COSMIN database

Measuring symptoms in gastrointestinal cancer: a systematic review of assessment instruments

Authors:
Pullmer, R., Linden, W., Rnic, K., and Vodermaier, A.
Abstract:
PURPOSE: It is critical for gastrointestinal cancer researchers and clinicians to have access to comprehensive, sensitive and simple-to-use symptom measures that allow them to understand and quantify the subjective patient experience. Development and validation of such scales requires training in psychometrics and occasionally uses technical jargon that can be difficult to penetrate. This review evaluates existing measures of gastrointestinal cancer symptoms, provides tool descriptions, and uses predefined, objective quality criteria to rate psychometric quality and facilitate tool choices for researchers and clinicians.

METHODS: MEDLINE, EMBASE, CINAHL, and PsycINFO databases were systematically reviewed for scales assessing gastrointestinal cancer and gastrointestinal cancer site-specific symptoms. Evaluation criteria were the following: breadth of domain coverage (content validity), high internal consistency (alpha >/= .80), sensitivity to change, and extent of validation.

RESULTS: In n = 36 validation studies, 26 gastrointestinal cancer symptom measures were identified. Of these, n = 13 tools met criteria for recommendation, and six in particular showed strong psychometric properties. The Functional Assessment of Cancer Therapy-Colorectal (FACT-C), European Organization for Research and Treatment of Cancer (EORTC) gastric cancer module (QLQ-STO22), FACT-Hepatobiliary (FACT-Hep), and EORTC oesophagus, oesophago-gastric junction and stomach module (QLQ OG-25) were identified as the most comprehensive and best validated scales for each of the major gastrointestinal cancer sites. The FACT-Colorectal Symptom Index (FCSI-9) and the National Comprehensive Cancer Network (NCCN) FACT-Hepatobiliary Symptom Index (FHSI-18) were specifically validated in patients with advanced colorectal and liver cancer and also demonstrated superior psychometric properties.

CONCLUSIONS: Several comprehensive, well-validated scales exist to adequately assess gastrointestinal cancer site-specific symptoms. Specifically, gastrointestinal cancer submodules of the FACT quality of life questionnaire represent adequate tool choices in most instances and overall, were better validated than the respective EORTC tools. Further improvement of existing, highly rated measures is recommended.
DOI:
10.1007/s00520-014-2250-z
URL:
https://www.ncbi.nlm.nih.gov/pubmed/24865875
Journal:
Support Care Cancer
issn:
1433-7339 (Electronic)
Publication year:
2014
pages:
2941-55
Symptom status:
Physical state
Functional status:
Physical functioning
Overall quality of life:
Overall quality of life
Age:
Adults (18-65)
Seniors (65+)
Disease:
Neoplasms and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
Instrument:
Adelstein Symptom Scale
DAUGS20 - Dysfunction After Upper Gastrointestinal Surgery scoring system
EORTC QLQ-CR29 - European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Colorectal Cancer 29 [alias: QLQ-CR29]
EORTC QLQ-HCC18 - the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Module for Hepatocellular Carcinoma
EORTC QLQ-OES18 - European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire in patients with oesophageal cancer 18 items
EORTC QLQ-OG25 - European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Oesophagus,Oesophago-Gastric Junction and Stomach Module
EORTC QLQ-STO22 - European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire in patients with gastric cancer 22 item
EQOL - Esophageal Quality of Life Questionnaire
FACT-C - Functional Assessment of Cancer Therapy-Colorectal
FACT-E - Functional Assessment of Cancer Therapy-Esophageal cancer
FACT-Ga - Functional Assessment of Cancer Therapy Gastric cancer subscale
FACT-Hep - Functional Assessment of Cancer Therapy-Hepatobiliary questionnaire
FCSI-19 - National Comprehensive Cancer Network (NNCN) FACT Colorectal Cancer Symptom Index-19
FCSI-9 - Functional Assessment of Cancer Therapy Colorectal Symptom Index-9 items
FHSI-18 - National Comprehensive Cancer Network (NCCN) FACT Hepatobiliary Cancer Symptom Index-18
FHSI-8 - National Comprehensive Cancer Network (NCCN) Functional Assessment of Cancer Therapy (FACT)-Hepatobiliary Symptom Index-8
GIQLI - Gastrointestinal Quality of Life Index
LDQOL - Liver Disease Quality of Life questionnaire
Modified FIQL - Modified Fecal Incontinence Quality of Life
MSKCC Bowel Function - Memorial Sloan Kettering Cancer Center Bowel Function
PGI - Patient Generated Index
QLICP-ST - Quality of Life Instruments for Cancer Patients-Stomach Cancer
QLIP-CR - Quality of Life Instruments for Cancer Patients: Colorectal Cancer
QLQ-LMC21 - Liver Metastases from Colorectal Cancer-specific Quality-of-Life Questionnaire Module
QOL-LC - Quality of Life Instrument for Patients with Liver Cancer
SBFQ - Subjective Bowel Function Questionnaire