Patients’ reported outcome measures and clinical scales in brain tumor surgery: results from a prospective cohort study

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Abstract

Background: This study aims to assess surgical outcome in brain tumor surgery using patient reported outcome measures (PROMs) and to compare their results with traditional clinical outcome measurements. Method: Neuro-oncological patients undergoing surgical removal for the lesion were enrolled; MOCA test, PROMs (EUROHIS-QoL, PGWB-S, WHODAS-12), and the clinical scale Karnofsky Performance Status (KPS) were administered to evaluate respectively cognitive status, quality of life, well-being, disability, and functional status before surgery and at 3-month follow-up. Wilcoxon test was performed to evaluate the longitudinal change of test scores, the smallest detectable difference to classify the change of patients in PROMs, the Cohen kappa to investigate the concordance between KPS and PROMs in classifying the patients’ change, and Mann-Whitney U test to compare patients with complications and no complications. Results: A total of 101 patients were enrolled (54 woman, mean age 50.2 ± 14.1, range 20–85): psychological well-being improved at follow-up; 95 patients (94.1%) were improved/unchanged and 6 (5.9%) were worsened according to PROMs; functional status measured with KPS had a slight agreement with quality of life and disability and no agreement with psychological well-being questionnaires; patients with complications had a greater worsening in KPS. Conclusions: According to PROMs measuring QoL, disability, and psychological well-being, most of the patients were improved/unchanged after surgery. Since PROMs and KPS detect different aspects of the patients’ health status, PROMs should be integrated in surgical outcome evaluation. Furthermore, their association with complications and with other clinical and subjective variables that could influence patient’s perception of health status should be investigated.

Original languageEnglish
Pages (from-to)1053-1061
Number of pages9
JournalActa Neurochirurgica
Volume160
Issue number5
DOIs
Publication statusPublished - May 1 2018

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Brain Neoplasms
Cohort Studies
Prospective Studies
Karnofsky Performance Status
Psychology
Health Status
Methylenebis(chloroaniline)
Quality of Life
Patient Reported Outcome Measures
Nonparametric Statistics

Keywords

  • Brain tumor
  • Clinical outcome
  • Neurosurgery
  • Patient reported outcomes

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

@article{efe106eda9044343b2f1b3e2245f3854,
title = "Patients’ reported outcome measures and clinical scales in brain tumor surgery: results from a prospective cohort study",
abstract = "Background: This study aims to assess surgical outcome in brain tumor surgery using patient reported outcome measures (PROMs) and to compare their results with traditional clinical outcome measurements. Method: Neuro-oncological patients undergoing surgical removal for the lesion were enrolled; MOCA test, PROMs (EUROHIS-QoL, PGWB-S, WHODAS-12), and the clinical scale Karnofsky Performance Status (KPS) were administered to evaluate respectively cognitive status, quality of life, well-being, disability, and functional status before surgery and at 3-month follow-up. Wilcoxon test was performed to evaluate the longitudinal change of test scores, the smallest detectable difference to classify the change of patients in PROMs, the Cohen kappa to investigate the concordance between KPS and PROMs in classifying the patients’ change, and Mann-Whitney U test to compare patients with complications and no complications. Results: A total of 101 patients were enrolled (54 woman, mean age 50.2 ± 14.1, range 20–85): psychological well-being improved at follow-up; 95 patients (94.1{\%}) were improved/unchanged and 6 (5.9{\%}) were worsened according to PROMs; functional status measured with KPS had a slight agreement with quality of life and disability and no agreement with psychological well-being questionnaires; patients with complications had a greater worsening in KPS. Conclusions: According to PROMs measuring QoL, disability, and psychological well-being, most of the patients were improved/unchanged after surgery. Since PROMs and KPS detect different aspects of the patients’ health status, PROMs should be integrated in surgical outcome evaluation. Furthermore, their association with complications and with other clinical and subjective variables that could influence patient’s perception of health status should be investigated.",
keywords = "Brain tumor, Clinical outcome, Neurosurgery, Patient reported outcomes",
author = "Silvia Schiavolin and Alberto Raggi and Chiara Scaratti and Matilde Leonardi and Alberto Cusin and Sergio Visintini and Francesco Acerbi and Marco Schiariti and Costanza Zattra and Morgan Broggi and Paolo Ferroli",
year = "2018",
month = "5",
day = "1",
doi = "10.1007/s00701-018-3505-0",
language = "English",
volume = "160",
pages = "1053--1061",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
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TY - JOUR

T1 - Patients’ reported outcome measures and clinical scales in brain tumor surgery

T2 - results from a prospective cohort study

AU - Schiavolin, Silvia

AU - Raggi, Alberto

AU - Scaratti, Chiara

AU - Leonardi, Matilde

AU - Cusin, Alberto

AU - Visintini, Sergio

AU - Acerbi, Francesco

AU - Schiariti, Marco

AU - Zattra, Costanza

AU - Broggi, Morgan

AU - Ferroli, Paolo

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: This study aims to assess surgical outcome in brain tumor surgery using patient reported outcome measures (PROMs) and to compare their results with traditional clinical outcome measurements. Method: Neuro-oncological patients undergoing surgical removal for the lesion were enrolled; MOCA test, PROMs (EUROHIS-QoL, PGWB-S, WHODAS-12), and the clinical scale Karnofsky Performance Status (KPS) were administered to evaluate respectively cognitive status, quality of life, well-being, disability, and functional status before surgery and at 3-month follow-up. Wilcoxon test was performed to evaluate the longitudinal change of test scores, the smallest detectable difference to classify the change of patients in PROMs, the Cohen kappa to investigate the concordance between KPS and PROMs in classifying the patients’ change, and Mann-Whitney U test to compare patients with complications and no complications. Results: A total of 101 patients were enrolled (54 woman, mean age 50.2 ± 14.1, range 20–85): psychological well-being improved at follow-up; 95 patients (94.1%) were improved/unchanged and 6 (5.9%) were worsened according to PROMs; functional status measured with KPS had a slight agreement with quality of life and disability and no agreement with psychological well-being questionnaires; patients with complications had a greater worsening in KPS. Conclusions: According to PROMs measuring QoL, disability, and psychological well-being, most of the patients were improved/unchanged after surgery. Since PROMs and KPS detect different aspects of the patients’ health status, PROMs should be integrated in surgical outcome evaluation. Furthermore, their association with complications and with other clinical and subjective variables that could influence patient’s perception of health status should be investigated.

AB - Background: This study aims to assess surgical outcome in brain tumor surgery using patient reported outcome measures (PROMs) and to compare their results with traditional clinical outcome measurements. Method: Neuro-oncological patients undergoing surgical removal for the lesion were enrolled; MOCA test, PROMs (EUROHIS-QoL, PGWB-S, WHODAS-12), and the clinical scale Karnofsky Performance Status (KPS) were administered to evaluate respectively cognitive status, quality of life, well-being, disability, and functional status before surgery and at 3-month follow-up. Wilcoxon test was performed to evaluate the longitudinal change of test scores, the smallest detectable difference to classify the change of patients in PROMs, the Cohen kappa to investigate the concordance between KPS and PROMs in classifying the patients’ change, and Mann-Whitney U test to compare patients with complications and no complications. Results: A total of 101 patients were enrolled (54 woman, mean age 50.2 ± 14.1, range 20–85): psychological well-being improved at follow-up; 95 patients (94.1%) were improved/unchanged and 6 (5.9%) were worsened according to PROMs; functional status measured with KPS had a slight agreement with quality of life and disability and no agreement with psychological well-being questionnaires; patients with complications had a greater worsening in KPS. Conclusions: According to PROMs measuring QoL, disability, and psychological well-being, most of the patients were improved/unchanged after surgery. Since PROMs and KPS detect different aspects of the patients’ health status, PROMs should be integrated in surgical outcome evaluation. Furthermore, their association with complications and with other clinical and subjective variables that could influence patient’s perception of health status should be investigated.

KW - Brain tumor

KW - Clinical outcome

KW - Neurosurgery

KW - Patient reported outcomes

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