title: Using the EORTC-QLQ-C30 in clinical practice for patient management: identifying scores requiring a clinician's attention.
abstract: OBJECTIVE
  Patient-reported outcomes (PROs) are used increasingly for individual patient management. Identifying which PRO scores require a clinician's attention is an ongoing challenge. Previous research used a needs assessment to identify EORTC-QLQ-C30 cutoff scores representing unmet needs. This analysis attempted to replicate the previous findings in a new and larger sample.
  
  
  METHODS
  This analysis used data from 408 Japanese ambulatory breast cancer patients who completed the QLQ-C30 and Supportive Care Needs Survey-Short Form-34 (SCNS-SF34). Applying the methods used previously, SCNS-SF34 item/domain scores were dichotomized as no versus some unmet need. We calculated area under the receiver operating characteristic curve (AUC) to evaluate QLQ-C30 scores' ability to discriminate between patients with no versus some unmet need based on SCNS-SF34 items/domains. For QLQ-C30 domains with AUC ≥ 0.70, we calculated the sensitivity, specificity, and predictive value of various cutoffs for identifying unmet needs. We hypothesized that compared to our original analysis, (1) the same six QLQ-C30 domains would have AUC ≥ 0.70, (2) the same SCNS-SF34 items would be best discriminated by QLQ-C30 scores, and (3) the sensitivity and specificity of our original cutoff scores would be supported.
  
  
  RESULTS
  The findings from our original analysis were supported. The same six domains with AUC ≥ 0.70 in the original analysis had AUC ≥ 0.70 in this new sample, and the same SCNS-SF34 item was best discriminated by QLQ-C30 scores. Cutoff scores were identified with sensitivity ≥0.84 and specificity ≥0.54.
  
  
  CONCLUSIONS
  Given these findings' concordance with our previous analysis, these QLQ-C30 cutoffs could be implemented in clinical practice and their usefulness evaluated.
authors.affiliation: Division of General Internal Medicine, Johns Hopkins School of Medicine, 624 N. Broadway, Room 657, Baltimore, MD, 21205, USA, csnyder@jhsph.edu.
authors.forename: Claire F
authors.initials: CF
authors.lastname: Snyder
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Blackford
authors.forename: Toru
authors.initials: T
authors.lastname: Okuyama
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Yamashita
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Toyama
authors.forename: Michael A
authors.initials: MA
authors.lastname: Carducci
authors.forename: Albert W
authors.initials: AW
authors.lastname: Wu
mesh_terms: D000368:Aged; D044466:Asian People / Q000523:psychology; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D005791:Patient Care; D010348:Patient Care Team; D063868:Patient Outcome Assessment; D011237:Predictive Value of Tests; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires