A Tool for Rapid Assessment of Functional Outcomes in Patients with Head and Neck Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Identification of HNC-Relevant Functional Domains
2.2. External Criteria for Uniform Scoring and Draft Development
2.3. Draft Revision through Semi-Structured Expert Interviews
2.4. Empirical Validation of the Adapted HNC-FIT Scale
2.4.1. Patients and Controls
2.4.2. Empirical Validity, Reliability, Responsiveness, and Fill-In Time
2.4.3. Sample Size Estimation
2.5. Data Analysis
3. Results
3.1. HNC-Relevant Functional Domains
3.2. External Criteria for Uniform Scoring
3.3. Draft Revision through Semi-Structured Expert Interviews
3.4. Empirical Validation of the Expert Adapted HNC-FIT Scale
3.4.1. Patients and Controls
3.4.2. Empirical Validity, Reliability, Responsiveness, and Fill-In Time
4. Discussion
4.1. Introduction
4.2. Development
4.3. Mode of Administration
4.4. Empirical Validation
4.5. Presentation of Functional Outcomes
4.6. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Controls (n = 37) | Pretreatment Group (n = 24) | Posttreatment Group (n = 60) | |
---|---|---|---|
Sex | |||
Male | 25 | 21 | 49 |
Female | 12 | 3 | 11 |
Age | |||
≤50 | 4 | 3 | 3 |
51–60 | 13 | 7 | 12 |
61–70 | 16 | 7 | 19 |
71–80 | 4 | 4 | 19 |
≥80 | 0 | 3 | 5 |
P16 status | |||
Negative | n.a. 4 | 20 | 49 |
Positive | n.a. 4 | 4 | 11 |
Tumor site | |||
Oral cavity | n.a. 4 | 5 | 12 |
Oropharynx | n.a. 4 | 6 | 25 |
Hypopharynx | n.a. 4 | 4 | 8 |
Larynx | n.a. 4 | 8 | 13 |
CUP 1 | n.a. 4 | 1 | 2 |
Clinical UICC stage 2 | |||
Stage I | n.a. 4 | 10 | 13 |
Stage II | n.a. 4 | 5 | 14 |
Stage III | n.a. 4 | 2 | 9 |
Stage IVa | n.a. 4 | 6 | 21 |
Stage IVb | n.a. 4 | 1 | 3 |
Stage IVc | n.a. 4 | 0 | 0 |
Treatment 3 | |||
No surgery only | n.a. 4 | 0 | 8 |
Surgery only | n.a. 4 | 13 | 15 |
Multimodality | n.a. 4 | 11 | 37 |
Functional Domain | Controls | Pretreatment Group | Posttreatment Group | p-Value 1 |
---|---|---|---|---|
Food intake | 80.8 | 63.5 | 47.9 | <0.001 |
Breathing | 71.7 | 67.8 | 51.7 | 0.004 |
Speech | 74.4 | 65.3 | 50.4 | 0.001 |
Pain | 68.9 | 56.5 | 57.9 | 0.140 |
Mood | 69.3 | 56.8 | 56.7 | 0.140 |
Mobility | 66.8 | 69.8 | 53.9 | 0.027 |
HNC-FIT Scale | |||||||
---|---|---|---|---|---|---|---|
Food Intake | Breathing | Speech | Pain | Mood | Mobility | ||
EORTC QoL H&N35 | Teeth | −0.16 | −0.01 | −0.17 | −0.13 | −0.32 3 | −0.09 |
Swallowing | −0.72 1 | −0.20 | −0.31 3 | −0.31 3 | −0.22 | −0.41 2 | |
Social eating | −0.56 1 | 0.02 | −0.20 | −0.24 | −0.15 | −0.42 2 | |
Opening mouth | −0.36 2 | −0.05 | −0.21 | −0.24 | −0.26 | −0.40 2 | |
Dry mouth | −0.29 3 | 0.15 | 0.10 | −0.12 | −0.06 | −0.21 | |
Sticky saliva | −0.38 2 | −0.13 | −0.12 | −0.11 | −0.26 | −0.32 3 | |
Nutritional Supplements | −0.35 2 | −0.02 | −0.09 | −0.15 | −0.09 | −0.07 | |
Feeding tube | −0.73 1 | −0.20 | −0.32 3 | −0.15 | 0.10 | −0.26 | |
Weight loss | −0.38 2 | −0.15 | −0.21 | −0.26 | −0.01 | −0.02 | |
Weight gain | 0.04 | −0.26 | −0.26 | 0.05 | −0.16 | −0.23 | |
Coughed | −0.15 | −0.16 | −0.15 | 0.03 | −0.11 | 0.05 | |
Speech | −0.34 2 | −0.37 2 | −0.55 1 | −0.35 2 | −0.28 | −0.11 | |
Pain | −0.36 2 | 0.04 | −0.16 | −0.47 1 | −0.24 | −0.18 | |
Pain killers | −0.35 2 | −0.05 | −0.16 | −0.61 1 | −0.21 | −0.05 | |
Social contact | −0.01 | −0.03 | −0.09 | −0.29 3 | −0.25 | −0.08 | |
Sexuality | −0.27 3 | −0.39 2 | −0.30 3 | −0.05 | −0.25 | −0.22 | |
Senses | −0.37 2 | −0.19 | −0.25 | −0.19 | −0.19 | −0.26 | |
Feeling ill | −0.26 3 | −0.14 | −0.09 | −0.11 | −0.30 3 | −0.21 |
rICC 1 | 95% CI 2 | p-Value 2 | ||
---|---|---|---|---|
Interrater Reliability | Food intake | 0.99 | 0.98–0.99 | 0.006 |
Breathing | 0.95 | 0.93–0.97 | 0.006 | |
Speech | 0.96 | 0.94–0.98 | 0.006 | |
Pain | 0.93 | 0.89–0.95 | 0.006 | |
Mood | 0.91 | 0.86–0.94 | 0.006 | |
Shoulder–neck mobility | 0.90 | 0.85–0.93 | 0.006 | |
Test-Retest-Reliability | Food intake | 0.94 | 0.84–0.98 | 0.006 |
Breathing | 0.95 | 0.91–0.99 | 0.006 | |
Speech | 0.97 | 0.94–0.98 | 0.006 | |
Pain | 0.93 | 0.81–0.98 | 0.006 | |
Mood | 0.71 | 0.18–0.91 | 0.012 | |
Dhoulder–neck mobility | 0.98 | 0.93–0.99 | 0.006 |
Functional Domain | Pretreatment Assessment 1 | Posttreatment Assessment 1 | F-Value | p-Value 2 | η2 |
---|---|---|---|---|---|
Food intake | 3.3 ± 1.0 | 2.8 ± 1.1 | 8.64 | 0.040 | 0.313 |
Breathing | 3.8 ± 0.6 | 3.5 ± 1 | 2.11 | 0.326 | 0.100 |
Speech | 3.8 ± 0.4 | 3.2 ± 1 | 6.54 | 0.076 | 0.256 |
Pain | 3.7 ± 0.8 | 2.3 ± 1.1 | 24.18 | 0.006 | 0.560 |
Mood | 3.4 ± 0.8 | 3.1 ± 0.9 | 3.06 | 0.270 | 0.139 |
Mobility | 3.8 ± 0.4 | 3.8 ± 0.4 | 0.00 | >0.99 | <0.001 |
Score | Verbal Rating | Controls (n = 37) | Pretreatment (n = 24) | Posttreatment (n = 60) | |
---|---|---|---|---|---|
Food intake | 0 | No oral feeding; only via gastrostomy tube | 0 | 0 | 3 |
1 | Gastrostomy tube needed; some oral feeding possible | 0 | 0 | 12 | |
2 | No gastrostomy tube, oral diet, but only liquid/soft food | 0 | 2 | 4 | |
3 | No gastrostomy tube, diet/swallowing near-normal | 2 | 7 | 15 | |
4 | Normal | 35 | 15 | 26 | |
Breathing | 0 | Tracheostoma, needs blocked cannula | 0 | 0 | 2 |
1 | Tracheostoma, speech cannula no cannula | 0 | 1 | 8 | |
2 | No tracheostoma, breathing difficult at rest | 0 | 0 | 2 | |
3 | No tracheostoma, breathing difficulties only on exertion | 4 | 3 | 13 | |
4 | Normal | 33 | 20 | 35 | |
Speech | 0 | Not possible/without phonation | 0 | 0 | 4 |
1 | Difficult to understand, no phone calls | 0 | 1 | 5 | |
2 | Telephoning possible | 1 | 0 | 5 | |
3 | Easy to understand, but pronunciation/voice changed | 3 | 6 | 16 | |
4 | Normal | 33 | 17 | 30 | |
Pain | 0 | Pain despite opiate therapy | 0 | 0 | 3 |
1 | Controlled with opiates | 0 | 1 | 2 | |
2 | Regularly needs non-opioid analgesics | 1 | 2 | 5 | |
3 | Needs analgesics from time to time | 2 | 4 | 5 | |
4 | Normal | 34 | 17 | 45 | |
Mood | 0 | Suicidal thoughts | 0 | 0 | 0 |
1 | Very depressed despite antidepressants | 1 | 1 | 3 | |
2 | With antidepressants overall normal mood, very depressed without antidepressants | 2 | 3 | 6 | |
3 | Occasionally depressed, no antidepressants needed | 4 | 5 | 15 | |
4 | Normal | 30 | 14 | 36 | |
Mobility | 0 | Stiff neck and/or shoulder, hardly any movement possible | 0 | 0 | 0 |
1 | Can hair hairdly comb, looking backwards in car not possible | 0 | 0 | 3 | |
2 | Combing with problems, looking backwards in car difficult | 0 | 0 | 4 | |
3 | Combing and looking backwards in car slightly restricted | 5 | 2 | 13 | |
4 | Normal | 32 | 22 | 40 |
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Dejaco, D.; Riedl, D.; Gasser, S.; Schartinger, V.H.; Innerhofer, V.; Gottfried, T.; Steinbichler, T.B.; Riechelmann, F.; Moschen, R.; Galvan, O.; et al. A Tool for Rapid Assessment of Functional Outcomes in Patients with Head and Neck Cancer. Cancers 2021, 13, 5529. https://doi.org/10.3390/cancers13215529
Dejaco D, Riedl D, Gasser S, Schartinger VH, Innerhofer V, Gottfried T, Steinbichler TB, Riechelmann F, Moschen R, Galvan O, et al. A Tool for Rapid Assessment of Functional Outcomes in Patients with Head and Neck Cancer. Cancers. 2021; 13(21):5529. https://doi.org/10.3390/cancers13215529
Chicago/Turabian StyleDejaco, Daniel, David Riedl, Sebastian Gasser, Volker Hans Schartinger, Veronika Innerhofer, Timo Gottfried, Teresa Bernadette Steinbichler, Felix Riechelmann, Roland Moschen, Oliver Galvan, and et al. 2021. "A Tool for Rapid Assessment of Functional Outcomes in Patients with Head and Neck Cancer" Cancers 13, no. 21: 5529. https://doi.org/10.3390/cancers13215529