Skip to main content
Erschienen in: Quality of Life Research 3/2019

03.12.2018

Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery

verfasst von: C. Quinten, C. Kenis, L. Decoster, P. R. Debruyne, I. De Groof, C. Focan, F. Cornelis, V. Verschaeve, C. Bachmann, D. Bron, S. Luce, G. Debugne, H. Van den Bulck, J. C. Goeminne, A. Baitar, K. Geboers, B. Petit, C. Langenaeken, R. Van Rijswijk, P. Specenier, G. Jerusalem, J. P. Praet, K. Vandenborre, M. Lycke, J. Flamaing, K. Milisen, J. P. Lobelle, H. Wildiers

Erschienen in: Quality of Life Research | Ausgabe 3/2019

Einloggen

Aktivieren Sie unsere intelligente Suche um passende Fachinhalte oder Patente zu finden.

search-config
loading …

Abstract

Purpose

Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes.

Methods

Our analysis included 1424 (G8 ≤ 14) older patients with cancer scheduled to receive chemotherapy (n = 683) or surgery (n = 741). Anchor-based methods, linking the GHS score to clinical indicators, were used to determine MCID between baseline and follow-up at 3 months. A threshold of 0.2 standard deviation (SD) was used to exclude MCID estimates too small for interpretation. Logistic regressions analysed baseline patient characteristics prognostic for HRQOL changes.

Results

The 15-item Geriatric Depression Scale (GDS15), Visual Analogue Scale (VAS) for Fatigue and ECOG Performance Status (PS) were selected as clinical anchors. In the surgery group, MCID estimates for improvement and deterioration were ECOG PS (5*, 11*), GDS15 (5*, 2) and VAS Fatigue (3, 9*). In the chemotherapy group, MCID estimates for improvement and deterioration were ECOG PS (8*, 7*), GDS15 (5, 4) and VAS Fatigue (5, 5*). Estimates with * were > 0.2 SD threshold. Patients experiencing pain or malnutrition (surgery group) or fatigue (chemotherapy group) at baseline showed a significantly stable or improved HRQOL (p < 0.05) after their treatment.

Conclusion

The reported MCID for improvement and deterioration depended on the anchor used and treatment received. The estimates can be used to evaluate significant changes in HRQOL and to determine sample sizes in clinical trials.

Sie haben noch keine Lizenz? Dann Informieren Sie sich jetzt über unsere Produkte:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

  • über 102.000 Bücher
  • über 537 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Maschinenbau + Werkstoffe
  • Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Springer Professional "Wirtschaft"

Online-Abonnement

Mit Springer Professional "Wirtschaft" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 340 Zeitschriften

aus folgenden Fachgebieten:

  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Versicherung + Risiko




Jetzt Wissensvorsprung sichern!

Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Zikos, E., Coens, C., Quinten, C., Ediebah, D. E., Martinelli, F., Ghislain, I., et al. (2016). The added value of analyzing pooled health-related quality of life data: A review of the EORTC PROBE initiative. Journal of the National Cancer Institute, 108(5), djv391.CrossRefPubMed Zikos, E., Coens, C., Quinten, C., Ediebah, D. E., Martinelli, F., Ghislain, I., et al. (2016). The added value of analyzing pooled health-related quality of life data: A review of the EORTC PROBE initiative. Journal of the National Cancer Institute, 108(5), djv391.CrossRefPubMed
2.
Zurück zum Zitat King, M. T. (2011). A point of minimal important difference (MID): A critique of terminology and methods. Expert Review of Pharmacoeconomics & Outcomes Research, 11(2), 171.CrossRef King, M. T. (2011). A point of minimal important difference (MID): A critique of terminology and methods. Expert Review of Pharmacoeconomics & Outcomes Research, 11(2), 171.CrossRef
3.
Zurück zum Zitat Kane, R. C. (2008). The clinical significance of statistical significance. The Oncologist, 13(11), 1129–1133.CrossRefPubMed Kane, R. C. (2008). The clinical significance of statistical significance. The Oncologist, 13(11), 1129–1133.CrossRefPubMed
4.
Zurück zum Zitat Revicki, D., Hays, R. D., Cella, D., & Sloan, J. (2008). Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. Journal of Clinical Epidemiology, 61(2), 102–109.CrossRefPubMed Revicki, D., Hays, R. D., Cella, D., & Sloan, J. (2008). Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. Journal of Clinical Epidemiology, 61(2), 102–109.CrossRefPubMed
5.
Zurück zum Zitat Terwee, C. B., Roorda, L. D., Dekker, J., Bierma-Zeinstra, S. M., Peat, G., Jordan, K. P., et al. (2010). Mind the MIC: Large variation among populations and methods. Journal of Clinical Epidemiology, 63(5), 524–534.CrossRefPubMed Terwee, C. B., Roorda, L. D., Dekker, J., Bierma-Zeinstra, S. M., Peat, G., Jordan, K. P., et al. (2010). Mind the MIC: Large variation among populations and methods. Journal of Clinical Epidemiology, 63(5), 524–534.CrossRefPubMed
6.
Zurück zum Zitat Wright, A., Hannon, J., Hegedus, E. J., & Kavchak, A. E. (2012). Clinimetrics corner: A closer look at the minimal clinically important difference (MCID). Journal of Manual & Manipulative Therapy, 20(3), 160–166.CrossRef Wright, A., Hannon, J., Hegedus, E. J., & Kavchak, A. E. (2012). Clinimetrics corner: A closer look at the minimal clinically important difference (MCID). Journal of Manual & Manipulative Therapy, 20(3), 160–166.CrossRef
7.
Zurück zum Zitat Bedard, G., Zeng, L., Zhnag, L., Lauzon, N., Holden, L., Tsao, M., et al. (2014). Minimal important differences in the EORTC QLQ-C30 in patients with advanced cancer. Asia-Pacific Journal of Clinical Oncology, 10(2), 109–117.CrossRefPubMed Bedard, G., Zeng, L., Zhnag, L., Lauzon, N., Holden, L., Tsao, M., et al. (2014). Minimal important differences in the EORTC QLQ-C30 in patients with advanced cancer. Asia-Pacific Journal of Clinical Oncology, 10(2), 109–117.CrossRefPubMed
8.
Zurück zum Zitat Boyce, M. B., Browne, J. P., & Greenhalgh, J. (2014). The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: A systematic review of qualitative research. BMJ Quality Safety, 23(6), 508–518.CrossRefPubMed Boyce, M. B., Browne, J. P., & Greenhalgh, J. (2014). The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: A systematic review of qualitative research. BMJ Quality Safety, 23(6), 508–518.CrossRefPubMed
10.
Zurück zum Zitat Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health related quality of life scores. Journal of Clinical Oncology, 16(1), 139–144.CrossRefPubMed Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health related quality of life scores. Journal of Clinical Oncology, 16(1), 139–144.CrossRefPubMed
11.
Zurück zum Zitat King, M. T. (1996). The interpretation of scores form the EORTC quality of life questionnaire QLQ-C30. Quality of Life Research, 5(6), 555–567.CrossRefPubMed King, M. T. (1996). The interpretation of scores form the EORTC quality of life questionnaire QLQ-C30. Quality of Life Research, 5(6), 555–567.CrossRefPubMed
12.
Zurück zum Zitat Bedard, G., Zeng, L., Lam, H., Cella, D., Zhang, L., Lauzon, N., et al. (2012). Meaningful change in oncology quality-of-life instruments: A systematic literature review. Expert Review of Pharmacoeconomics & Outcomes Research, 12(4), 475–483.CrossRef Bedard, G., Zeng, L., Lam, H., Cella, D., Zhang, L., Lauzon, N., et al. (2012). Meaningful change in oncology quality-of-life instruments: A systematic literature review. Expert Review of Pharmacoeconomics & Outcomes Research, 12(4), 475–483.CrossRef
14.
Zurück zum Zitat Coens, C., van der Graaf, W. T. A., Blay, J. Y., Chawla, S. P., Judson, I., Sanfilippo, R., et al. (2015). Health-related quality-of-life results from PALETTE: A randomized, double-blind, phase 3 trial of pazopanib versus placebo in patients with soft tissue sarcoma whose disease has progressed during or after prior chemotherapy-a European Organization for research and treatment of cancer soft tissue and bone sarcoma group global network study (EORTC 62072). Cancer, 121(17), 2933–2941.CrossRefPubMed Coens, C., van der Graaf, W. T. A., Blay, J. Y., Chawla, S. P., Judson, I., Sanfilippo, R., et al. (2015). Health-related quality-of-life results from PALETTE: A randomized, double-blind, phase 3 trial of pazopanib versus placebo in patients with soft tissue sarcoma whose disease has progressed during or after prior chemotherapy-a European Organization for research and treatment of cancer soft tissue and bone sarcoma group global network study (EORTC 62072). Cancer, 121(17), 2933–2941.CrossRefPubMed
15.
Zurück zum Zitat Quidde, J., Hegewisch Becker, S., Graven, U., Lerchenmueller, C., Killing, B., Depenbusch, R., et al. (2016). Quality of life in patients with metastatic colorectal cancer receiving maintenance therapy after first-line inductive treatment: A quality of life sub-analysis of the AIO KRK 0207 phase III trial. Annals of Oncology. https://doi.org/10.1093/annonc/mdw370.105.PubMedCrossRef Quidde, J., Hegewisch Becker, S., Graven, U., Lerchenmueller, C., Killing, B., Depenbusch, R., et al. (2016). Quality of life in patients with metastatic colorectal cancer receiving maintenance therapy after first-line inductive treatment: A quality of life sub-analysis of the AIO KRK 0207 phase III trial. Annals of Oncology. https://​doi.​org/​10.​1093/​annonc/​mdw370.​105.PubMedCrossRef
17.
Zurück zum Zitat Wildiers, H., Heeren, P., Puts, M., Topinkova, E., Janssen-Heijnen, M., Extermann, M., et al. (2014). International society of geriatric oncology consensus on geriatric assessment in older patients with cancer. Journal of Clinical Oncology, 32(24), 2595–2603.CrossRefPubMedPubMedCentral Wildiers, H., Heeren, P., Puts, M., Topinkova, E., Janssen-Heijnen, M., Extermann, M., et al. (2014). International society of geriatric oncology consensus on geriatric assessment in older patients with cancer. Journal of Clinical Oncology, 32(24), 2595–2603.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Quinten, C., Kenis, C., Hamaker, M., Coolbrandt, A., Brouwers, B., Dal Lago, L., et al. (2018). The effect of adjuvant chemotherapy on symptom burden and quality of life over time; a preliminary prospective observational study using individual data of patients aged ≥ 70 with early stage invasive breast cancer. Journal of Geriatric Oncology, 9(2), 152–162.CrossRefPubMed Quinten, C., Kenis, C., Hamaker, M., Coolbrandt, A., Brouwers, B., Dal Lago, L., et al. (2018). The effect of adjuvant chemotherapy on symptom burden and quality of life over time; a preliminary prospective observational study using individual data of patients aged ≥ 70 with early stage invasive breast cancer. Journal of Geriatric Oncology, 9(2), 152–162.CrossRefPubMed
19.
Zurück zum Zitat Wedding, U., Röhrig, B., Klippstein, A., Brix, C., Pientka, L., & Höffken, K. (2007). Co-morbidity and functional deficits independently contribute to quality of life before chemotherapy in elderly cancer patients. Support Care Cancer, 15, 1097–1104.CrossRefPubMed Wedding, U., Röhrig, B., Klippstein, A., Brix, C., Pientka, L., & Höffken, K. (2007). Co-morbidity and functional deficits independently contribute to quality of life before chemotherapy in elderly cancer patients. Support Care Cancer, 15, 1097–1104.CrossRefPubMed
20.
Zurück zum Zitat Ediebah, D., Quinten, C., Coens, C., Ringash, J., Dancey, J., Zikos, E., et al. (2018). Quality of life as prognostic indicator of survival: A pooled analysis of individual patient data from Canadian Cancer Trials Group clinical trials. Cancer, 124(16), 3409–3416.CrossRefPubMed Ediebah, D., Quinten, C., Coens, C., Ringash, J., Dancey, J., Zikos, E., et al. (2018). Quality of life as prognostic indicator of survival: A pooled analysis of individual patient data from Canadian Cancer Trials Group clinical trials. Cancer, 124(16), 3409–3416.CrossRefPubMed
21.
Zurück zum Zitat Folstein, M. F., Foldestein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.CrossRefPubMed Folstein, M. F., Foldestein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.CrossRefPubMed
22.
Zurück zum Zitat Katz, S. (1983). Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. Journal of the American Geriatrics Society, 31(12), 721–727.CrossRefPubMed Katz, S. (1983). Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. Journal of the American Geriatrics Society, 31(12), 721–727.CrossRefPubMed
23.
Zurück zum Zitat Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9(3), 179–186.CrossRefPubMed Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9(3), 179–186.CrossRefPubMed
24.
Zurück zum Zitat Vellas, B., Guigoz, Y., Garry, P. J., Nourhashemi, F., Bennahum, D., Lauque, S., et al. (1999). The mini nutritional assessment (MNA-SF) and its use in grading the nutritional state of elderly patients. Nutrition, 15(2), 116–122.CrossRefPubMed Vellas, B., Guigoz, Y., Garry, P. J., Nourhashemi, F., Bennahum, D., Lauque, S., et al. (1999). The mini nutritional assessment (MNA-SF) and its use in grading the nutritional state of elderly patients. Nutrition, 15(2), 116–122.CrossRefPubMed
25.
Zurück zum Zitat Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist, 5(1/2), 165–173. Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist, 5(1/2), 165–173.
26.
Zurück zum Zitat Jensen, M. P., Chen, C., & Brugger, A. M. (2003). Interpretation of visual analogue scale rating and change scores: A reanalysis of two clinical trials of postoperative pain. The Journal of Pain, 4(7), 407–411.CrossRefPubMed Jensen, M. P., Chen, C., & Brugger, A. M. (2003). Interpretation of visual analogue scale rating and change scores: A reanalysis of two clinical trials of postoperative pain. The Journal of Pain, 4(7), 407–411.CrossRefPubMed
28.
Zurück zum Zitat Samsa, S., Edelman, D., Rothman, M. L., Williams, G. R., Lipscomb, J., & Matchar, D. (1999). Determining clinically important differences in health status measures: A general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics, 15(2), 141–155.CrossRefPubMed Samsa, S., Edelman, D., Rothman, M. L., Williams, G. R., Lipscomb, J., & Matchar, D. (1999). Determining clinically important differences in health status measures: A general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics, 15(2), 141–155.CrossRefPubMed
29.
Zurück zum Zitat Eton, D., Cella, D., Yost, K. J., Yount, S. E., Peterman, A. H., Neuberg, D. S., et al. (2004). A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoint in a breast cancer scale. Journal of Clinical Epidemiology, 57(9), 898–910.CrossRefPubMed Eton, D., Cella, D., Yost, K. J., Yount, S. E., Peterman, A. H., Neuberg, D. S., et al. (2004). A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoint in a breast cancer scale. Journal of Clinical Epidemiology, 57(9), 898–910.CrossRefPubMed
30.
Zurück zum Zitat Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003). Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation. Medical Care, 41(5), 582–592.PubMed Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003). Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation. Medical Care, 41(5), 582–592.PubMed
31.
Zurück zum Zitat Hjermstad, M. J., Fossa, S. D., Bjordal, K., & Kaasa, S. (1995). Test/retest study of the European Organization for research and treatment of cancer core quality of life questionnaire. Journal of Clinical Oncology, 13(5), 1249–1254.CrossRefPubMed Hjermstad, M. J., Fossa, S. D., Bjordal, K., & Kaasa, S. (1995). Test/retest study of the European Organization for research and treatment of cancer core quality of life questionnaire. Journal of Clinical Oncology, 13(5), 1249–1254.CrossRefPubMed
32.
Zurück zum Zitat Cella, D., Eton, D. T., Lai, J., Peterman, A. H., & Merkel, D. E. (2002). Combining anchor and distribution-based methods to derive minimal clinically important differences on the Function Assessement of Cancer Therapy (FACT) Anemia and Fatigue Scales. Journal of Pain and Symptom Management, 24(6), 547–561.CrossRefPubMed Cella, D., Eton, D. T., Lai, J., Peterman, A. H., & Merkel, D. E. (2002). Combining anchor and distribution-based methods to derive minimal clinically important differences on the Function Assessement of Cancer Therapy (FACT) Anemia and Fatigue Scales. Journal of Pain and Symptom Management, 24(6), 547–561.CrossRefPubMed
33.
Zurück zum Zitat Szumilas, M. (2010). Explaining odds ratios. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(3), 227–229.PubMedPubMedCentral Szumilas, M. (2010). Explaining odds ratios. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19(3), 227–229.PubMedPubMedCentral
34.
Zurück zum Zitat Tashjian, R. Z., Deloach, J., Porucznik, C. A., & Powell, A. P. (2009). Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scale (VAS) measuring pain in patients treated for rotator cuff disease. Journal of Shoulder and Elbow Surgery, 18(6), 927–932.CrossRefPubMed Tashjian, R. Z., Deloach, J., Porucznik, C. A., & Powell, A. P. (2009). Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scale (VAS) measuring pain in patients treated for rotator cuff disease. Journal of Shoulder and Elbow Surgery, 18(6), 927–932.CrossRefPubMed
35.
Zurück zum Zitat Vinkers, D. J., Gussekloo, J., Stek, M. L., Westendorp, R. G., & Van Der Mast, R. C. (2004). The 15-item Geriatric Depression Scale (GDS-15) detects changes in depressive symptoms after a major negative life event. The Leiden 85-plus study. International Journal of Geriatric Psychiatry, 19(1), 80–84.CrossRefPubMed Vinkers, D. J., Gussekloo, J., Stek, M. L., Westendorp, R. G., & Van Der Mast, R. C. (2004). The 15-item Geriatric Depression Scale (GDS-15) detects changes in depressive symptoms after a major negative life event. The Leiden 85-plus study. International Journal of Geriatric Psychiatry, 19(1), 80–84.CrossRefPubMed
36.
Zurück zum Zitat Cocks, K., King, M. T., Velikova, G., de Castro Jr. G., Martyn St-James, M., Fayers, P. M., Brown, J. M. (2012). Evidence-based guidelines for interpreting change scores for the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. European Journal of Cancer, 48(11), 1713–1721.CrossRefPubMed Cocks, K., King, M. T., Velikova, G., de Castro Jr. G., Martyn St-James, M., Fayers, P. M., Brown, J. M. (2012). Evidence-based guidelines for interpreting change scores for the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. European Journal of Cancer, 48(11), 1713–1721.CrossRefPubMed
38.
Zurück zum Zitat Ringash, J., O’Sullivan, B., & Bezjak, A. (2007). Interpreting clinically significant changes in patient-reported outcomes. Cancer, 110(1), 196–202.CrossRefPubMed Ringash, J., O’Sullivan, B., & Bezjak, A. (2007). Interpreting clinically significant changes in patient-reported outcomes. Cancer, 110(1), 196–202.CrossRefPubMed
39.
Zurück zum Zitat Cohen, J. (1998). Statistical power analysis for the behavioural sciences. New York: Academic New York. Cohen, J. (1998). Statistical power analysis for the behavioural sciences. New York: Academic New York.
40.
Zurück zum Zitat Howard, G. S., Ralph, K. M., Gulanick, N. A., Maxwell, S. E., Nance, D. W., & Gerber, S. K. (1979). Internal invalidity in pretest-posttest self-report evaluations and a re-evaluation of retrospective pretests. Applied Psychological Measurement, 3(1), 1–23.CrossRef Howard, G. S., Ralph, K. M., Gulanick, N. A., Maxwell, S. E., Nance, D. W., & Gerber, S. K. (1979). Internal invalidity in pretest-posttest self-report evaluations and a re-evaluation of retrospective pretests. Applied Psychological Measurement, 3(1), 1–23.CrossRef
41.
Zurück zum Zitat Oort, F. H., Visser, M. R. M., & Spranger, M. A. G. (2005). An application of structural equation modelling to detect response shifts and true change in quality of life data from cancer patients undergoing invasive surgery. Quality of Life Research, 14(3), 599–609.CrossRefPubMed Oort, F. H., Visser, M. R. M., & Spranger, M. A. G. (2005). An application of structural equation modelling to detect response shifts and true change in quality of life data from cancer patients undergoing invasive surgery. Quality of Life Research, 14(3), 599–609.CrossRefPubMed
43.
Zurück zum Zitat Verdam, M. G. E., Oort, F. J., & Sprangers, M. A. G. (2017). Structural equation modelling – based effect-size indices were used to evaluate and interpret the impact of response shift effects. Journal of Clinical Epidemiology, 85, 37–44.CrossRefPubMed Verdam, M. G. E., Oort, F. J., & Sprangers, M. A. G. (2017). Structural equation modelling – based effect-size indices were used to evaluate and interpret the impact of response shift effects. Journal of Clinical Epidemiology, 85, 37–44.CrossRefPubMed
44.
Zurück zum Zitat Ousmen, A., Conroy, T., Guillemin, F., Velten, M., Jolly, D., Mercier, M., et al. (2016). Impact of the occurrence of a response shift on the determination of the minimal important difference in a health-related quality of life score over time. Health and Quality of Life Outcomes, 15, 167. https://doi.org/10.1186/s12955-016-0569-5.CrossRef Ousmen, A., Conroy, T., Guillemin, F., Velten, M., Jolly, D., Mercier, M., et al. (2016). Impact of the occurrence of a response shift on the determination of the minimal important difference in a health-related quality of life score over time. Health and Quality of Life Outcomes, 15, 167. https://​doi.​org/​10.​1186/​s12955-016-0569-5.CrossRef
46.
Metadaten
Titel
Determining clinically important differences in health-related quality of life in older patients with cancer undergoing chemotherapy or surgery
verfasst von
C. Quinten
C. Kenis
L. Decoster
P. R. Debruyne
I. De Groof
C. Focan
F. Cornelis
V. Verschaeve
C. Bachmann
D. Bron
S. Luce
G. Debugne
H. Van den Bulck
J. C. Goeminne
A. Baitar
K. Geboers
B. Petit
C. Langenaeken
R. Van Rijswijk
P. Specenier
G. Jerusalem
J. P. Praet
K. Vandenborre
M. Lycke
J. Flamaing
K. Milisen
J. P. Lobelle
H. Wildiers
Publikationsdatum
03.12.2018
Verlag
Springer International Publishing
Erschienen in
Quality of Life Research / Ausgabe 3/2019
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-018-2062-6

Weitere Artikel der Ausgabe 3/2019

Quality of Life Research 3/2019 Zur Ausgabe