title: The symptom phenotype of oncology outpatients remains relatively stable from prior to through 1 week following chemotherapy.
abstract: Some oncology outpatients experience a higher number of and more severe symptoms during chemotherapy (CTX). However, little is known about whether this high risk phenotype persists over time. Latent transition analysis (LTA) was used to examine the probability that patients remained in the same symptom class when assessed prior to the administration of and following their next dose of CTX. For the patients whose class membership remained consistent, differences in demographic and clinical characteristics, and quality of life (QOL) were evaluated. The Memorial Symptom Assessment Scale (MSAS) was used to evaluate symptom burden. LTA was used to identify subgroups of patients with distinct symptom experiences based on the occurrence of the MSAS symptoms. Of the 906 patients evaluated, 83.9% were classified in the same symptom occurrence class at both assessments. Of these 760 patients, 25.0% were classified as Low-Low, 44.1% as Moderate-Moderate and 30.9% as High-High. Compared to the Low-Low class, the other two classes were younger, more likely to be women and to report child care responsibilities, and had a lower functional status and a higher comorbidity scores. The two higher classes reported lower QOL scores. The use of LTA could assist clinicians to identify higher risk patients and initiate more aggressive interventions.
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Miaskowski
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Cooper
authors.affiliation: College of Dentistry, New York University, New York, NY, USA.
authors.forename: B
authors.initials: B
authors.lastname: Aouizerat
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Melisko
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: L-M
authors.initials: LM
authors.lastname: Chen
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Dunn
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: X
authors.initials: X
authors.lastname: Hu
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Kober
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Mastick
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Levine
authors.affiliation: New York University College of Nursing, New York, NY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hammer
authors.affiliation: School of Nursing, Yale University, New Haven, CT, USA.
authors.forename: F
authors.initials: F
authors.lastname: Wright
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: J
authors.identifier: http://orcid.org/0000-0001-8933-117X
authors.initials: J
authors.lastname: Harris
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Armes
authors.affiliation: School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Furlong
authors.affiliation: School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Fox
authors.affiliation: School of Health Sciences, University of Surrey, Guilford, UK.
authors.forename: E
authors.initials: E
authors.lastname: Ream
authors.affiliation: School of Health Sciences, University of Surrey, Guilford, UK.
authors.forename: R
authors.initials: R
authors.lastname: Maguire
authors.affiliation: School of Health Sciences, University of Surrey, Guilford, UK.
authors.forename: N
authors.initials: N
authors.lastname: Kearney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010045:Outpatients / Q000706:statistics & numerical data; D010641:Phenotype; D011788:Quality of Life; D013997:Time Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: cancer; chemotherapy; latent transition analysis; predictive risk modelling; quality of life; symptoms