Evidence map›Paper›PMID 33011919›Full record

ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2021

A non-compensatory analysis of quality of life in breast cancer survivors using multivariate hidden Markov modeling.

Edward H Ip, Beverly J Levine, Nancy E Avis

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 47% 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.

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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
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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

3 authors at 2 institutions in 1 country.

Edward H IpDepartment of Biostatistics and Data Science, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA. eip@wakehealth.edu.ORCID http://orcid.org/0000-0002-4811-4205
Beverly J LevineDepartment of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
Nancy E AvisDepartment of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
Wake Forest University · USAtrium Health Wake Forest Baptist · US

Funding

Tumor Tissue CoreP30CA012197 · NCI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Ruben A. Mesa · 1985 to 2026
$55.4M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
Comprehensive Cancer Center of Wake Forest University CCOP Research BaseU10CA081851 · NCI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI SHAW, EDWARD G · 1999 to 2013
$22.0M
NCATS NIH HHS UL1 TR001420NCI NIH HHS P30 CA012197NCI NIH HHS U10 CA081851NIH HHS UL1TR001420-01U.S. Department of Defense DAMD17-01-1-0447
6 · The paper itself

Abstract

purposeHealth-related quality of life (HRQoL) is a multidimensional concept comprising multiple domains such as physical, emotional, and social well-being. Many analyses use a sum score to represent the construct. However, this approach implies that gain in one domain can compensate for a deficit in another, and thus such analyses may not capture HRQoL profiles. Additionally, within-individual change over time, such as improvement in one domain but deterioration in another, may not be detected. The objectives of this research are to demonstrate the utility of a non-compensatory approach by (1) evaluating this approach applied to HRQoL data, and (2) comparing the approach to a compensatory method.

methodsData from a sample of 653 breast cancer survivors (BCS) provided five measurement time points over 18 months. We analyzed the scores from five domains on the FACT-B questionnaire (physical, functional, social, and emotional well-being and breast cancer-related concerns) using the multivariate hidden Markov model (MHMM), a non-compensatory approach that identifies different HRQoL states and associated BCS subgroups and their trajectories.

resultsThe MHMM delineated six states. States 1 and 2 had low well-being scores across all domains, with state 2 slightly better than state 1. States 3 and 4 had similar overall HRQoL scores, but different profiles with compensation occurring across the domains of both physical and social well-being. States 5 and 6 had almost identical overall scores with compensation occurring between the domains of both social and emotional well-being. Over time, states 3-6 mostly "communicated" with each other (with moderate probabilities of transitioning between states). Compensation across domains could mask subtle changes occurring in BCS. We found that a trend analysis using both compensatory and non-compensatory approaches showed improvement in the HRQoL in BCS over time.

conclusionThe non-compensatory analysis of FACT-B shows differential profiles and trajectories in the HRQoL of BCS not captured by the sum score or one-domain-at-a-time approach.

Indexed as

Breast NeoplasmsCancer SurvivorsFemaleHumansMarkov ChainsMental HealthMiddle AgedQuality of LifeSurveys and QuestionnairesEmotional well-beingFACT-BMasking due to compensationSocial well-beingSum scoreTransition analysis

Identifiers

PMID33011919
PMCPMC7887059
OpenAlexW3091500195

What OpenQuestion holds

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LicenceTDM
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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.