E A C Albers, K M de Ligt, I M C van der Ploeg, M J W M Wouters, S B Schagen, L V van de Poll-Franse
{"title":"在常规临床肿瘤学实践中筛查认知障碍:一项使用患者报告结果测量法和在线认知测试对黑色素瘤和乳腺癌患者进行筛查的试点研究。","authors":"E A C Albers, K M de Ligt, I M C van der Ploeg, M J W M Wouters, S B Schagen, L V van de Poll-Franse","doi":"10.1007/s00520-025-09325-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This pilot study aimed to identify patients with cognitive impairment by a stepped-care use of patient-reported outcome measures (PROMs) and complementary online cognitive tests implemented in routine clinical practice.</p><p><strong>Methods: </strong>Self-reported cognitive functioning was measured in breast cancer or melanoma patients, 6 months after start of treatment, with two items of the EORTC QLQ-C30. Scores below a predefined threshold of 75 indicated clinically relevant cognitive impairment. Subsequent objective cognitive functioning was assessed with an online test battery, consisting of seven tests. Impaired cognitive functioning was defined as a z score of ≤ - 1.5 on 2 or more tests, a z score of ≤ - 2 on one single test, or both. Descriptive statistics were used to analyze the prevalence of impairment.</p><p><strong>Results: </strong>In total, 261 patients completed PROMs 6 months after start treatment; 38/154 (25%) melanoma and 43/107 (40%) breast cancer patients reported clinically relevant self-reported cognitive impairment. Of them, 12/38 (32%) melanoma and 15/43 (35%) breast cancer patients opted for complementary online cognitive testing. Of those completing formal tests, objectively measured cognitive impairment was identified in 4/12 (33%) melanoma and 10/15 (67%) breast cancer patients.</p><p><strong>Conclusion: </strong>A significant number of patients report cognitive problems 6 months after starting treatment. Only onethird was able and/or expressed the need for further diagnostics. Among those who were formally tested, 33-67% had cognitive impairment, which is 3-9% of the total group that completed PROMs in routine care.</p><p><strong>Implications for cancer survivors: </strong>This pilot study suggests that a stepped care pathway for cognitive problems is relevant and also mangable in terms of clinical care.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"273"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Screening for cognitive impairment in routine clinical oncology practice: a pilot study using patient-reported outcome measures and online cognitive testing in melanoma and breast cancer patients.\",\"authors\":\"E A C Albers, K M de Ligt, I M C van der Ploeg, M J W M Wouters, S B Schagen, L V van de Poll-Franse\",\"doi\":\"10.1007/s00520-025-09325-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This pilot study aimed to identify patients with cognitive impairment by a stepped-care use of patient-reported outcome measures (PROMs) and complementary online cognitive tests implemented in routine clinical practice.</p><p><strong>Methods: </strong>Self-reported cognitive functioning was measured in breast cancer or melanoma patients, 6 months after start of treatment, with two items of the EORTC QLQ-C30. Scores below a predefined threshold of 75 indicated clinically relevant cognitive impairment. Subsequent objective cognitive functioning was assessed with an online test battery, consisting of seven tests. Impaired cognitive functioning was defined as a z score of ≤ - 1.5 on 2 or more tests, a z score of ≤ - 2 on one single test, or both. Descriptive statistics were used to analyze the prevalence of impairment.</p><p><strong>Results: </strong>In total, 261 patients completed PROMs 6 months after start treatment; 38/154 (25%) melanoma and 43/107 (40%) breast cancer patients reported clinically relevant self-reported cognitive impairment. Of them, 12/38 (32%) melanoma and 15/43 (35%) breast cancer patients opted for complementary online cognitive testing. Of those completing formal tests, objectively measured cognitive impairment was identified in 4/12 (33%) melanoma and 10/15 (67%) breast cancer patients.</p><p><strong>Conclusion: </strong>A significant number of patients report cognitive problems 6 months after starting treatment. Only onethird was able and/or expressed the need for further diagnostics. Among those who were formally tested, 33-67% had cognitive impairment, which is 3-9% of the total group that completed PROMs in routine care.</p><p><strong>Implications for cancer survivors: </strong>This pilot study suggests that a stepped care pathway for cognitive problems is relevant and also mangable in terms of clinical care.</p>\",\"PeriodicalId\":22046,\"journal\":{\"name\":\"Supportive Care in Cancer\",\"volume\":\"33 4\",\"pages\":\"273\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-03-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Supportive Care in Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00520-025-09325-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Supportive Care in Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00520-025-09325-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Screening for cognitive impairment in routine clinical oncology practice: a pilot study using patient-reported outcome measures and online cognitive testing in melanoma and breast cancer patients.
Purpose: This pilot study aimed to identify patients with cognitive impairment by a stepped-care use of patient-reported outcome measures (PROMs) and complementary online cognitive tests implemented in routine clinical practice.
Methods: Self-reported cognitive functioning was measured in breast cancer or melanoma patients, 6 months after start of treatment, with two items of the EORTC QLQ-C30. Scores below a predefined threshold of 75 indicated clinically relevant cognitive impairment. Subsequent objective cognitive functioning was assessed with an online test battery, consisting of seven tests. Impaired cognitive functioning was defined as a z score of ≤ - 1.5 on 2 or more tests, a z score of ≤ - 2 on one single test, or both. Descriptive statistics were used to analyze the prevalence of impairment.
Results: In total, 261 patients completed PROMs 6 months after start treatment; 38/154 (25%) melanoma and 43/107 (40%) breast cancer patients reported clinically relevant self-reported cognitive impairment. Of them, 12/38 (32%) melanoma and 15/43 (35%) breast cancer patients opted for complementary online cognitive testing. Of those completing formal tests, objectively measured cognitive impairment was identified in 4/12 (33%) melanoma and 10/15 (67%) breast cancer patients.
Conclusion: A significant number of patients report cognitive problems 6 months after starting treatment. Only onethird was able and/or expressed the need for further diagnostics. Among those who were formally tested, 33-67% had cognitive impairment, which is 3-9% of the total group that completed PROMs in routine care.
Implications for cancer survivors: This pilot study suggests that a stepped care pathway for cognitive problems is relevant and also mangable in terms of clinical care.
期刊介绍:
Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease.
Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.