title: Evaluating patients for psychosocial distress and supportive care needs based on health-related quality of life in primary brain tumors: a prospective multicenter analysis of patients with gliomas in an outpatient setting.
abstract: The association between health-related quality of life (HRQoL), psychosocial distress, and supportive care is in the focus of patient-centered neuro-oncology. We investigated the relationship between the aforementioned in glioma-patients to evaluate the association of these instruments and determine cut-off values for suitable HRQoL scales indicating a potential need for intervention. In an observational multi-center study, outpatients completed the Distress Thermometer (DT), EORTC Quality of Life Questionnaire (EORTC-QLQ-C30/BN20, HRQoL), and Supportive-Care-Needs-Survey-SF34-G (SCNS). Based on nine EORTC-function and selected -symptom scales items of the questionnaires were matched. Convergent validity of related single items and scores across the instruments was estimated. EORTC cut-off values were calculated. Data of 167 patients were analyzed. The strongest correlation of EORTC-QLQ-C30 and DT was found for cognitive function (cogf), global health status (GHS), emotional (emof), role function (rolef), future uncertainty (FU), fatigue, and between EORTC-QLQ-C30 and SCNS for FU, emof, rolef (r = |0.4-0.7|; p < 0.01). EORTC cut-off values of <54.2 (GHS/QoL) and <62.5 (emof) predicted a DT ≥ 6 (AUC 0.79, 0.85, p < 0.01). EORTC cut-off values of <70.8 (emof) and <52.8 (FU) predicted the need for supportive care (AUC 0.78, 0.85; p < 0.01). Worse EORTC-C30 scores correlate with higher DT and SCNS scores. With this exploratory assessment, cut-off values for EORTC-C30 subscores to predict distress and pathological SCNS-scores could be determined, which could influence patients' referral to further treatment. However, further prospective clinical trials are needed to confirm the clinical relevance of these cut-off values.
authors.affiliation: Department of Neurosurgery, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany. anne-katrin.hickmann@hirslanden.ch.|Center for Endoscopic and Minimally Invasive Neurosurgery, Clinic Hirslanden, Zürich, Switzerland. anne-katrin.hickmann@hirslanden.ch.
authors.forename: Anne-Katrin
authors.initials: AK
authors.lastname: Hickmann
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz, Germany.|German Cancer Consortium (DKTK), Heidelberg, Germany.|German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Marlene
authors.initials: M
authors.lastname: Hechtner
authors.affiliation: Department of Neurosurgery, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany.
authors.forename: Minou
authors.initials: M
authors.lastname: Nadji-Ohl
authors.affiliation: Department of Neurosurgery, University Medical Center Johannes-Gutenberg-University Mainz, Mainz, Germany.
authors.forename: Mareile
authors.initials: M
authors.lastname: Janko
authors.affiliation: Department of Neurosurgery, University Medical Center Johannes-Gutenberg-University Mainz, Mainz, Germany.
authors.forename: Ann Katrin
authors.initials: AK
authors.lastname: Reuter
authors.affiliation: Department of Neurosurgery, University Medical Center Johannes-Gutenberg-University Mainz, Mainz, Germany.
authors.forename: Karoline
authors.initials: K
authors.lastname: Kohlmann
authors.affiliation: Department of Neurosurgery, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Haug
authors.affiliation: Department of Neurosurgery, University Ulm, Günzburg, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Grüninger
authors.affiliation: Department of Neurosurgery, University Ulm, Günzburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Deininger
authors.affiliation: Department of Neurosurgery, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Ganslandt
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes-Gutenberg-University Mainz, Mainz, Germany.
authors.forename: Jochem
authors.initials: J
authors.lastname: König
authors.affiliation: Department of Neurosurgery, University Ulm, Günzburg, Germany.
authors.forename: Christian Rainer
authors.initials: CR
authors.lastname: Wirtz
authors.affiliation: Department of Neurosurgery, University Ulm, Günzburg, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Coburger
authors.affiliation: Department of Neurosurgery, University Medical Center Johannes-Gutenberg-University Mainz, Mainz, Germany.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Renovanz
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications* / Q000523:psychology; D005260:Female; D005910:Glioma / Q000150:complications* / Q000523:psychology; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000209:etiology* / Q000451:nursing*; D011795:Surveys and Questionnaires
keywords: Assessment; Brain tumor; Quality of life; Questionnaires