Evidence map›Paper›PMID 28838866›Full record

ArticleJournal of pain and symptom management2018

Stability of Symptom Clusters in Patients With Breast Cancer Receiving Chemotherapy.

Carmen W Sullivan, Heather Leutwyler, Laura B Dunn, Bruce A Cooper, Steven M Paul, Jon D Levine, Marilyn Hammer, Yvette P Conley, Christine A Miaskowski

Abstract read
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In one paragraph

Article in Journal of pain and symptom management, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Trial
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  8. Factors influencing acupuncture regimen completion by breast cancer patients: real-world data from an NCI-designated comprehensive cancer center.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  9. Article
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  11. Latent profile analysis for assessing symptom clusters in women with breast cancer.Journal of cancer survivorship : research and practice · 2026
    Article
  12. Article
  13. Article
  14. The change of symptom clusters in gastric cancer patients during the perioperative period: a longitudinal study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
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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

9 authors.

Carmen W SullivanSchool of Nursing, University of California, San Francisco, California, USA.
Heather LeutwylerSchool of Nursing, University of California, San Francisco, California, USA.
Laura B DunnSchool of Medicine, Stanford University, Palo Alto, California, USA.
Bruce A CooperSchool of Nursing, University of California, San Francisco, California, USA.
Steven M PaulSchool of Nursing, University of California, San Francisco, California, USA.
Jon D LevineSchool of Medicine, University of California, San Francisco, California, USA.
Marilyn HammerDepartment of Nursing, Mount Sinai Medical Center, New York, New York, USA.
Yvette P ConleySchool of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Christine A MiaskowskiSchool of Nursing, University of California, San Francisco, California, USA. Electronic address: chris.miaskowski@ucsf.edu.

Funding

NURSING RESEARCH TRAINING IN SYMPTOM MANAGEMENTT32NR007088 · NINR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LEE, KATHRYN · 1996 to 2015
$7.5M
Symptoms Clusters in Oncology Patients Receiving ChemotherapyR01CA134900 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI AOUIZERAT, BRADLEY E, MIASKOWSKI, CHRISTINE A. · 2009 to 2014
$5.9M
Advancing the Science of Symptom Management in Oncology PatientsK05CA168960 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MIASKOWSKI, CHRISTINE A. · 2013 to 2017
$453k
NCI NIH HHS K05 CA168960NCI NIH HHS R01 CA134900NINR NIH HHS T32 NR007088
6 · The paper itself

Abstract

contextPatients with breast cancer who undergo chemotherapy (CTX) experience between 10 and 32 concurrent symptoms. An evaluation of how these symptoms cluster together and how these symptom clusters change over time may provide insights into how to treat these multiple co-occurring symptoms.

objectivesThe purposes of this study were to determine the occurrence rates and severity ratings for 38 common symptoms, evaluate for differences in the number and types of symptom clusters, and evaluate for changes over time in these symptom clusters (i.e., before CTX, the week after CTX, and two weeks after CTX).

methodsAt each of the assessments, a modified version of the Memorial Symptom Assessment Scale was used to assess the occurrence and severity of the 38 symptoms. Exploratory factor analyses were used to extract the symptom clusters.

resultsAlthough across the two symptom dimensions (i.e., occurrence and severity) and the three assessments, eight distinct symptom clusters were identified, only five were relatively stable across both dimensions and across time (i.e., psychological, hormonal, nutritional, gastrointestinal, and epithelial). Two of the additional clusters varied by time but not by symptom dimension (i.e., sickness behavior and weight change). The CTX neuropathy cluster was identified only at the assessment performed in the week after CTX.

conclusionThese findings provide insights into the most common symptom clusters in patients undergoing CTX for breast cancer. In addition, the most common symptoms within each cluster appear to be relatively stable across the two dimensions, as well as across time.

Indexed as

Antineoplastic AgentsBreast NeoplasmsFactor Analysis, StatisticalFemaleHumansLongitudinal StudiesMaleMiddle AgedSelf ReportSeverity of Illness IndexTime FactorsAntineoplastic Agentsbreast cancerchemotherapysymptom clusterssymptom occurrenceSymptomssymptom severity

Identifiers

PMID28838866
PMCPMC5734998

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Registered trials

None linked

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.