Pamela S Hinds1, Meaghann S Weaver2, Janice S Withycombe3, Justin N Baker4, Shana S Jacobs5, Jennifer W Mack6, Scott H Maurer7, Molly McFatrich8, Laura C Pinheiro9, Bryce B Reeve10, Jichuan Wang11. 1. Department of Nursing Science, Professional Practice and Quality, Children's National Hospital, Washington, District of Columbia, USA; Department of Pediatrics, The George Washington University, Washington, District of Columbia, USA. Electronic address: pshinds@childrensnational.org. 2. Division of Pediatric Palliative Care, Children's Hospital and Medical Center, Omaha, Nebraska, USA; Division of Pediatric Oncology, Children's Hospital and Medical Center, Omaha, Nebraska, USA. 3. School of Nursing, Clemson University, Clemson, South Carolina, USA. 4. St. Jude Children's Research Hospital, Memphis, Tennessee, USA. 5. Department of Pediatrics, Children's National Hospital, The George Washington University, Washington, District of Columbia, USA. 6. Department of Pediatric Oncology and Center for Population Sciences, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, Massachusetts, USA. 7. Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; Division of Palliative Medicine and Supportive Care, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA. 8. Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA. 9. Department of Medicine, Weill Cornell Medicine, New York, New York, USA. 10. Department of Population Health Sciences, Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA; Department of Pediatrics, Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA. 11. Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, District of Columbia, USA; Epidemiology and Biostatistics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Abstract
CONTEXT: Children and adolescents with cancer experience treatment-related, subjective adverse events (AEs). Identifying distinct groups of patients who predictably experience higher prevalence of AEs could guide patient care. OBJECTIVES: Study aims were to 1) identify groups of children and adolescents reporting AEs using the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE); 2) determine whether demographic and clinical characteristics predict AE group membership; and 3) examine whether AE group membership was related to the distal outcome of psychological stress. METHODS: Four hundred seventy-seven patients self-reported AEs via the Ped-PRO-CTCAE at T1 (beginning of treatment) and the PROMIS Pediatric Psychological Stress measure at T2 (7-28 days later). Latent class analysis was conducted to identify groups of patients and the relationships of the groups with demographic and clinical characteristics, and with stress. RESULTS: Three distinct a priori unknown AE groups were identified (high AE prevalence, moderate AE prevalence, and low AE prevalence). Females, blacks, patients with high psychological stress, and patients more recently diagnosed were more likely to be in the high AE prevalence group. Gender, age, race, and time since diagnosis were associated with psychological stress. CONCLUSION: Children with cancer are heterogeneous in experiencing subjective AEs. Gender, race, and time since diagnosis were significantly associated with higher subjective AE prevalence that may lead to psychological stress.
CONTEXT: Children and adolescents with cancer experience treatment-related, subjective adverse events (AEs). Identifying distinct groups of patients who predictably experience higher prevalence of AEs could guide patient care. OBJECTIVES: Study aims were to 1) identify groups of children and adolescents reporting AEs using the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE); 2) determine whether demographic and clinical characteristics predict AE group membership; and 3) examine whether AE group membership was related to the distal outcome of psychological stress. METHODS: Four hundred seventy-seven patients self-reported AEs via the Ped-PRO-CTCAE at T1 (beginning of treatment) and the PROMIS Pediatric Psychological Stress measure at T2 (7-28 days later). Latent class analysis was conducted to identify groups of patients and the relationships of the groups with demographic and clinical characteristics, and with stress. RESULTS: Three distinct a priori unknown AE groups were identified (high AE prevalence, moderate AE prevalence, and low AE prevalence). Females, blacks, patients with high psychological stress, and patients more recently diagnosed were more likely to be in the high AE prevalence group. Gender, age, race, and time since diagnosis were associated with psychological stress. CONCLUSION: Children with cancer are heterogeneous in experiencing subjective AEs. Gender, race, and time since diagnosis were significantly associated with higher subjective AE prevalence that may lead to psychological stress.
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