Evidence map›Paper›PMID 30266893›Full record

ArticleThe oncologist2019

A Patient-Reported Outcome Instrument to Assess Symptom Burden and Predict Survival in Patients with Advanced Cancer: Flipping the Paradigm to Improve Timing of Palliative and End-of-Life Discussions and Reduce Unwanted Health Care Costs.

Stuart L Goldberg, Dhakshila Paramanathan, Raya Khoury, Sharmi Patel, Dayo Jagun, Srikesh Arunajadai, Victoria DeVincenzo, Ruth Pe Benito, Brooke Gruman, Sukhi Kaur and 7 more

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In one paragraph

Article in The oncologist, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 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

12 citing papers in PubMed, 2 syntheses or guidelines 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

17 authors.

Stuart L GoldbergCota Inc, New York, New York, USA stuartgoldberg@cotahealthcare.com.
Dhakshila ParamanathanCota Inc, New York, New York, USA.
Raya KhouryGenentech, South San Francisco, California, USA.
Sharmi PatelGenentech, South San Francisco, California, USA.
Dayo JagunGenentech, South San Francisco, California, USA.
Srikesh ArunajadaiCota Inc, New York, New York, USA.
Victoria DeVincenzoCota Inc, New York, New York, USA.
Ruth Pe BenitoCota Inc, New York, New York, USA.
Brooke GrumanCota Inc, New York, New York, USA.
Sukhi KaurCota Inc, New York, New York, USA.
Scott PaddockCota Inc, New York, New York, USA.
Andrew D NordenCota Inc, New York, New York, USA.
Eric V SchultzCota Inc, New York, New York, USA.
John HerveyCota Inc, New York, New York, USA.
Terrill JordanRegional Cancer Care Associates, Hackensack, New Jersey, USA.
Andre GoyJohn Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, USA.
Andrew L PecoraCota Inc, New York, New York, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiscussions regarding palliative care and end-of-life care issues are frequently delayed past the time of usefulness, resulting in unwanted medical care. We sought to develop a patient-reported outcome (PRO) instrument that allows patients to voice their symptom burdens and facilitate timing of discussions. SUBJECTS, MATERIALS, AND

methodsA seven-item PRO instrument (Cota Patient Assessed Symptom Score-7 item [CPASS-7]) covering physical performance status, pain, burden, and depression was administered (September 2015 through October 2016) with correlation to overall survival, correcting for time to complete survey since diagnosis.

resultsA total of 1,191 patients completed CPASS-7 at a median of 560 days following the diagnosis of advanced cancer. Of these patients, 49% were concerned that they could not do the things they wanted; 35% reported decreased performance status. Financial toxicity was reported by 39% of patients, with family burdens noted in 25%. Although depression was reported by 15%, 43% reported lack of pleasure. Pain was reported by 33%. The median CPASS-7 total symptom burden score was 16 (possible 0-112). With a median follow-up of 15 months from initial survey, 46% had died. Patients with symptom burden scores <29 and ≥29 had a 6-month overall survival rate of 87% and 67%, respectively, and 12-month survival rates of 72% and 50%. A one-point score increase resulted in a 1.8% increase in expected hazard.

conclusionPatients with advanced cancer with higher levels of symptom burden, as self-reported on the CPASS-7, had inferior survival. The PRO facilitates identification of patients appropriate for reassessment of treatment goals and potentially palliative and end-of-life care in response to symptom burden concerns. IMPLICATIONS FOR PRACTICE: A seven-item patient-reported outcome (PRO) instrument was administered to 1,191 patients with advanced cancers. Patients self-reporting higher levels of physical and psychological symptom burden had inferior overall survival rates. High individual item symptom PRO responses should serve as a useful trigger to initiate supportive interventions, but when scores indicate global problems, discussions regarding end-of-life care might be appropriate.

Indexed as

Patient Reported Outcome MeasuresAgedFemaleHealth Care CostsHumansMaleNeoplasmsPalliative CareQuality of LifeTerminal CareHospiceNeoplasmsPalliative carePatient‐reported outcome measures

Identifiers

PMID30266893
PMCPMC6324621

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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.