Evidence map›Paper›PMID 27061408›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2016

Who experiences higher and increasing breathlessness in advanced cancer? The longitudinal EPCCS Study.

M Ekström, M J Johnson, L Schiöler, S Kaasa, M J Hjermstad, D C Currow

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01362816 (The European Palliative Care Cancer Symptom Study), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01362816 completednot on this map

The European Palliative Care Cancer Symptom Study (EPCCS). A Prospective Data Collection

TypeobservationalSponsorNorwegian University of Science and TechnologyRan2011 to 2013Enrolled1,739ConditionsCancer
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 4 countries.

M EkströmDiscipline Palliative and Supportive Services, Flinders University, Daws Road, Adelaide, SA, 5001, Australia. pmekstrom@gmail.com.
M J JohnsonHull York Medical School, University of Hull, Hull, UK.
L SchiölerSection of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
S KaasaEuropean Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU) and St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
M J HjermstadEuropean Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU) and St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
D C CurrowDiscipline Palliative and Supportive Services, Flinders University, Daws Road, Adelaide, SA, 5001, Australia.
Flinders University · AUHull York Medical School · GBNorwegian University of Science and Technology · NOSt Olav's University Hospital · NOUniversity of Gothenburg · SE

Funding

Department of Health PB-PG-0609-19066
6 · The paper itself

Abstract

purposeBreathlessness is a major cause of suffering in advanced cancer. We aimed to determine the symptom trajectory in people with advanced cancer and to identify those at increased risk of experiencing higher or increasing breathlessness over time in advanced cancer. PATIENTS AND

methodsThis was an analysis of the multinational, prospective, longitudinal European Palliative Care Cancer Symptom (EPCCS) study. We included adults with confirmed incurable cancer enrolled in palliative care, with prospective monthly assessments for up to 6 months, withdrawal or death, whichever came first. Symptom severity (0-10 numerical rating scales) was analyzed using multivariate random coefficients regression.

resultsA total of 1689 patients (50 % women; mean age 65.7 ± [standard deviation; SD] 12.4 years) were included. Main diagnoses were digestive (31 %), lung (20 %), and breast (17 %) cancers. During a median follow-up of 62 (interquartile range, 0 to 133) days, 65 % were breathless at some point and 36 % of all patients reported moderate/severe breathlessness. The group mean (1.6 points; SD, 2.4) was unchanged over time, but the severity varied markedly between patients and over time. Independent predictors for worse breathlessness were COPD, lung cancer, living alone, lung metastases, anxiety, pain, depression, and lower performance status. Predictors of worsening breathlessness over time were low performance status (p = 0.039) and moderate to severe pain (p = 0.012).

conclusionIn the largest longitudinal clinical study to date in advanced cancer alone, breathlessness was frequent and associated with factors including respiratory disease, other concurrent unpleasant symptoms, and impaired performance status. Increase in severity over time was predicted by performance status and pain.

Indexed as

AgedDyspneaFemaleHumansInternationalityLongitudinal StudiesMaleNeoplasmsProspective StudiesRisk FactorsBreathlessnessCancerCOPDPainPalliative carePredictor

Identifiers

PMID27061408
OpenAlexW2327994081

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.