Introduction
Methods
Sample/participants
Data collection
Measures
RS-SC
EORTC QLQ-C30
CD-RISC
HADS
ALI
Data analysis
Results
Demographics
Characteristics (%) | Lung cancer | Gastric cancer | Colon-rectal cancer | Liver cancer | Leukemia | Breast cancer |
---|---|---|---|---|---|---|
No | 102 (13.3) | 154 (20.1) | 98 (12.8) | 81 (10.6) | 74 (9.7) | 256 (33.5) |
Sex | ||||||
Female | 29 (28.4) | 73 (47.4) | 50 (51.0) | 29 (35.8) | 34 (45.9) | 256 (100.0) |
Man | 73 (71.6) | 81 (52.6) | 48 (49.0) | 52 (64.2) | 40 (54.1) | 0 (0.0) |
Age (years, SD) | 44.7 (17.1) | 57.1 (16.9) | 53.1 (14.8) | 46.8 (13.9) | 39.1 (16.9) | 39.3 (14.7) |
Time since first confirmed diagnosis (months, SD) | 14.1 (12.0) | 17.8 (8.7) | 20.9 (12.5) | 9.9 (10.1) | 8.1 (6.9) | 5.2 (6.1) |
Duration of treatment (months, SD) | 6.7 (5.5) | 11.9 (8.0) | 15.9 (9.2) | 6.3 (5.4) | 7.1 (8.0) | 4.6 (7.4) |
Education level | ||||||
Middle school or lower | 58 (56.9) | 91 (59.1) | 52 (53.1) | 42 (51.9) | 43 (58.1) | 112 (43.8) |
High school or higher | 44 (43.1) | 63 (40.9) | 46 (46.9) | 39 (48.1) | 31 (41.9) | 144 (56.2) |
Family income (RMB per month) | ||||||
< 5000 | 47 (46.1) | 85 (55.2) | 49 (50.0) | 39 (48.1) | 34 (45.9) | 97 (37.9) |
5000–10,000 | 28 (27.5) | 41 (26.6) | 26 (26.5) | 32 (39.5) | 28 (37.8) | 116 (45.3) |
> 10,000 | 27 (26.4) | 28 (18.2) | 23 (23.5) | 10 (12.4) | 12 (16.2) | 43 (16.8) |
Marital status | ||||||
Married | 85 (83.3) | 124 (80.5) | 77 (78.6) | 62 (76.5) | 58 (78.4) | 157 (61.3) |
Single or other | 17 (16.7) | 30 (19.5) | 21 (21.4) | 19 (23.5) | 16 (21.6) | 99 (38.7) |
Religious beliefs | ||||||
Yes | 18 (17.6) | 41 (26.6) | 28 (28.6) | 28 (34.6) | 21 (28.4) | 65 (25.4) |
None | 84 (82.4) | 113 (73.4) | 70 (71.4) | 53 (65.4) | 53 (71.6) | 191 (74.6) |
Employment status | ||||||
Employment | 54 (52.9) | 76 (49.4) | 43 (43.9) | 30 (37.0) | 38 (51.4) | 162 (63.3) |
Unemployment | 48 (47.1) | 78 (50.6) | 55 (56.1) | 51 (63.0) | 36 (48.6) | 94 (36.7) |
Stage of cancer | ||||||
I | 15 (14.7) | 19 (12.3) | 21 (21.4) | 15 (18.5) | NA | 77 (30.1) |
II | 29 (28.4) | 71 (46.1) | 23 (23.5) | 28 (34.6) | NA | 87 (34.0) |
III | 41 (40.2) | 46 (29.9) | 32 (32.7) | 25 (30.9) | NA | 74 (28.9) |
IV | 17 (16.7) | 18 (11.7) | 22 (22.4) | 13 (16.0) | NA | 18 (7.0) |
Type of therapy | ||||||
Chemo | 41 (40.2) | 63 (40.9) | 45 (45.9) | 57 (70.4) | 56 (75.7) | 146 (57.0) |
Radiation | 23 (22.5) | 32 (20.8) | 30 (30.6) | 31 (38.3) | 13 (17.6) | 54 (21.1) |
Surgery | 22 (21.6) | 84 (54.5) | 57 (58.2) | 37 (45.7) | 10 (13.5) | 138 (53.9) |
Combordities | ||||||
None | 25 (34.3) | 55 (35.7) | 26 (26.5) | 25 (30.9) | 40 (54.1) | 152 (59.4) |
One | 36 (35.3) | 62 (40.3) | 41 (41.8) | 38 (46.9) | 24 (32.4) | 83 (32.4) |
Two or more | 41 (40.2) | 37 (24.0) | 31 (31.7) | 18 (22.2) | 10 (13.5) | 21 (8.2) |
Correlations between RS-SCs and anchors at baseline (T0)
Variables | Mean (SD) | Score range | Item No | Cronbach α | RS-SC-10 | RS-SC-25 | ||
---|---|---|---|---|---|---|---|---|
r (95%CI) | P | r (95%CI) | P | |||||
QoL GHS | 55.73 (20.62) | 0–100 | 1 | NA | 0.54 (0.48 to 0.59) | < 0.001 | 0.51 (0.45 to 0.57) | < 0.001 |
QoL PF | 64.86 (29.37) | 0–100 | 5 | 0.85 | 0.39 (0.32 to 0.45) | < 0.001 | 0.38 (0.31 to 0.44) | < 0.001 |
QoL RF | 47.89 (19.89) | 0–100 | 2 | 0.79 | 0.56 (0.50 to 0.61) | < 0.001 | 0.53 (0.47 to 0.58) | < 0.001 |
QoL EF | 40.54 (16.91) | 0–100 | 4 | 0.86 | 0.65 (0.60 to 0.69) | < 0.001 | 0.60 (0.55 to 0.65) | < 0.001 |
QoL CF | 58.97 (21.12) | 0–100 | 2 | 0.74 | 0.53 (0.47 to 0.58) | < 0.001 | 0.52 (0.46 to 0.57) | < 0.001 |
QoL SF | 68.78 (30.66) | 0–100 | 2 | 0.76 | 0.61 (0.56 to 0.66) | < 0.001 | 0.57 (0.51 to 0.62) | < 0.001 |
CD-RISC-25 | 46.34 (21.88) | 0–100 | 25 | 0.83 | 0.64 (0.59 to 0.68) | < 0.001 | 0.59 (0.54 to 0.64) | < 0.001 |
CD-RISC-10 | 18.85 (6.93) | 0–40 | 10 | 0.85 | 0.73 (0.69 to 0.76) | < 0.001 | 0.67 (0.62 to 0.71) | < 0.001 |
CD-RISC-2 | 3.48 (1.46) | 0–8 | 2 | 0.74 | 0.51 (0.45 to 0.57) | < 0.001 | 0.48 (0.42 to 0.54) | < 0.001 |
HADS total | 18.08 (6.95) | 0–42 | 14 | 0.80 | − 0.59 (− 0.64 to − 0.54) | < 0.001 | − 0.56 (− 0.61 to − 0.50) | < 0.001 |
HADS-A | 8.43 (3.12) | 0–21 | 7 | 0.84 | − 0.46 (− 0.52 to − 0.40) | < 0.001 | − 0.45 (− 0.51 to − 0.39) | < 0.001 |
HADS-D | 9.65 (3.89) | 0–21 | 7 | 0.87 | − 0.68 (− 0.72 to − 0.64) | < 0.001 | − 0.59 (− 0.64 to − 0.54) | < 0.001 |
ALI | 5.86 (2.87) | 0–14 | 14 | NA | − 0.45 (− 0.51 to − 0.39) | < 0.001 | − 0.43 (− 0.49 to − 0.36) | < 0.001 |
Correlations between changes in RS-SCs and changes in anchors from T0 to T1
Variables | Changes (95%CI) | Effect size | RS-SC-10 | RS-SC-25 | ||
---|---|---|---|---|---|---|
r (95%CI) | P | r (95%CI) | P | |||
QoL GHS | 5.13 (3.34 to 7.20) | 0.26 | 0.38 (0.28 to 0.47) | < 0.001 | 0.32 (0.22 to 0.41) | < 0.001 |
QoL PF | 1.21 (0.96 to 1.51) | 0.05 | 0.15 (0.04 to 0.26) | 0.092 | 0.18 (0.08 to 0.28) | 0.004 |
QoL RF | 2.52 (2.30–2.79) | 0.16 | 0.31 (0.21 to 0.41) | < 0.001 | 0.26 (0.16 to 0.35) | < 0.001 |
QoL EF | 4.04 (3.63 to 4.39) | 0.23 | 0.39 (0.29 to 0.48) | < 0.001 | 0.33 (0.23 to 0.42) | < 0.001 |
QoL CF | 0.55 (0.37 to 0.74) | 0.03 | 0.16 (0.05 to 0.27) | 0.061 | 0.17 (0.07 to 0.27) | 0.029 |
QoL SF | 3.51 (3.19–3.81) | 0.13 | 0.32 (0.22 to 0.42) | < 0.001 | 0.32 (0.22 to 0.41) | < 0.001 |
CD-RISC-25 | 6.12 (5.54 to 6.81) | 0.27 | 0.36 (0.26 to 0.45) | < 0.001 | 0.34 (0.24 to 0.43) | < 0.001 |
CD-RISC-10 | 1.22 (0.97 to 1.54) | 0.21 | 0.44 (0.35 to 0.52) | < 0.001 | 0.38 (0.29 to 0.47) | < 0.001 |
CD-RISC-2 | 0.24 (0.18 to 0.29) | 0.19 | 0.32 (0.22 to 0.42) | < 0.001 | 0.29 (0.19 to 0.38) | < 0.001 |
HADS total | − 1.26 (− 1.45 to − 1.07) | − 0.22 | − 0.38 (− 0.47 to − 0.28) | < 0.001 | − 0.34 (− 0.43 to − 0.24) | < 0.001 |
HADS-A | − 0.51 (− 0.64 to − 0.38) | − 0.19 | − 0.35 (− 0.44 to − 0.25) | < 0.001 | − 0.30 (− 0.39 to − 0.20) | < 0.001 |
HADS− D | − 0.75 (− 0.89 to − 0.60) | − 0.23 | − 0.41 (− 0.50 to − 0.31) | < 0.001 | − 0.36 (− 0.45 to − 0.27) | < 0.001 |
ALI | − 0.27 (− 0.32 to − 0.22) | − 0.11 | − 0.19 (− 0.29 to − 0.08) | 0.001 | − 0.20 (− 0.30 to − 0.10) | < 0.001 |
MCID estimation of RS-SCs from T0 to T1
Scales | T0 | T1 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
S.E.M | MDC90 | MDC95 | 0.2SD | 0.3SD | 0.5SD | S.E.M | MDC90 | MDC95 | 0.2SD | 0.3SD | 0.5SD | |
RS-SC-10 | 3.28 | 7.66 | 9.10 | 1.70 | 2.54 | 4.24 | 3.74 | 8.72 | 10.35 | 1.81 | 2.72 | 4.53 |
RS-SC-25 | 8.01 | 18.70 | 22.21 | 3.78 | 5.67 | 9.45 | 10.35 | 24.15 | 28.68 | 4.75 | 7.12 | 11.87 |
Indicators | Scale | Anchors | Mean change (95%CI) | Effect Size | Cut-off | Sen | Spe | YI | AUC | P |
---|---|---|---|---|---|---|---|---|---|---|
aImprovement | RS-SC-10 | QoL GHS | 3.62 (3.34 to 3.91) | 0.48 | 2.00 | 0.62 | 0.69 | 0.31 | 0.68 | < 0.001 |
CD-RISC-10 | 3.29 (3.10 to 3.48) | 0.41 | 2.00 | 0.71 | 0.69 | 0.40 | 0.73 | < 0.001 | ||
HADS-A | 3.05 (2.79 to 3.20) | 0.40 | 2.00 | 0.61 | 0.66 | 0.27 | 0.67 | < 0.001 | ||
HADS-D | 3.42 (3.18 to 3.66) | 0.44 | 2.00 | 0.69 | 0.64 | 0.33 | 0.69 | < 0.001 | ||
RS-SC-25 | QoL GHS | 9.31 (8.83 to 9.81) | 0.51 | 5.50 | 0.58 | 0.67 | 0.25 | 0.65 | < 0.001 | |
CD-RISC-10 | 8.56 (8.23 to 8.91) | 0.41 | 5.50 | 0.72 | 0.65 | 0.37 | 0.70 | < 0.001 | ||
HADS-A | 8.78 (8.29 to 9.29) | 0.44 | 5.50 | 0.59 | 0.67 | 0.26 | 0.66 | < 0.001 | ||
HADS-D | 8.97 (8.50 to 9.44) | 0.48 | 5.50 | 0.70 | 0.61 | 0.31 | 0.68 | < 0.001 | ||
bDeterioration | RS-SC-10 | QoL GHS | − 2.59 (− 2.79 to − 2.39) | − 0.35 | − 1.50 | 0.64 | 0.68 | 0.32 | 0.69 | < 0.001 |
CD-RISC-10 | − 2.26 (− 2.39 to − 2.14) | − 0.28 | − 1.50 | 0.71 | 0.71 | 0.42 | 0.74 | < 0.001 | ||
HADS-A | − 2.61 (− 2.77 to − 2.43) | − 0.34 | − 1.50 | 0.60 | 0.66 | 0.26 | 0.66 | < 0.001 | ||
HADS-D | − 2.48 (− 2.65 to − 2.32) | − 0.32 | − 1.50 | 0.74 | 0.67 | 0.41 | 0.72 | < 0.001 | ||
RS-SC-25 | QoL GHS | − 6.81 (− 7.18 to − 6.42) | − 0.37 | − 4.50 | 0.61 | 0.68 | 0.29 | 0.68 | < 0.001 | |
CD-RISC-10 | − 6.19 (− 6.64 to − 5.93) | − 0.29 | − 4.50 | 0.72 | 0.69 | 0.41 | 0.73 | < 0.001 | ||
HADS-A | − 7.05 (− 7.39 to − 6.70) | − 0.36 | − 4.50 | 0.59 | 0.68 | 0.27 | 0.66 | < 0.001 | ||
HADS-D | − 6.79 (− 7.11 to 6.47) | − 0.36 | − 4.50 | 0.72 | 0.64 | 0.36 | 0.70 | < 0.001 |
Scale | Approach | Anchor/method | MCID estimate | |
---|---|---|---|---|
Improvement | Deterioration | |||
RS-SC-10 | Distribution | S.E.M | 3.51a | − 3.51a |
Distribution | 0.5SD | 4.39a | − 4.39a | |
Linear regression | QoL GHS | 3.62 | − 2.59 | |
Linear regression | CD-RISC-10 | 3.29 | − 2.26 | |
Linear regression | HADS-A | 3.05 | − 2.61 | |
Linear regression | HADS-D | 3.42 | − 2.48 | |
ROC | QoL GHS | 2.00 | − 1.50 | |
ROC | CD-RISC-10 | 2.00 | − 1.50 | |
ROC | HADS-A | 2.00 | − 1.50 | |
ROC | HADS-D | 2.00 | − 1.50 | |
RS-SC-25 | Distribution | S.E.M | 9.18 a | − 9.18 a |
Distribution | 0.5SD | 10.66 a | − 10.66 a | |
Linear regression | QoL GHS | 9.31 | − 6.81 | |
Linear regression | CD-RISC-10 | 8.56 | − 6.19 | |
Linear regression | HADS-A | 8.78 | − 7.05 | |
Linear regression | HADS-D | 8.97 | − 6.79 | |
ROC | QoL-total | 5.50 | − 4.50 | |
ROC | CD-RISC-10 | 5.50 | − 4.50 | |
ROC | HADS-A | 5.50 | − 4.50 | |
ROC | HADS-D | 5.50 | − 4.50 |