A comprehensive multiattribute system for classifying the health status of survivors of childhood cancer.
OBJECTIVE
A multiattribute health status classification system was devised to describe comprehensively the health status of survivors of childhood cancer.


METHODS
The system consists of seven attributes: sensation, mobility, emotion, cognition, self-care, pain, and fertility. Three to five levels of functioning are defined for each attribute. Any specific combination of seven attribute levels constitutes a health state. In the first survey, the system was used to classify the health status of 20 children currently undergoing therapy for high-risk acute lymphoblastic leukemia (ALL), Wilms' tumor, or neuroblastoma, and eight who had completed treatment. A second survey consisted of 13 children with brain tumors on active treatment.


RESULTS
In general, independent ratings by clinicians were in agreement, and consensus was readily achieved in 1 to 2 minutes per patient. Children on therapy experienced a higher burden of morbidity than those off treatment. Brain tumor patients experienced more morbidity than patients in the first survey.


CONCLUSIONS
The multiattribute system provides a compact but comprehensive tool for long-term follow-up of survivors of childhood cancer. It captures both multiple sequelae and varying levels of severity. By using a mathematical utility function, a single summary score of health-related quality of life may be assigned to each health state. Additional studies to establish reproducibility, validity, responsiveness, and generalizability are indicated.
Feeny
D
D
Department of Economics, McMaster University, Hamilton, Ontario, Canada.
Furlong
W
W
Barr
R D
RD
Torrance
G W
GW
Rosenbaum
P
P
Weitzman
S
S
D000203:Activities of Daily Living; D001932:Brain Neoplasms / Q000150:complications; D002648:Child; D004644:Emotions; D005298:Fertility; D006304:Health Status; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications; D007858:Learning; D008124:Locomotion; D009369:Neoplasms / Q000150:complications* / Q000523:psychology / Q000628:therapy; D009447:Neuroblastoma / Q000150:complications; D010146:Pain; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications; D012677:Sensation; D009396:Wilms Tumor / Q000150:complications