Incorporation of Patient‐Reported Outcomes Measurement Information System to assess quality of life among patients with breast cancer initiating care at an academic center

Abstract

Background Symptom burden and reduced quality of life (QOL) are considerable hurdles in oncology. The authors used the Patient‐Reported Outcomes Measurement Information System (PROMIS), which assesses physical and psychosocial health, to establish a mean symptom burden, examine potential drivers, and characterize severe symptom burden in breast cancer patient subgroups with the goal of characterizing stage IV patient QOL and triaging patients to individualized supportive care services. Methods New patients at the University of California San Francisco Breast Care Center received questionnaires with 8 PROMIS domains: depression, anxiety, fatigue, sleep‐related impairment, sleep disturbance, cognitive function, cognitive abilities, and physical function. PROMIS values were scored with the HealthMeasures service and were compared by age, cancer stage, and educational status. Results Stage IV patients with breast cancer (n = 169) reported higher depression and fatigue and worse cognitive function, cognitive abilities, and physical function than patients with stage 0 to III disease (n = 2577). As age increased, cognitive function impairment, depression, anxiety, and sleep‐related symptoms decreased. More educated patients showed better physical function and less severe sleep disturbance and fatigue. Across all subgroups, patients with high anxiety had the greatest probability of worse symptom burden and function in other domains. CONCLUSIONS This study provides an additional set of PROMIS population estimates across breast cancer demographic groups. The analysis of a large stage IV population reinforces that metastatic patients have impaired QOL across multiple domains. Because anxiety emerged as a potential driver of impaired QOL in other domains, earlier interventions to reduce anxiety could improve QOL overall. These analyses will help to determine appropriate thresholds of intervention. Lay Summary Patients receiving treatment for breast cancer can experience decreased quality of life. This study characterized differences in self‐reported quality of life among patients of different ages, with different stages of cancer, and with different educational backgrounds. This study also examined the effect of decreased quality of life in one area (eg, anxiety) on another area (eg, difficulty in sleeping). Patients who were younger, had not attended college or technical school, or had stage IV cancer tended to have worse quality of life. Patients who had high levels of anxiety also tended to have high levels of impairment in other areas.

Characterization of Physical Function and Cancer-Related Physical Impairments in Hispanic Women With Breast Cancer: A Descriptive Study

“…In this study, we reported data on the subjective and objective measures of physical function among Hispanic women with breast cancer. We found that some measures of physical function such as TUG and 4SB were worse in Hispanics, while PROMIS-PF score, PROMIS-F score, STS, and GS were comparable to women of other race/ethnicity with breast cancer, as reported in the literature (Blackwood & Rybicki, 2021a, 2021bMatthys et al, 2021;Van der Weijden-Van Doornik et al, 2017). In addition, we also found that one in every five patients in our sample had depression.…”

“…For example, in a study done by Matthys et al (2021), breast cancer survivors showed that PROMIS-PF and PROMIS-F scores were comparable to that of our patient population. Similar results were reported in a study among 2,968 cancer patients, which also showed similar results to ours (Jensen et al, 2017).…”

Patient Reported Outcomes in Metastatic Spine Disease: Concurrent Validity of PROMIS with the Spine Oncology Study Group Outcome Questionnaire

“…If shown to be concurrently valid, PROMIS may adequately replace PROMs and reduce both patient and physician burden. Previous studies have found that PROMIS sufficiently captures information obtained through disease-specific PROMs 4,5,14–16 . PROMIS is unique in that it utilizes an iterative CAT system, based on item response theory that improves flexibility, sensitivity, and efficiency 13 .…”

Predicting the survival benefit of local surgery in patients aged 70 years or older with stage IV breast cancer: A population-based analysis

“…In this study, nomograms were constructed to predict the prognosis of stage IV BC patients after 3 or 5 years, which may be used as a reference for clinicians to decide whether to perform surgery in these patients. However, for older patients with metastatic tumors, the survival prognosis may not be the key to their well-being compared with other endpoints, such as functional status, quality of life and complications with standard therapy options [24,25]. Unfortunately, no relevant data were recorded in the SEER database.…”