title: Can quality of life assessments differentiate heterogeneous cancer patients?
abstract: OBJECTIVE
  This research conducted a face validation study of patient responses to the application of an HRQOL assessment research tool in a comprehensive community cancer program setting across a heterogeneous cohort of cancer patients throughout the natural history of diagnosed malignant disease, many of whom would not be considered candidates for clinical research trial participation.
  
  
  METHODS
  Cancer registries at two regional cancer treatment centers identified 11072 cancer patients over a period of nine years. The EORTC QLQ-C30 was administered to patients at the time of their initial clinical presentation to these centers. To determine the significance of differences between patient subgroups, two analytic criteria were used. The Mann-Whitney test was used to determine statistical significance; clinical relevance defined a range of point differences that could be perceived by patients with different health states.
  
  
  RESULTS
  Univariate analyses were conducted across stratification variables for population, disease severity and demographic characteristics. The largest differences were associated with cancer diagnosis and recurrence of disease. Large differences were also found for site of origin, mortality and stage; minimal differences were observed for gender and age. Consistently sensitive QoL scales were appetite loss, fatigue and pain symptoms, and role (work-related), social and physical functions.
  
  
  CONCLUSIONS
  1) The EORTC QLQ-C30 collected meaningful patient health assessments in the context of non-research based clinical care, 2) patient assessment differences are manifested disparately across 15 QoL domains, and 3) in addition to indicating how a patient may feel at a point in time, QoL indicators may also reveal information about underlying biological responses to disease progression, treatments, and prospective survival.
authors.affiliation: Medicine & Science, Cancer Treatment Centers of America at Midwestern Regional Medical Center, Zion, Illinois, United States of America.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: McCabe
authors.affiliation: Medicine & Science, Cancer Treatment Centers of America at Midwestern Regional Medical Center, Zion, Illinois, United States of America; Department of Epidemiology, University of Illinois School of Public Health, Chicago, Illinois, United States of America.
authors.forename: James F
authors.initials: JF
authors.lastname: Grutsch
authors.affiliation: Medicine & Science, Cancer Treatment Centers of America at Midwestern Regional Medical Center, Zion, Illinois, United States of America.
authors.forename: Swetha B
authors.initials: SB
authors.lastname: Nutakki
authors.affiliation: Medicine & Science, Cancer Treatment Centers of America at Midwestern Regional Medical Center, Zion, Illinois, United States of America.
authors.forename: Donald P
authors.initials: DP
authors.lastname: Braun
authors.affiliation: Medicine & Science, Cancer Treatment Centers of America at Eastern Regional Medical Center, Philadelphia, Pennsylvania, United States of America.
authors.forename: Maurie
authors.initials: M
authors.lastname: Markman
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology* / Q000523:psychology; D011788:Quality of Life