University of Surrey

Test tubes in the lab Research in the ATI Dance Research

Symptom clusters for revising scale membership in the analysis of prostate cancer patient reported outcome measures: a secondary data analysis of the Medical Research Council RT01 trial (ISCRTN47772397)

Lemanska, Agnieszka, Chen, Tao, Dearnaley, DP, Jena, R, Sydes, MR and Faithfull, Sara (2017) Symptom clusters for revising scale membership in the analysis of prostate cancer patient reported outcome measures: a secondary data analysis of the Medical Research Council RT01 trial (ISCRTN47772397) Quality of Life Research, 26 (8). pp. 2103-2116.

[img]
Preview
Text
10.1007%2Fs11136-017-1548-y.pdf - Version of Record

Download (2MB) | Preview
[img]
Preview
Text (licence)
SRI_deposit_agreement.pdf
Available under License : See the attached licence file.

Download (33kB) | Preview
[img] Text
Full Manuscript 22 03 2017.docx - Accepted version Manuscript
Restricted to Repository staff only
Available under License : See the attached licence file.

Download (980kB)

Abstract

Purpose: To investigate the role of symptom clusters in the analysis and utilisation of Patient-Reported Outcome Measures (PROMs) for data modelling and clinical practice. To compare symptom clusters with scales, and explore their value in PROMs interpretation and symptom management. Methods: A dataset called RT01 (ISCRTN47772397) of 843 prostate cancer patients was used. PROMs were reported with the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI). Symptom clusters were explored with hierarchical cluster analysis (HCA) and average linkage method (correlation >0.6). The reliability of the Urinary Function Scale was evaluated with Cronbach's Alpha. The strength of the relationship between the items was investigated with Spearman's correlation. Predictive accuracy of the clusters was compared to the scales by receiver operating characteristic (ROC) analysis. Presence of urinary symptoms at 3 years measured with the Late Effects on Normal Tissue: Subjective, Objective, Management tool (LENT/SOM) was an endpoint. Results: Two symptom clusters were identified (Urinary Cluster and Sexual Cluster). The grouping of symptom clusters was different than UCLA-PCI Scales. Two items of the Urinary Function Scales (“Number of pads” and “Urinary leak interfering with sex”) were excluded from the Urinary Cluster. The correlation with the other items in the scale ranged from 0.20-0.21 and 0.31-0.39 respectively. Cronbach's Alpha showed low correlation of those items with the Urinary Function Scale (0.14-0.36 and 0.33-0.44 respectively). All Urinary Function Scale items were subject to a ceiling effect. Clusters had better predictive accuracy, AUC = 0.70-0.65, while scales AUC = 0.67-0.61. Conclusion: This study adds to the knowledge on how cluster analysis can be applied for the interpretation and utilisation of PROMs. We conclude that multiple-item scales should be evaluated and that symptom clusters provide an adaptive and study specific approach for modelling and interpretation of PROMs.

Item Type: Article
Subjects : Health Sciences
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
NameEmailORCID
Lemanska, Agnieszkaa.lemanska@surrey.ac.ukUNSPECIFIED
Chen, TaoT.Chen@surrey.ac.ukUNSPECIFIED
Dearnaley, DPUNSPECIFIEDUNSPECIFIED
Jena, RUNSPECIFIEDUNSPECIFIED
Sydes, MRUNSPECIFIEDUNSPECIFIED
Faithfull, SaraS.Faithfull@surrey.ac.ukUNSPECIFIED
Date : 28 March 2017
Identification Number : 10.1007/s11136-017-1548-y
Copyright Disclaimer : © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Uncontrolled Keywords : : Symptom clusters; UCLA-PCI; urinary symptoms; PROMs analysis; summative scores
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 24 Mar 2017 10:41
Last Modified : 08 Sep 2017 08:24
URI: http://epubs.surrey.ac.uk/id/eprint/813848

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year


Information about this web site

© The University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom.
+44 (0)1483 300800