ObjectiveTo investigate the preoperative symptom burden and quality of life of patients undergoing lung cancer surgery.MethodsThis study was a cross-sectional study. We used the MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) and the single-item quality of life scale (UNISCALE) to collect the preoperative patient-reported outcomes of 265 patients with lung cancer from November 2017 to July 2019 in Sichuan Cancer Hospital.ResultsOf 265 patients, 90.9% had preoperative symptoms. The five most common symptoms were coughing (66.8%), dry mouth (53.6%), memory problems (52.8%), disturbed sleep (52.1%) and fatigue (44.2%). The five most common moderate to severe symptoms were disturbed sleep (23.0%), distress (18.5%), memory problems (16.6%), coughing (16.2%) and dry mouth (16.2%). Patients with early-stage lung cancer had less pain, fatigue, shortness of breath, lack of appetite, numbness and coughing, and their symptoms had less impact on work (including housework), relations with other people, walking and enjoyment of life as well as better quality of life before surgery (P<0.05). Patients with adenocarcinoma had milder coughing and a better quality of life before surgery (P<0.05). Symptom score was positively correlated with symptom interference with life score (r=0.66, P<0.01) and negatively correlated with quality of life score (r=-0.41, P<0.01).ConclusionMost patients undergoing lung cancer surgery have a mild symptom burden before surgery. The most common and severe symptoms are coughing, dry mouth, lung cancer and disturbed sleep. Patients with early-stage lung cancer have a milder symptom burden and a better quality of life.
Esophageal carcinoma is a malignant tumor with high morbidity and mortality worldwide, and surgery is the main treatment currently. With the development of patient-centered care, the effect of surgery should not be limited to the improvement of the incidence of postoperative complications, mortality and other indicators. It is also important to provide experience related to disease and surgery from the perspective of patients. Therefore, more and more attention is paid to patient-reported outcomes by scholars. This paper will provide an overview of the international widely used, reliable and effective scales and researches about patient-reported outcomes in esophageal carcinoma.
Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.
Objective To analyse the consistency of perioperative self-reported pain scores of lung cancer patients with clinical records to provide a basis for optimal pain management. MethodsThe patients with lung cancer who underwent surgical treatment in the Department of Thoracic Surgery, Sichuan Cancer Hospital from November 2017 to January 2020 were selected. They were divided into two groups based on the source of pain data. The self-report group used a questionnaire in which patients self-reported their pain scores, and the pain scores for the clinical record group were extracted from the electronic medical record system. Kappa test was used to compare the concordance of pain scores between the two groups preoperatively, on postoperative 1-6 days and on the day of discharge. McNemar's paired χ2 test was used to compare the differences in pain intensity levels between the two groups. Binary logistic multi-factor regression was used to analyse the factors influencing the concordance of severe pain (7-10 points) between the two groups. Results Totally 354 patients were collected, including 191 males and 163 females, with an average age of 55.64±10.34 years. The median postoperative hospital stay was 6 days. The consistency of pain scores between the two groups was poor (Kappa=–0.035 to 0.262, P<0.05), and the distribution of pain levels at each time point was inconsistent and statistically significant (P<0.001). The percentage of inconsistent severe pain assessment ranged from 0.28% to 35.56%, with the highest percentage of inconsistent severe pain assessment on postoperative day 1 (35.56%). Single-port thoracoscopic surgical access was an influencing factor for inconsistent assessment of severe pain on postoperative day 3 (OR=2.571, P=0.005). Conclusion Self-reported perioperative pain scores of lung cancer patients are poorly aligned with clinical records. Clinical measures are needed to improve the accuracy of patient pain data reporting by choosing the correct assessment method, increasing education, and developing effective quality control measures.
ObjectiveTo summarize the applied research status on the evaluation tools of patient-reported outcome at home and abroad in patients with venous thromboembolism (VTE). MethodBy searching and analyzing the literatures, this paper summarized the concept, evaluation tools and application status of patient-reported outcome in the field of VTE. ResultsThe patient-reported outcomes can more comprehensively and accurately evaluate the disease burden and treatment effect of patients with venous thromboembolism, and can help doctors better understand patients' needs and guide individualized treatment and rehabilitation plans. ConclusionsPatient-reported outcome has a broad application prospect in the field of venous thromboembolism. Further promotion and application of patient-reported outcome can promote the development of medical research and provide reference guidelines for improving the management of patients with venous thromboembolism.
Objective To comprehensively analyze the research trends in the reported outcomes for lung cancer patients and related management, reveal research hotspots and trends, and provide references for future related research. Method We searched for relevant literature in the Web of Science core databases, PubMed, and Scopus databases from inception to December 31, 2023. CiteSpace bibliometric software was used to analyze the distribution of authors, countries and regions, research institution, keyword co-occurrence, keyword emergence, and draw keyword clusters and timeline analysis maps. Result A total of 479 qualified literatures were included, and the number of published papers showed an overall upward trend. The highest number of articles are issued in the United States. The journal with the highest number of articles is Journal of Pain and Symptom Management, and the journal with the highest citation frequency is Journal of Clinical Oncology. The results of keyword outburst analysis showed that hot topics were mainly focused on "prospective study", "physical activity", "exercise", "vomiting", "survival". ConclusionAlthough the research on lung cancer surgical treatment and the management of patients is developing rapidly, the application of management based on reported outcomes of lung cancer patients in lung cancer surgery is still in the exploratory stage and needs to be continuously improved in clinical research and clinical practice. The establishment of relevant assessment systems needs to be improved. In the future, more researchers need to focus on this area, strengthen multi-regional and multi-institutional collaborations, and accelerate research progress in the management of reported outcomes in lung cancer patients.
ObjectiveTo develop a symptom and function assessment scale for patients after Nuss procedure for pectus excavatum and to test its reliability and validity. MethodsFollowing the principles and procedures of patient-reported outcome (PRO) scale development stipulated by the U.S. Food and Drug Administration, an initial draft was formed through literature analysis, qualitative interviews, and Delphi expert consultation. The preliminary draft was used to conduct a pre-survey on patients who underwent Nuss procedure for pectus excavatum at Guangdong Provincial People's Hospital, and the reliability and validity of the scale were tested. ResultsA preliminary PRO-based symptom and function scale was constructed, covering two domains: symptoms and impact on daily functions. The symptom dimension includes six items: chest tightness, palpitations, pain, shortness of breath, foreign body sensation of the steel plate, and distress; while the impact on daily functions includes four items: difficulty in getting out of bed or lying down, raising arms, bending over, and standing or sitting for a long time. A total of 73 patients who underwent Nuss procedure for pectus excavatum were included in the questionnaire survey, with 70 valid questionnaires collected, including 64 males and 6 females, with 56 patients aged 12-17 years and 14 patients≥18 years. Through exploratory factor analysis, two common factors were extracted, with a cumulative variance contribution rate of 70%. The Cronbach's α coefficient of the scale is 0.917. ConclusionThe scale developed in this study has good reliability and validity, high reliability and stability, and can be used as an evaluation tool for the recovery status of patients after Nuss procedure for pectus excavatum.
Objective To evaluate the reporting quality and influencing factors of patient-reported outcome (PRO) data in lung cancer randomized controlled trials (RCTs) from 2010 to 2024. Methods RCTs of lung cancer with PRO as either primary or secondary endpoints were searched from PubMed, EMbase, Medline, CNKI (China National Knowledge Infrastructure), Wanfang Data Knowledge Service Platform, and VIP Chinese Journal Service Platform between January 1, 2010 and April 20, 2024. Reporting quality of included RCT were assessed based on the CONSORT-PRO extension. Descriptive statistics and bivariate regression analysis were used to describe the reporting quality and analyze the factors influencing the reporting quality. Results A total of 740 articles were retrieved. After screening, 53 eligible lung cancer RCTs with 22 780 patients were included. The patients mainly were non-small cell lung cancer (84.91%), with the median sample size was 364 (160.50, 599.50) patients. The primary PRO tool used was the EORTC QLQ-C30 (60.38%). There were 52 studies (98.11%) whose PRO measured the domain of "symptom management of cough, dyspnea, fatigue, pain, etc.", and 45 studies (84.91%) measured "health-related quality of life." Multicenter studies accounted for 84.91%, and randomized non-blind trials accounted for 62.26%. PRO was used as the primary endpoint in 33.96% of the studies and as secondary endpoints in 66.04%. The reliability and validity of the PRO tools were explicitly mentioned in 11.32% and 7.55% of the studies, respectively. The average completeness of reporting according to the CONSORT-PRO guidelines was 60.00%, ranging from 25% to 93%. The main factors affecting the completeness of CONSORT-PRO reporting included sample size and publication year. For each additional sample size, the completeness of reporting increased by 27.5% (SE=0.000, t=2.04, P=0.046). Additionally, studies published after 2019 had a 67.2% higher completeness of reporting compared to those published in or before 2019 (SE=0.178, t=–3.273, P=0.006). Conclusion The study reveals that the overall reporting quality of PRO in lung cancer RCTs is poor. Particularly, the reporting of patient reported outcome measures reliability and validity, PRO assumptions, applicability, and handling of missing data needs further improvement. Future research should emphasize comprehensive adherence to the CONSORT-PRO guidelines.
ObjectiveTo explore the necessity of routine X-ray examination after lung surgery based on patient symptom burden. MethodsA retrospective study was conducted including patients underwent thoracoscopic lung resection in the Department of Thoracic Surgery at uangdong Provincial People's Hospital from March 2020 to April 2023. Symptom burden was evaluated using the Perioperative Symptom Assessment Lung inventory. Results A total of 2 101 patients were included in the analysis. The median age was 56 years and 52.3% of included patients were female. Among patients who underwent routine postoperative chest X-ray, only 1% patients accepted intervention. Among patients who had chest X-ray after chest tube removal, only 0.5% of them needed intervention. Among patients who had chest X-ray one month after discharge, only 1.3% of them required intervention. The intervention group had significantly worse shortness of breath (3 vs. 2, P<0.05), pain (2 point vs. 1 point, P=0.039), and disturbed sleep (3 vs. 2, P<0.05) compared with the normal group. Conclusion Very few routine postoperative chest X-ray examinations changed patients’ management, and patients who needed extra intervention tended to have more severe symptom burden after surgery.