Meaningful change in cancer-specific quality of life scores: differences between improvement and worsening.

摘要: Introduction: There has been increased recent attention to the clinical meaningfulness of group change scores on health-related quality life (HRQL) questionnaires. It assumed that improvements and declines comparable magnitude have same meaning or value. Method: We assessed 308 cancer patients with Functional Assessment Cancer Therapy (FACT) a Global Rating Change. Patients were classified into five levels in HRQL its dimensions based upon their responses retrospective ratings after 2 months: sizably worse, minimally no change, better, better. Raw score standardized changes FACT-G subscales total then compared across different categories patient-rated change. Results: The relationship between actual FACT was modest but usually statistically significant (r: 0.07 0.35). Change associated each rating category evaluated determine estimates meaningful difference. who reported global worsening had considerably larger than those reporting improvements. Although related ceiling effect, this remained true even removing cases began near questionnaire. Discussion: Relatively small gains Comparable may be less meaningful, perhaps due patients' tendency minimize personal negative evaluations about one's condition. This important implications for interpretation Factors such as adaptation disease, response shift, dispositional optimism need signs improvement contributing results should investigated future studies.