The Cancer Care Monitor: psychometric content evaluation and pilot testing of a computer administered system for symptom screening and quality of life in adult cancer patients

Abstract

Technology is making the routine screening of symptoms and the measurement of quality of life (QoL) more feasible at the point of care. However, most existing symptom screening scales and QoL measures were not developed for clinical use and were not formatted and validated for administration through computerized mediums. The Cancer Care Monitor (CCM) is a symptom-based scale developed for administration on pen-based computers. This study is an initial evaluation of the reliability and validity of the CCM. Three samples of adult outpatients provided ratings on 38 physical, psychological, and functional oriented items of the CCM that comprise six symptom scales and one global QoL index. All additive scales are converted to normalized T scores. Reliability was examined through internal consistency and confirmatory factor analysis. Convergent and divergent validity were examined by comparing CMM scores to established measures of corresponding constructs and physician judgments. Alternative forms reliability was established by comparing paper and pencil administration with computer administration. Internal consistency reliability and factor analyses confirmed the structure of the CCM as comprising six primary symptom scales and one global QoL index. Internal consistency reliabilities ranged from 0.80 to 0.89. The pattern of correlations between CCM scales and established measures supported the convergent and divergent validity of the CCM scales. Alternate forms reliability based on paper and computer forms of the CCM scales was high. Patients indicated a preference for the computer-administered version. Results suggest that CCM items can be scored as a reliable and valid measure of constructs related to physical, psychological, and functional status, and global health-related QoL in adult cancer patients. Future studies should replicate and further evaluate the properties of the CCM, especially in relation to clinical utility.

Sexual concerns in lung cancer patients: an examination of predictors and moderating effects of age and gender

“…All items reference the past week. The PCM has been validated against standard symptom inventories and QOL scales [3,4]. The sexual concerns item has been used by our group to examine sexual problems in GI cancer and breast cancer samples [10].…”

Patient and practice impact of capecitabine compared to taxanes in first-/second-line chemotherapy for metastatic breast cancer

“…Endpoints The primary endpoint was symptom burden and quality of life as measured by the Patient Care Monitor (PCM), version 1.0, a 38-item self-report measure administered by touch-screen tablet PC, or as pencil and paper measure [9]. The instrument assesses physical symptoms, psychological symptoms and physical functioning, and produces standardized scores (T scores) for six screening scales: General Physical Symptoms, Treatment Side Effects, Acute Distress, Despair and Depression, Impaired Ambulation, and Impaired Performance.…”

“…The Patient Care Monitor has been validated against the Brief Symptom Inventory [6], Medical Outcomes Study SF-36 Health Survey [12,28], Memorial Symptom Assessment Scale [3,20,21], Life Satisfaction Index-Short Form [1,19], and the Satisfaction with Life Scale [7], and was shown to be valid for assessing patient quality of life. The internal consistency reliability (Cronbach's alpha) for the six primary scales ranged from 0.80 to 0.89, and for the overall Quality-of-Life index was 0.84 [9].…”

Longitudinal Patient-Reported Performance Status Assessment in the Cancer Clinic Is Feasible and Prognostic

“…10,12 Data are collected electronically, for example, via point-of-care tablet computers, facilitating the efficient collection of patient-reported data with less burden and more accuracy. 16,17 Collection of PRO information using the PCM v2.0 is an efficient real-time method to catalogue reliable and valid symptom and QOL data for use in clinical care, research, and quality reporting. 18 Although clinician-reported performance status (using KPS or ECOG scores) is prognostic, the patient's assessment of their own performance status could obviate the need for clinician data collection, improve data quality, and potentially better reflect prognosis.…”