title: Systematic review reveals limitations of studies evaluating health-related quality of life after potentially curative treatment for esophageal cancer.
abstract: OBJECTIVE
  To (1) assess the quality of studies evaluating Health-Related Quality of Life (HRQL) after potentially curative treatment for esophageal cancer, and (2) to identify high-quality studies that provide robust HRQL results.
  
  
  METHODS
  A systematic literature search is to identify studies evaluating HRQL with a validated multidimensional patient-reported outcome measure. Study quality focused on study design, risk of bias, HRQL outcome reporting, and additional issues of reporting and methodology. A study was deemed high-quality if criteria for robust study methodology and robust HRQL outcome reporting were met.
  
  
  RESULTS
  Six RCTs, 12 cohort studies, 13 case-series, and 31 cross-sectional studies were identified. Overall risk of bias was high. Reporting of HRQL concept (e.g., a priori hypothesis), methodology (e.g., reasons for missing data), and interpretation (e.g., clinical significance) was often absent or unclear. Additional issues of reporting (e.g., unclear treatment descriptions) and methodology (e.g., no control for multiple testing) were identified. Four studies (6%) met the criteria for robust study methodology, and 26 studies (42%) met the criteria for robust HRQL outcome reporting. We identified three high-quality studies (5%)--two RCTs and one case-series--capable of providing robust results.
  
  
  CONCLUSIONS
  Current evidence is restricted in its ability to inform practice on HRQL after potentially curative treatment for esophageal cancer.
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. m.jacobs@amc.uva.nl
authors.forename: Marc
authors.initials: M
authors.lastname: Jacobs
authors.forename: Rhiannon C
authors.initials: RC
authors.lastname: Macefield
authors.forename: Jane M
authors.initials: JM
authors.lastname: Blazeby
authors.forename: Ida J
authors.initials: IJ
authors.lastname: Korfage
authors.forename: Mark I
authors.initials: MI
authors.lastname: van Berge Henegouwen
authors.forename: Hanneke C J M
authors.initials: HC
authors.lastname: de Haes
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Smets
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
mesh_terms: D004938:Esophageal Neoplasms / Q000523:psychology* / Q000601:surgery; D016629:Esophagectomy; D006304:Health Status; D006801:Humans; D017063:Outcome Assessment, Health Care; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life