Quality of Life Research最新文献

Background: Gastroesophageal cancer has a poor prognosis, and treatment significantly impacts health-related quality of life (HRQoL). Accurate prediction of HRQoL changes after treatment can support shared decision-making. This study aimed to develop and validate HRQoL prediction models for patients with gastroesophageal cancer using established risk-prediction models and a newly proposed sequential score model.

Methods: HRQoL data came from the Prospective Observational Cohort Study of Esophageal-Gastric Cancer Patients registry, linked to the Netherlands Cancer Registry. The EORTC QLQ-C30 functioning scales were used as outcomes. Risk-prediction models, based on logistic elastic-net regression, estimated the probability of meaningful HRQoL deterioration at 3, 6, and 12 months post-treatment. The sequential score model, using XGBoost regression, predicted the next HRQoL score at any time. Calibration curves and integrated calibration index (ICI) assessed predictive performance, with Brier scores and AUC for risk-prediction models and root mean squared error plus Out-of-Sample r^² for sequential models.

Results: Risk-prediction models showed strong performance (ICI: 0.03-0.08; Brier score: 0.09-0.17; AUC: 0.79-0.87) for predicting significant deterioration in Summary Score, Physical Functioning, and Fatigue, with good calibration. Sequential score models explained up to 40% of the variance in HRQoL scores.

Conclusion: Both models effectively predicted HRQoL in gastroesophageal cancer patients, demonstrating potential to enhance patient care and information sharing through accurate prediction of HRQoL outcomes.

Objective: As part of a large mixed-methods study, we aim to develop culturally relevant additional dimensions (bolt-ons) for the EQ-5D-5L in China. In the qualitative phase, we developed seven candidate bolt-ons. In this first quantitative phase, we aimed to test the psychometric properties of these bolt-ons in the Chinese adult general population.

Methods: An online survey was conducted among a representative sample of the Chinese general population (n = 1,037) to collect data on the EQ-5D-5L + bolt-ons, SF-6Dv2, EQ-HWB-9, general health status, and socio-demographics. Psychometric analysis was performed to assess the EQ-5D-5L + bolt-ons, including ceiling, informativity, convergent and divergent validity, known-group validity and explanatory power.

Results: Adding bolt-ons reduced the ceiling of the EQ-5D-5L by 2.3%-points (adaptation to society) to 7.6%-points (tiredness/lack of strength). Tiredness/lack of strength had the highest relative informativity (Shannon's evenness index = 0.67). Appetite and social relationships showed the best divergent validity from the five core dimensions. Tiredness/lack of strength demonstrated strong or moderate correlations with SF-6Dv2 vitality (r = 0.648) and EQ-HWB-9 exhaustion (r = 0.541) dimensions. Adding tiredness/lack of strength, climate adaptation and emotional control improved the explanatory power for the EQ VAS score. Tiredness/lack of strength enhanced the known-groups validity for differentiating between respondents based on the presence of chronic diseases and in group comparisons by SF-6Dv2 level sum scores.

Conclusion: The tiredness/lack of strength bolt-ons performed best, but the sleep problems and appetite bolt-ons also improved several psychometric properties of the EQ-5D-5L in the Chinese general population. Combined with patient evidence, these findings may inform evidence-based bolt-on selection in the Chinese context.

Purpose: The purpose of this study was to explore the content validity of the Danish version of the PROMIS-10 Global Health questionnaire in patients with high-impact chronic pain by (1) identifying problematic items and reasons for misunderstandings between participants' interpretations and the intended meaning, and (2) exploring how participants understand and interpret the items.

Methods: Individual cognitive interviews were conducted with participants with high-impact chronic pain referred to two Danish Pain Centers using a structured step-by-step interview approach. The first objective was analyzed mainly using a deductive structured approach, while the second objective was analyzed mainly using an inductive thematic approach focusing on participants' perspectives.

Results: Participants (n = 19) generally understood the items as intended but showed 21% and 11% non-congruency for items 8r (fatigue) and 7r (pain intensity), as they responded based on a longer timeframe than "the past 7 days". Overall, participants interpreted the items through a physical, psychological and social perspective. Further, items 5 (social activities and relationships) and 6 (daily physical activities) were perceived to overlap thematically with item 9r (social activities and roles). Additionally, the provided examples in items 5 and 6 influenced responses, and some deemed item 7r irrelevant, as it did not reflect their pain experiences.

Conclusion: The findings contribute to the validation of PROMIS-10 Global Health in patients with high-impact chronic pain by providing insights into how participants understand and interpret the items, highlighting areas for minor refinement. Further qualitative research on the validity of PROMIS-10 Global Health in this population is needed.

Purpose: Obstructive Sleep Apnea (OSA) impairs children's quality of life (QoL), but the impact of air pollution and heat wave on pediatric OSA-related QoL remains unclear. This retrospective cross-sectional study investigated associations between short-term air pollutant (PM_2.5, PM₁₀, SO₂, and NO₂) exposure, heat wave, and QoL in children with OSA, including pollutant lag effects.

Methods: A retrospective cross-sectional study was conducted at Henan Provincial Children's Hospital (2021-2023). Eligible participants were ≤ 14-year-old Henan residents with confirmed OSA (OAHI > 1) via polysomnography. QoL was assessed by the OSA-18 Scale. Air pollutant and heat wave data were from national monitoring networks. Generalized Linear Regression Models (GLMs) analyzed continuous QoL outcomes, with sensitivity analyses performed.

Results: 1943 children were included. The statistical analysis results showed that PM_2.5 lag03-lag07; PM₁₀ lag0-lag6, lag01-lag07; SO₂ lag0-lag2, lag01-lag07; NO₂ lag7, lag05-lag07 were statistically correlated with the impact on the QoL of pediatric patients. The maximum effect values OR were 1.042 (95% CI 1.006, 1.079), 1.030 (95% CI 1.016, 1.045), 1.774 (95% CI 1.279, 2.462), and 1.101 (95% CI 1.013, 1.197), respectively. Additionally, heat wave was associated with worse QoL (OR:1.537, 95% CI 1.021, 2.313). Sensitivity analyses confirmed result stability.

Conclusions: Air pollutants (especially SO₂ and NO₂) and heat waves reduce QoL in children with OSA, highlighting the need for targeted environmental interventions.

Purpose: The global burden of chronic health conditions is significant. Medicinal cannabis (MC) is a legalised treatment option for patients with chronic health conditions in some countries. Health-related quality of life (HRQL) is an important patient-reported outcome across all chronic health conditions. We aimed to determine how studies of MC therapy justify, measure, and report HRQL, and assess the current evidence for HRQL following MC treatment.

Methods: Systematic review searching AMED, Medline, Web of Science, Scopus, Embase, Cinahl, and PsycINFO from Jan 2015 to Apr 2025. Studies using validated HRQL measures pre-, and post-MC treatment for any chronic health condition were included. Screening and data extraction were performed independently by two reviewers. Completeness of HRQL reporting was evaluated. Meta-analyses for short-term (2-weeks to 3-months), medium-term (> 3 to < 12-months), and long-term (≥ 12-months) HRQL outcomes were conducted, with Risk of Bias (RoB) assessed in randomised control trials (RCTs).

Results: Of 16,674 retrieved citations, 64 studies were retained for analysis:12 RCTs; 38 cohort studies; 13 case series; 1 non-randomised experimental study. Thirty-nine studies (61%) provided justification for assessing HRQL and five (8%) provided HRQL definitions. Studies used generic (n = 52, 81%) or condition-specific (n = 12, 19%) HRQL measures, with EQ-5D-5L most commonly used. Meta-analyses: RCTs showed small short-term HRQL improvements (Cohen's d = 0.30, p = 0.03), with some concerns or low RoB. For observational studies, HRQL improved in all follow-up periods (d = 0.43 to 0.74; all p < 0.001). HRQL improvement varied between, and within, different health conditions.

Conclusion: This systematic review and meta-analyses of studies published between 2015 and 2025 found that few studies provided HRQL definitions, and a third of studies did not explain why they measured HRQL. To ensure appropriate measures are used for this important treatment outcome, future studies should define HRQL and justify the HRQL assessment in the context of research objectives. Overall, improvements in HRQL were observed across studies of patients using MC.