Development and prospective evaluation of CAPLET, a cancer ambulatory patient physical function longitudinal evaluation tool for routine clinical practice

Purpose A patient’s physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of physical function are not routinely assessed in cancer outpatients, in part due to limitations of tools available. This study presen...

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Vydané v:	Supportive care in cancer Ročník 27; číslo 2; s. 521 - 530
Hlavní autori:	Hall, Elizabeth, Tam, Emily, Liang, Mindy, Zhang, Quihuang, Liu, Lin, Wong, Lauren, Sarabia, Samantha, Yeung, Sabrina, Gill, Gursharan, Eng, Lawson, Perez-Cosio, Andrea, Brown, M. Catherine, Xu, Wei, Li, Madeline, Mittmann, Nicole, Jones, Jennifer, Howell, Doris, Liu, Geoffrey
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2019 Springer Springer Nature B.V
Predmet:	Acceptability Algorithms Ambulatory care Cancer Clinical medicine Clinical outcomes Clinical trials Cooperation Disability Epidemiology Evaluation Feasibility Function Health care management Measures Medical screening Medicine Medicine & Public Health Mental health Mobility Nursing Nursing Research Oncology Original Article Outpatients Pain Medicine Patients People with disabilities Physical ability Physical fitness Public health Quality of life Questionnaires Rehabilitation Medicine Responses Self care Tree structures Sensitivity Specificity Patient reported outcome Physical function Computer logic Cancer
ISSN:	0941-4355, 1433-7339, 1433-7339
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Abstract	Purpose A patient’s physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of physical function are not routinely assessed in cancer outpatients, in part due to limitations of tools available. This study presents the development and evaluation of the Cancer Ambulatory Patient Physical Function Longitudinal Evaluation Tool (CAPLET) as an adaptive response tool for routinely screening for physical dysfunction in oncology clinical practice. Methods In phase 1, 407 adult outpatients at Princess Margaret Cancer Centre completed the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, Health Assessment Questionnaire Disability Index (HAQ-DI), EuroQuol-5D-3L ( EQ-5D-3L), and patient-reported outcome (PRO)-Eastern Cooperative Oncology Group (ECOG). CAPLET was developed based on a branching logic algorithm navigating patients to appropriate domains of HAQ-DI/WHOAS using their responses to the PRO-ECOG/EQ-5D-3L as screeners. Sensitivity/specificity of CAPLET screeners for HAQ-DI/WHODAS items were reported. In phase 2, CAPLET vs the WHODAS/HAQ-DI were alternatively administrated to 318 adult outpatients in a two-arm trial comparing time to completion and acceptability between the tools. Results Using a patient’s ECOG status and the sum of the mobility, self-care, and usual activity dimensions of the EQ-5D-3L to dichotomize patients as with or without difficulty, CAPLET achieved a sensitivity > 90% against recommended WHODAS and HAQ-DI cutoffs for significant dysfunction. Sensitivity of screeners for capturing dysfunction in individual WHODAS/HAQ-DI items ranged from 85 to 100%. Compared to the HAQ-DI/WHODAS, CAPLET was associated with a 50% reduction in administration times and improved patient acceptability, while reducing question burden by 84% for half the sample population. Conclusions CAPLET improves the feasibility of capturing detailed assessments of patient-reported physical function in cancer outpatients.
AbstractList	Purpose A patient's physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of physical function are not routinely assessed in cancer outpatients, in part due to limitations of tools available. This study presents the development and evaluation of the Cancer Ambulatory Patient Physical Function Longitudinal Evaluation Tool (CAPLET) as an adaptive response tool for routinely screening for physical dysfunction in oncology clinical practice. Methods In phase 1, 407 adult outpatients at Princess Margaret Cancer Centre completed the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, Health Assessment Questionnaire Disability Index (HAQ-DI), EuroQuol-5D-3L ( EQ-5D-3L), and patient-reported outcome (PRO)-Eastern Cooperative Oncology Group (ECOG). CAPLET was developed based on a branching logic algorithm navigating patients to appropriate domains of HAQ-DI/WHOAS using their responses to the PRO-ECOG/EQ-5D-3L as screeners. Sensitivity/specificity of CAPLET screeners for HAQ-DI/WHODAS items were reported. In phase 2, CAPLET vs the WHODAS/HAQ-DI were alternatively administrated to 318 adult outpatients in a two-arm trial comparing time to completion and acceptability between the tools. Results Using a patient's ECOG status and the sum of the mobility, self-care, and usual activity dimensions of the EQ-5D-3L to dichotomize patients as with or without difficulty, CAPLET achieved a sensitivity > 90% against recommended WHODAS and HAQ-DI cutoffs for significant dysfunction. Sensitivity of screeners for capturing dysfunction in individual WHODAS/HAQ-DI items ranged from 85 to 100%. Compared to the HAQ-DI/WHODAS, CAPLET was associated with a 50% reduction in administration times and improved patient acceptability, while reducing question burden by 84% for half the sample population. Conclusions CAPLET improves the feasibility of capturing detailed assessments of patient-reported physical function in cancer outpatients. A patient's physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of physical function are not routinely assessed in cancer outpatients, in part due to limitations of tools available. This study presents the development and evaluation of the Cancer Ambulatory Patient Physical Function Longitudinal Evaluation Tool (CAPLET) as an adaptive response tool for routinely screening for physical dysfunction in oncology clinical practice. In phase 1, 407 adult outpatients at Princess Margaret Cancer Centre completed the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, Health Assessment Questionnaire Disability Index (HAQ-DI), EuroQuol-5D-3L ( EQ-5D-3L), and patient-reported outcome (PRO)-Eastern Cooperative Oncology Group (ECOG). CAPLET was developed based on a branching logic algorithm navigating patients to appropriate domains of HAQ-DI/WHOAS using their responses to the PRO-ECOG/EQ-5D-3L as screeners. Sensitivity/specificity of CAPLET screeners for HAQ-DI/WHODAS items were reported. In phase 2, CAPLET vs the WHODAS/HAQ-DI were alternatively administrated to 318 adult outpatients in a two-arm trial comparing time to completion and acceptability between the tools. Using a patient's ECOG status and the sum of the mobility, self-care, and usual activity dimensions of the EQ-5D-3L to dichotomize patients as with or without difficulty, CAPLET achieved a sensitivity > 90% against recommended WHODAS and HAQ-DI cutoffs for significant dysfunction. Sensitivity of screeners for capturing dysfunction in individual WHODAS/HAQ-DI items ranged from 85 to 100%. Compared to the HAQ-DI/WHODAS, CAPLET was associated with a 50% reduction in administration times and improved patient acceptability, while reducing question burden by 84% for half the sample population. CAPLET improves the feasibility of capturing detailed assessments of patient-reported physical function in cancer outpatients. A patient's physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of physical function are not routinely assessed in cancer outpatients, in part due to limitations of tools available. This study presents the development and evaluation of the Cancer Ambulatory Patient Physical Function Longitudinal Evaluation Tool (CAPLET) as an adaptive response tool for routinely screening for physical dysfunction in oncology clinical practice.PURPOSEA patient's physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of physical function are not routinely assessed in cancer outpatients, in part due to limitations of tools available. This study presents the development and evaluation of the Cancer Ambulatory Patient Physical Function Longitudinal Evaluation Tool (CAPLET) as an adaptive response tool for routinely screening for physical dysfunction in oncology clinical practice.In phase 1, 407 adult outpatients at Princess Margaret Cancer Centre completed the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, Health Assessment Questionnaire Disability Index (HAQ-DI), EuroQuol-5D-3L ( EQ-5D-3L), and patient-reported outcome (PRO)-Eastern Cooperative Oncology Group (ECOG). CAPLET was developed based on a branching logic algorithm navigating patients to appropriate domains of HAQ-DI/WHOAS using their responses to the PRO-ECOG/EQ-5D-3L as screeners. Sensitivity/specificity of CAPLET screeners for HAQ-DI/WHODAS items were reported. In phase 2, CAPLET vs the WHODAS/HAQ-DI were alternatively administrated to 318 adult outpatients in a two-arm trial comparing time to completion and acceptability between the tools.METHODSIn phase 1, 407 adult outpatients at Princess Margaret Cancer Centre completed the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, Health Assessment Questionnaire Disability Index (HAQ-DI), EuroQuol-5D-3L ( EQ-5D-3L), and patient-reported outcome (PRO)-Eastern Cooperative Oncology Group (ECOG). CAPLET was developed based on a branching logic algorithm navigating patients to appropriate domains of HAQ-DI/WHOAS using their responses to the PRO-ECOG/EQ-5D-3L as screeners. Sensitivity/specificity of CAPLET screeners for HAQ-DI/WHODAS items were reported. In phase 2, CAPLET vs the WHODAS/HAQ-DI were alternatively administrated to 318 adult outpatients in a two-arm trial comparing time to completion and acceptability between the tools.Using a patient's ECOG status and the sum of the mobility, self-care, and usual activity dimensions of the EQ-5D-3L to dichotomize patients as with or without difficulty, CAPLET achieved a sensitivity > 90% against recommended WHODAS and HAQ-DI cutoffs for significant dysfunction. Sensitivity of screeners for capturing dysfunction in individual WHODAS/HAQ-DI items ranged from 85 to 100%. Compared to the HAQ-DI/WHODAS, CAPLET was associated with a 50% reduction in administration times and improved patient acceptability, while reducing question burden by 84% for half the sample population.RESULTSUsing a patient's ECOG status and the sum of the mobility, self-care, and usual activity dimensions of the EQ-5D-3L to dichotomize patients as with or without difficulty, CAPLET achieved a sensitivity > 90% against recommended WHODAS and HAQ-DI cutoffs for significant dysfunction. Sensitivity of screeners for capturing dysfunction in individual WHODAS/HAQ-DI items ranged from 85 to 100%. Compared to the HAQ-DI/WHODAS, CAPLET was associated with a 50% reduction in administration times and improved patient acceptability, while reducing question burden by 84% for half the sample population.CAPLET improves the feasibility of capturing detailed assessments of patient-reported physical function in cancer outpatients.CONCLUSIONSCAPLET improves the feasibility of capturing detailed assessments of patient-reported physical function in cancer outpatients. Purpose A patient’s physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of physical function are not routinely assessed in cancer outpatients, in part due to limitations of tools available. This study presents the development and evaluation of the Cancer Ambulatory Patient Physical Function Longitudinal Evaluation Tool (CAPLET) as an adaptive response tool for routinely screening for physical dysfunction in oncology clinical practice. Methods In phase 1, 407 adult outpatients at Princess Margaret Cancer Centre completed the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, Health Assessment Questionnaire Disability Index (HAQ-DI), EuroQuol-5D-3L ( EQ-5D-3L), and patient-reported outcome (PRO)-Eastern Cooperative Oncology Group (ECOG). CAPLET was developed based on a branching logic algorithm navigating patients to appropriate domains of HAQ-DI/WHOAS using their responses to the PRO-ECOG/EQ-5D-3L as screeners. Sensitivity/specificity of CAPLET screeners for HAQ-DI/WHODAS items were reported. In phase 2, CAPLET vs the WHODAS/HAQ-DI were alternatively administrated to 318 adult outpatients in a two-arm trial comparing time to completion and acceptability between the tools. Results Using a patient’s ECOG status and the sum of the mobility, self-care, and usual activity dimensions of the EQ-5D-3L to dichotomize patients as with or without difficulty, CAPLET achieved a sensitivity > 90% against recommended WHODAS and HAQ-DI cutoffs for significant dysfunction. Sensitivity of screeners for capturing dysfunction in individual WHODAS/HAQ-DI items ranged from 85 to 100%. Compared to the HAQ-DI/WHODAS, CAPLET was associated with a 50% reduction in administration times and improved patient acceptability, while reducing question burden by 84% for half the sample population. Conclusions CAPLET improves the feasibility of capturing detailed assessments of patient-reported physical function in cancer outpatients. PurposeA patient’s physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of physical function are not routinely assessed in cancer outpatients, in part due to limitations of tools available. This study presents the development and evaluation of the Cancer Ambulatory Patient Physical Function Longitudinal Evaluation Tool (CAPLET) as an adaptive response tool for routinely screening for physical dysfunction in oncology clinical practice.MethodsIn phase 1, 407 adult outpatients at Princess Margaret Cancer Centre completed the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, Health Assessment Questionnaire Disability Index (HAQ-DI), EuroQuol-5D-3L ( EQ-5D-3L), and patient-reported outcome (PRO)-Eastern Cooperative Oncology Group (ECOG). CAPLET was developed based on a branching logic algorithm navigating patients to appropriate domains of HAQ-DI/WHOAS using their responses to the PRO-ECOG/EQ-5D-3L as screeners. Sensitivity/specificity of CAPLET screeners for HAQ-DI/WHODAS items were reported. In phase 2, CAPLET vs the WHODAS/HAQ-DI were alternatively administrated to 318 adult outpatients in a two-arm trial comparing time to completion and acceptability between the tools.ResultsUsing a patient’s ECOG status and the sum of the mobility, self-care, and usual activity dimensions of the EQ-5D-3L to dichotomize patients as with or without difficulty, CAPLET achieved a sensitivity > 90% against recommended WHODAS and HAQ-DI cutoffs for significant dysfunction. Sensitivity of screeners for capturing dysfunction in individual WHODAS/HAQ-DI items ranged from 85 to 100%. Compared to the HAQ-DI/WHODAS, CAPLET was associated with a 50% reduction in administration times and improved patient acceptability, while reducing question burden by 84% for half the sample population.ConclusionsCAPLET improves the feasibility of capturing detailed assessments of patient-reported physical function in cancer outpatients.
Audience	Academic
Author	Sarabia, Samantha Liang, Mindy Brown, M. Catherine Xu, Wei Mittmann, Nicole Tam, Emily Howell, Doris Liu, Lin Li, Madeline Yeung, Sabrina Jones, Jennifer Liu, Geoffrey Zhang, Quihuang Gill, Gursharan Eng, Lawson Wong, Lauren Perez-Cosio, Andrea Hall, Elizabeth
Author_xml	– sequence: 1 givenname: Elizabeth surname: Hall fullname: Hall, Elizabeth organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 2 givenname: Emily surname: Tam fullname: Tam, Emily organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 3 givenname: Mindy surname: Liang fullname: Liang, Mindy organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 4 givenname: Quihuang surname: Zhang fullname: Zhang, Quihuang organization: Department of Biostatistics, Princess Margaret Cancer Centre, Dalla Lana School of Public Health, University of Toronto – sequence: 5 givenname: Lin surname: Liu fullname: Liu, Lin organization: Department of Biostatistics, Princess Margaret Cancer Centre, Dalla Lana School of Public Health, University of Toronto – sequence: 6 givenname: Lauren surname: Wong fullname: Wong, Lauren organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 7 givenname: Samantha surname: Sarabia fullname: Sarabia, Samantha organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 8 givenname: Sabrina surname: Yeung fullname: Yeung, Sabrina organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 9 givenname: Gursharan surname: Gill fullname: Gill, Gursharan organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 10 givenname: Lawson surname: Eng fullname: Eng, Lawson organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 11 givenname: Andrea surname: Perez-Cosio fullname: Perez-Cosio, Andrea organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 12 givenname: M. Catherine surname: Brown fullname: Brown, M. Catherine organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto – sequence: 13 givenname: Wei surname: Xu fullname: Xu, Wei organization: Department of Biostatistics, Princess Margaret Cancer Centre, Dalla Lana School of Public Health, University of Toronto – sequence: 14 givenname: Madeline surname: Li fullname: Li, Madeline organization: Psychosocial Oncology, Princess Margaret Cancer Centre – sequence: 15 givenname: Nicole surname: Mittmann fullname: Mittmann, Nicole organization: Sunnybrook Health Sciences Centre – sequence: 16 givenname: Jennifer surname: Jones fullname: Jones, Jennifer organization: Survivorship Program, Princess Margaret Cancer Centre – sequence: 17 givenname: Doris surname: Howell fullname: Howell, Doris email: Doris.Howell@uhn.ca organization: Psychosocial Oncology, Princess Margaret Cancer Centre, Lawrence Bloomberg School of Nursing, University of Toronto – sequence: 18 givenname: Geoffrey surname: Liu fullname: Liu, Geoffrey email: Geoffrey.Liu@uhn.ca organization: Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Departments of Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto, Department of Epidemiology, Dalla Lana School of Public Health, Departments of Medicine and Biophysics, University of Toronto
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Copyright	Springer-Verlag GmbH Germany, part of Springer Nature 2018 COPYRIGHT 2019 Springer Supportive Care in Cancer is a copyright of Springer, (2018). All Rights Reserved.
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Snippet	Purpose A patient’s physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome... A patient's physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome measures of... Purpose A patient's physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome... PurposeA patient’s physical function is a critical outcome variable for measuring and improving chronic care management. However, patient-reported outcome...
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SubjectTerms	Acceptability Algorithms Ambulatory care Cancer Clinical medicine Clinical outcomes Clinical trials Cooperation Disability Epidemiology Evaluation Feasibility Function Health care management Measures Medical screening Medicine Medicine & Public Health Mental health Mobility Nursing Nursing Research Oncology Original Article Outpatients Pain Medicine Patients People with disabilities Physical ability Physical fitness Public health Quality of life Questionnaires Rehabilitation Medicine Responses Self care Tree structures
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Title	Development and prospective evaluation of CAPLET, a cancer ambulatory patient physical function longitudinal evaluation tool for routine clinical practice
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