The early development phases of a European Organisation for Research and Treatment of Cancer (EORTC) module to assess patient reported outcomes (PROs) in women undergoing breast reconstruction.
BACKGROUND
A comprehensive evaluation of breast reconstruction (BRR) surgery includes measurement of patient reported outcomes (PROs). There is, however, a lack of validated BRR-specific PRO measures (PROMs) that adequately assess relevant issues. This study is developing a European Organisation for Research and Treatment of Cancer (EORTC) questionnaire/module specific for PROs in BRR to supplement the cancer-core and breast cancer EORTC questionnaires, respectively: the QLQ-C30 and QLQ-BR23.


METHODS
Phases I and II of questionnaire development followed EORTC guidelines including a systematic literature review to identify all potential 'issues' (concepts relevant to PROs) and semi-structured interviews with 89 patients and 9 European multi-disciplinary health care professionals (HCPs) (Sweden, Italy and the United Kingdom [UK]). Interviewers asked participants the 'relevance' of outcomes identified in the literature and captured additional 'issues' of importance.


RESULTS
The literature search and interviews of patients and HCPs yielded 69 issues relating to BRR operationalised into 31 provisional items (single questions) for the module, which was conceptualised to contain five scales: treatment/surgery related symptoms (affecting the shoulder, arm and reconstructed breast), body image, sexuality, cosmetic outcomes (pertaining to three areas: breast, donor site and nipple) and overall satisfaction.


CONCLUSIONS
The provisional development of the EORTC BRR module has 31 items addressing issues of importance to patients as well as HCPs. Further international testing is underway as a UK National Cancer Research Network trial to ensure that this PROM will be psychometrically and clinically robust and applicable for use in clinical trials, cohort studies, national audit and clinical practice.
School of Clinical Sciences and Breast Reconstruction Patient Reported and Clinical Outcomes Research Group, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
H J
HJ
Thomson
Z E
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Winters
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Brandberg
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Didier
J M
JM
Blazeby
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Mills
D000328:Adult; D000368:Aged; D000465:Algorithms; D035843:Biomedical Research / Q000379:methods / Q000458:organization & administration*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery; D002277:Carcinoma / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery; D005060:Europe; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016462:Mammaplasty / Q000523:psychology / Q000534:rehabilitation*; D008408:Mastectomy / Q000379:methods / Q000523:psychology / Q000534:rehabilitation / Q000706:statistics & numerical data; D008495:Medical Oncology / Q000379:methods / Q000458:organization & administration*; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods; D011785:Quality Assurance, Health Care / Q000379:methods*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome