Rachel McDonald1, Keyue Ding2, Edward Chow3, Ralph M Meyer4, Abdenour Nabid5, Pierre Chabot6, Genevieve Coulombe7, Shahida Ahmed8, Joda Kuk9, Rashid Dar10, Aamer Mahmud11, Alysa Fairchild12, Carolyn F Wilson2, Jackson S Y Wu13, Kristopher Dennis14, Carlo DeAngelis1, Rebecca K S Wong15, Liting Zhu2, Michael Brundage16. 1. Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada. 2. Canadian Clinical Trials Group, Cancer Research Institute, Queen's University, Kingston, ON, Canada. 3. Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada. Edward.Chow@sunnybrook.ca. 4. Juravinski Hospital and Cancer Centre and McMaster University, Hamilton, ON, Canada. 5. Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada. 6. Hopital Maisonneuve-Rosemont, Montreal, QC, Canada. 7. CHUM-Hopital Notre-Dame, Montreal, QC, Canada. 8. CancerCare Manitoba, Winnipeg, MB, Canada. 9. Grand River Regional Cancer Centre, Grand River Hospital, Kitchener, ON, Canada. 10. London Regional Cancer Program, London, ON, Canada. 11. Cancer Centre of Southeastern Ontario, Kingston General Hospital, Kingston, ON, Canada. 12. Cross Cancer Institute, Edmonton, AB, Canada. 13. Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada. 14. University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada. 15. Princess Margaret Hospital, Radiation Medicine Program, Ontario Cancer Institute, University of Toronto, Toronto, ON, Canada. 16. Queen's University, Kingston, ON, Canada.
Abstract
PURPOSE: Previous studies have determined optimal cut points (CPs) for the classification of pain severity as mild, moderate, or severe using only the Brief Pain Inventory (BPI) or the BPI in conjunction with a quality of life (QOL) tool. The purpose of our study was to determine the optimal CPs based on correlation with only QOL outcomes. METHODS: We conducted an analysis of 298 patients treated withradiation therapy for painful bone metastases on a phase III randomized trial. Prior to treatment, patients provided their worst pain score on a scale of 0 (no pain) to 10 (worst possible pain), as well as completed the European Organization of Cancer Research and Treatment (EORTC) QOL QuestionnaireBone Metastases module (QLQ-BM22) and the EORTC QOL QuestionnaireCore-15 Palliative (QLQ-C15-PAL). Optimal CPs were determined to be those that yielded the largest F ratio for the between category effect on each subscale of the QLQ-BM22 and QLQ-C15-PAL using the multivariate analysis of variance (MANOVA). RESULTS: The two largest F ratios for Wilk's λ, Pillai's Trace, and Hotelling's Trace were for CPs 5,6 and 5,7. Combining both, the optimal CPs to differentiate between mild, moderate, and severe pain were 5 and 7. Pain scores of 1-5, 6, and 7-10 were classified as mild, moderate, and severe, respectively. Patients with severe pain experienced greater functional interference and poorer QOL when compared to those with mild pain. CONCLUSION: Our results suggest that, based on the impact of pain on QOL measures, pain scores should be classified as follows: 1-5 as mild pain, 6 as moderate pain, and 7-10 as severe pain. Optimal CPs vary depending on the type of outcome measurement used.
RCT Entities:
PURPOSE: Previous studies have determined optimal cut points (CPs) for the classification of pain severity as mild, moderate, or severe using only the Brief Pain Inventory (BPI) or the BPI in conjunction with a quality of life (QOL) tool. The purpose of our study was to determine the optimal CPs based on correlation with only QOL outcomes. METHODS: We conducted an analysis of 298 patients treated with radiation therapy for painful bone metastases on a phase III randomized trial. Prior to treatment, patients provided their worst pain score on a scale of 0 (no pain) to 10 (worst possible pain), as well as completed the European Organization of Cancer Research and Treatment (EORTC) QOL Questionnaire Bone Metastases module (QLQ-BM22) and the EORTC QOL Questionnaire Core-15 Palliative (QLQ-C15-PAL). Optimal CPs were determined to be those that yielded the largest F ratio for the between category effect on each subscale of the QLQ-BM22 and QLQ-C15-PAL using the multivariate analysis of variance (MANOVA). RESULTS: The two largest F ratios for Wilk's λ, Pillai's Trace, and Hotelling's Trace were for CPs 5,6 and 5,7. Combining both, the optimal CPs to differentiate between mild, moderate, and severe pain were 5 and 7. Pain scores of 1-5, 6, and 7-10 were classified as mild, moderate, and severe, respectively. Patients with severe pain experienced greater functional interference and poorer QOL when compared to those with mild pain. CONCLUSION: Our results suggest that, based on the impact of pain on QOL measures, pain scores should be classified as follows: 1-5 as mild pain, 6 as moderate pain, and 7-10 as severe pain. Optimal CPs vary depending on the type of outcome measurement used.
Entities:
Keywords:
Bone metastases; Cut points; Functional interference; Pain severity; Quality of life; Survival
Authors: Edward Chow; Amanda Hird; Galina Velikova; Colin Johnson; Linda Dewolf; Andrea Bezjak; Jackson Wu; Jesmin Shafiq; Orhan Sezer; Dimitrios Kardamakis; Yvette van der Linden; Brigette Ma; Monica Castro; Palmira Foro Arnalot; Sam Ahmedzai; Mark Clemons; Peter Hoskin; Albert Yee; Michael Brundage; Andrew Bottomley Journal: Eur J Cancer Date: 2008-12-25 Impact factor: 9.162
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Authors: Karine A Ferreira; Manoel Jacobsen Teixeira; Tito R Mendonza; Charles S Cleeland Journal: Support Care Cancer Date: 2010-03-10 Impact factor: 3.603
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Authors: Aaron Woo; Breanne Lechner; Terence Fu; C Shun Wong; Nicholas Chiu; Henry Lam; Natalie Pulenzas; Hany Soliman; Carlo DeAngelis; Edward Chow Journal: Ann Palliat Med Date: 2015-10