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Development and validation of a prediction model of poor performance status and severe symptoms over time in cancer patients (PROVIEW+).
- Source :
-
Palliative Medicine . Oct2021, Vol. 35 Issue 9, p1713-1723. 11p. - Publication Year :
- 2021
-
Abstract
- Background: Predictive cancer tools focus on survival; none predict severe symptoms. Aim: To develop and validate a model that predicts the risk for having low performance status and severe symptoms in cancer patients. Design: Retrospective, population-based, predictive study Setting/Participants: We linked administrative data from cancer patients from 2008 to 2015 in Ontario, Canada. Patients were randomly selected for model derivation (60%) and validation (40%). Using the derivation cohort, we developed a multivariable logistic regression model to predict the risk of an outcome at 6 months following diagnosis and recalculated after each of four annual survivor marks. Model performance was assessed using discrimination and calibration plots. Outcomes included low performance status (i.e. 10–30 on Palliative Performance Scale), severe pain, dyspnea, well-being, and depression (i.e. 7–10 on Edmonton Symptom Assessment System). Results: We identified 255,494 cancer patients (57% female; median age of 64; common cancers were breast (24%); and lung (13%)). At diagnosis, the predicted risk of having low performance status, severe pain, well-being, dyspnea, and depression in 6-months is 1%, 3%, 6%, 13%, and 4%, respectively for the reference case (i.e. male, lung cancer, stage I, no symptoms); the corresponding discrimination for each outcome model had high AUCs of 0.807, 0.713, 0.709, 0.790, and 0.723, respectively. Generally these covariates increased the outcome risk by >10% across all models: lung disease, dementia, diabetes; radiation treatment; hospital admission; pain; depression; transitional performance status; issues with appetite; or homecare. Conclusions: The model accurately predicted changing cancer risk for low performance status and severe symptoms over time. [ABSTRACT FROM AUTHOR]
- Subjects :
- *DEMENTIA risk factors
*MENTAL depression risk factors
*DIABETES risk factors
*CANCER patient psychology
*EXPERIMENTAL design
*WELL-being
*APPETITE
*PREDICTIVE tests
*PAIN
*RESEARCH methodology
*RESEARCH methodology evaluation
*FUNCTIONAL status
*LUNG diseases
*RETROSPECTIVE studies
*LUNG tumors
*PATIENTS
*RISK assessment
*SEVERITY of illness index
*DYSPNEA
*HOSPITAL admission & discharge
*TREATMENT effectiveness
*DESCRIPTIVE statistics
*PREDICTION models
*STATISTICAL sampling
*LOGISTIC regression analysis
*STATISTICAL models
*BREAST tumors
*DISEASE risk factors
*DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 02692163
- Volume :
- 35
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Palliative Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 153180597
- Full Text :
- https://doi.org/10.1177/02692163211019302