstein L et al (1992) Benefits and obstacles of health status assessment in ambulatory settings. The clinician’s point of view. The Dartmouth Primary Care COOP Project. Med Care 30:MS42–MS49
Raiten DJ, Talbot JM (eds) (1999) Proceedings of the workshop ‘Clinical Trials for the Treatment of Secondary Wasting and Cachexia: Selection of Appropriate Endpoints’, May 22–23, 1997, Bethesda. J Nutr l29:223S–317S
Jatoi A, Daly BD, Hughes VA et al (2001) Do patients with nonmetastatic non-small cell lung cancer demonstrate altered resting energy expenditure? Ann Thorac Surg 72:348–351
MacDonald N, Easson AM, Mazurak VC et al (2003) Understanding and managing cancer cachexia. J Am Coll Surg 197:143–161
Tisdale MJ (2001) Loss of skeletal muscle in cancer: biochemical mechanisms. Front Biosci 6:D164–D174
Fearon KC, Hansell DT, Preston T et al (1988) Influence of whole body protein turnover rate on resting energy expenditure in patients with cancer. Cancer Res 48:2590–2595
Todorov P, Cariuk P, McDevitt T et al (1996) Characterization of a cancer cachectic factor. Nature 379:739–742
Scott HR, McMillan DC, Brown DJ et al (2003) A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer. Lung Cancer 40:295–299
Persson C, Glimelius B (2002) The relevance of weight loss for survival and quality of life in patients with advanced gastrointestinal cancer treated with palliative chemotherapy. Anticancer Res 22:3661–3668
O’Gorman P, McMillan DC, McArdle CS (1998) Impact of weight loss, appetite, and the inflammatory response on quality of life in gastrointestinal cancer patients. Nutr Cancer 32:76–80
O’Gorman P, McMillan DC, McArdle CS (1999) Longitudinal study of weight, appetite, performance status, and inflammation in advanced gastrointestinal cancer. Nutr Cancer 35:127–129
O’Gorman P, McMillan DC, McArdle CS (2000) Prognostic factors in advanced gastrointestinal cancer patients with weight loss. Nutr Cancer 37:36–40
Sarna L (1993) Fluctuations in physical function: adults with non-small cell lung cancer. J Adv Nurs 18:714–724
Yadav RR, Fossella F, Palmer JL et al (2003) An objective evaluation of functional ability (OEF) in patients with advanced lung cancer. Proc Am Soc Clin Oncol 22:746 (abs)
Simmonds MJ (2002) Physical function in patients with cancer: psychometric characteristics and clinical usefulness of a physical performance test battery. J Pain Symptom Manage 24:404–414
Bennett CL, Greenfield S, Aronow HU et al (1991) Patterns of care related to age of men with prostate cancer. Cancer 67:2633–2641
Newschaffer CJ, Penberthy L, Desch CD et al (1996) The effect of age and comorbidity in the treatment of elderly women with nonmetastatic breast cancer. Arch Intern Med 156:85–90
Johnson JR, Williams G, Pazdur R (2003) End points and United States Food and Drug Administration approval of oncology drugs. J Clin Oncol 21:1404–1411
Schambelan M, Mulligan K, Grunfeld C et al (1996) Recombinant human growth hormone in patients with HIV-associated wasting. A randomized, placebo-controlled trial. Serostim Study Group. Ann Intern Med 125:873–882
Schutz Y,W einsier RL, Hunter GR (2001) Assessment of free-living physical activity in humans: an overview of currently available and proposed new measures. Obes Res 9:368–379
Cella D (1998) Factors influencing quality of life in cancer patients: anemia and fatigue. Semin Oncol 25(3 Suppl 7):43–46
Gibney ER (2000) Energy expenditure in disease: time to revisit? Proc Nutr Soc 59:199–207
Ritz P, Coward WA (1995) Doubly labelled water measurement of total energy expenditure. Diabete Metab 21:241–251
Moses AW, Slater C, Preston T et al (2004) Reduced total energy expenditure and physical activity in cachectic patients with pancreatic cancer can be modulated by an energy and protein dense oral supplement enriched with n-3 fatty acids. Br J Cancer 90:996–1002
Ma J, Barbenel JC (1997) A new ambulatory monitoring instrument of posture and mobility related activities. Biomed Sci Instrum 33:88–93
Matsuoka S, Yonezawa Y, Maki H et al (2003) A microcomputer-based daily living activity recording system. Biomed Sci Instrum 39:220–223
Aminian K, Robert P, Buchser EE et al (1999) Physical activity monitoring based on accelerometry: validation and comparison with video observation. Med Biol Eng Comput 37:304–308
Makikawa M, Kurata S, Kawato M et al (1998) Ambulatory physical activity monitoring system. Medinfo 9 (Pt 1):277–281
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Dahele, M., Fearon, K.C.H. (2006). Functional Parameters of Nutrition. In: Mantovani, G., et al. Cachexia and Wasting: A Modern Approach. Springer, Milano. https://doi.org/10.1007/978-88-470-0552-5_12
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DOI: https://doi.org/10.1007/978-88-470-0552-5_12
Publisher Name: Springer, Milano
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