Background
Methods
Study population
Timing of assessments
Surveys
Data analyses
Non-response bias
Regression models
Meaningful effects
Results
Sample characteristics
Variable Type | Variablea | Evaluated Respondents (n= 496)b,c | Assessment of Response Biasb | ||
---|---|---|---|---|---|
Follow-up
Survey
Respondents
(
n
= 568)
|
Follow-up
Survey
Non-Respondents
(
n
= 236)
|
p
-value
d
| |||
Sociodemographic | Age at diagnosis (years) [mean (SD)] | 66.8 (10.4) | 66.7 (10.5) | 65.0 (12.1) | 0.07 |
Male | 48.0 | 48.6 | 50.0 | 0.72 | |
Race/ethnicity | |||||
Non-Hispanic White | 80.0 | 79.8 | 67.8 | <0.001 | |
Non-Hispanic Black | 5.7 | 5.6 | 14.0 | ||
Hispanic | 7.5 | 7.0 | 9.3 | ||
Asian/Other | 6.9 | 7.6 | 8.9 | ||
Married/Living as married | 65.9 | 65.7 | 56.6 | 0.02 | |
Education | |||||
High school or less | 38.1 | 38.2 | 44.0 | 0.30 | |
Post high school training/some college | 30.7 | 31.1 | 27.8 | ||
College degree or higher | 31.1 | 30.7 | 28.2 | ||
Working | 28.6 | 28.8 | 29.7 | 0.80 | |
Household Income | |||||
Missing | 8.9 | 10.2 | 11.9 | <0.001 | |
Less than $25,000 | 22.4 | 23.1 | 36.0 | ||
$25,000 to $50,000 | 31.1 | 30.3 | 20.8 | ||
Over $50,000 | 37.7 | 36.4 | 31.4 | ||
Financial problems due to cancer | |||||
Not at all | 76.6 | 77.2 | 66.4 | 0.01 | |
A little | 10.9 | 10.2 | 16.4 | ||
Somewhat | 7.3 | 7.1 | 11.2 | ||
A lot | 5.0 | 5.5 | 6.0 | ||
Cancer/Health-related | Late Stage (Stage IV) | 8.3 | 7.8 | 10.2 | 0.26 |
General Health | |||||
Poor | 5.0 | 5.3 | 5.1 | 0.21 | |
Fair | 23.2 | 22.4 | 23.3 | ||
Good | 38.7 | 38.2 | 41.1 | ||
Very Good | 21.2 | 22.7 | 24.6 | ||
Excellent | 11.9 | 11.4 | 5.9 | ||
Colostomy | 14.5 | 14.5 | 15.7 | 0.67 | |
History of radiation therapy | 15.3 | 17.4 | 19.4 | 0.51 | |
History of chemotherapy | 51.6 | 49.2 | 42.0 | 0.07 | |
Receiving chemotherapy at time of initial survey | 30.9 | 30.1 | 19.5 | 0.002 | |
Comorbidity Index [median (IQR)] | 2 (1–4) | 2 (1–4) | 3 (1–4) | 0.08 | |
Bowel Function [mean (SD)] | 8.6 (2.3) | 8.6 (2.3) | 8.8 (2.4) | 0.42 | |
Time since diagnosis [mean (SD)] | 8.6 (1.7) | 9.2 (2.6) | 9.8 (3.1) | 0.02 | |
Healthcare | Type of Insurance | ||||
Medicare | 24.2 | 24.3 | 28.8 | 0.40 | |
Commercial Insurance | 68.2 | 68.0 | 64.4 | ||
Other/none | 7.7 | 7.8 | 6.8 | ||
Picker problem scores [mean, (SD)] | |||||
Psychosocial Care | 30.6 (28.9) | 30.7 (28.5) | 32.4 (28.1) | 0.45 | |
Access to Care | 10.8 (22.5) | 10.7 (22.4) | 16.7 (26.9) | 0.003 | |
Treatment Information | 30.4 (30.7) | 30.5 (30.9) | 33.9 (33.6) | 0.17 | |
Health Information | 46.1 (33.6) | 46.6 (33.6) | 49.6 (35.7) | 0.25 | |
Confidence in Providers | 11.7 (20.6) | 11.8 (21.4) | 15.5 (26.7) | 0.05 | |
Coordination of Care | 19.4 (23.5) | 19.0 (23.5) | 24.4 (27.4) | 0.008 | |
Control of Nausea/Vomiting (% somewhat/not at all) | 11.3 | 10.9 | 14.0 | 0.22 | |
Control of Pain (% somewhat/not at all) | 10.3 | 10.4 | 18.2 | 0.002 | |
HRQL | Initial HRQL scores [mean, (SD)] | ||||
TOI | 66.6 (12.7) | 66.9 (12.7) | 64.6 (13.7) | 0.02 | |
SWB | 23.2 (4.4) | 23.2 (4.6) | 22.0 (5.1) | 0.002 | |
EWB | 20.4 (3.7) | 20.4 (3.7) | 19.6 (4.5) | 0.02 |
Clinically meaningful change in HRQL
Change in HRQL | TOI | SWB | EWB | |||
---|---|---|---|---|---|---|
n (%)
|
mean (SD)
|
n (%)
|
mean (SD)
|
n (%)
|
mean (SD)
| |
Meaningful Decline | 161 (32.5) | -11.0 (6.2) | 167 (33.7) | -5.2 (3.2) | 130 (26.2) | -4.5 (2.7) |
About the same | 163 (32.9) | .07 (2.0) | 193 (38.9) | -.15 (.85) | 236 (47.6) | .05 (.70) |
Meaningful Improvement | 172 (34.7) | 10.5 (7.3) | 125 (25.2) | 4.2 (2.4) | 130 (26.2) | 3.8 (2.2) |
Prognostic impact on patient-reported HRQL
Predictors of follow-up TOI scores
Variable Type | Variable | B (SE) | p-value |
sr
2
| Effect on follow-up HRQL* |
---|---|---|---|---|---|
HRQL | Initial TOI | .50 (.04) | <.0001 | .179 |
6.39
|
Cancer/Health-related | General health | 1.88 (.48) | <.0001 | .018 | 1.98 |
Healthcare | Treatment information problem score | -.04 (.01) | .005 | .009 | -1.18 |
Adjusted R2: 43.9 |
Predictors of follow-up SWB scores
Variable Type | Variable | B (SE) | p-value |
sr
2
| Effect on follow-up HRQL* |
---|---|---|---|---|---|
HRQL | Initial SWB | .59 (.04) | <.0001 | .222 |
2.59
|
Sociodemographic | Male | -1.08 (.39) | .006 | .010 | -1.08 |
Race/ethnicity (ref = White) | |||||
Black | -.90 (.78) | .25 | .002 | -.90 | |
Hispanic | -2.49 (.69) | .0003 | .016 |
-2.49
| |
Asian/other | -1.15 (.73) | .11 | .003 | -1.15 | |
Married/living as married | 1.10 (.41) | .008 | .009 | 1.10 | |
Cancer/Health-related | General health | .48 (.18) | .009 | .009 | .51 |
Healthcare | Problems with control of pain/discomfort | -1.43 (.61) | .02 | .007 | -1.43 |
Adjusted R2: 39.3 |
Predictors of follow-up EWB scores
Variable Type | Variable | B (SE) | p-value |
sr
2
| Effect on follow-up HRQL* |
---|---|---|---|---|---|
HRQL | Initial EWB | .55 (.04) | <.0001 | .210 |
2.05
|
Cancer/Health-related | General health | .54 (.15) | .0004 | .017 | .56 |
Healthcare | Problems with control of nausea/vomiting | -1.25 (.46) | .007 | .009 | -1.25 |
Adjusted R2: 36.5 |