TY - JOUR
T1 - Assessment of physical function by subjective and objective methods in patients undergoing open gynecologic surgery
AU - Wang, Xin Shelley
AU - Kamal, Mona
AU - Chen, Tsun Hsuan
AU - Shi, Qiuling
AU - Garcia-Gonzalez, Araceli
AU - Iniesta, Maria D.
AU - Cleeland, Charles S.
AU - Gottumukkala, Vijaya
AU - Meyer, Larissa A.
N1 - Funding Information:
We gratefully acknowledge NCI/NIH ?Improving Recovery After Major Cancer Surgery Using Patient-Reported Outcomes?, R01CA205146 to Dr. Wang and NIH K07-CA201013 to Dr. Meyer for supporting this project as well as the NCI Cancer Center Support Grant, P30-CA016672. Dr. Meyer reports research funding from AstraZeneca for unrelated research, and GSK (advisory board). The other authors have no financial disclosures to make.
Funding Information:
We gratefully acknowledge NCI / NIH “Improving Recovery After Major Cancer Surgery Using Patient-Reported Outcomes”, R01CA205146 to Dr. Wang and NIH K07-CA201013 to Dr. Meyer for supporting this project as well as the NCI Cancer Center Support Grant , P30-CA016672 . Dr. Meyer reports research funding from AstraZeneca for unrelated research, and GSK (advisory board). The other authors have no financial disclosures to make.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/4
Y1 - 2021/4
N2 - Objective: To evaluate the utility of patient-reported outcomes (PROs) to measure physical functioning in perioperative care for patients with gynecological (GYN) tumors. Methods: 180 patients with GYN tumors undergoing open surgery participated in this longitudinal study. The physical functioning was measured by a subjective PRO tool, the Interference subscales of the MD Anderson Symptom Inventory (MDASI-I); as well as by an objective tool, the Timed Up & Go test (TUGT), perioperatively. Longer time (>20 s) needed to complete the TUGT was defined as “Prolonged”. Patients completed EuroQoL-5D as well. The association between the scores of MDASI-I items and TUGT was assessed via the Spearman correlation coefficient. The known-group validity was assessed using the t-test and Cohen's D effect size. Results: Compliance rates at preoperative, discharge and postoperative time points of MDASI-I were 98%, 95%, 96%; while TUGT completion rates were 92%, 75%, and 80%, respectively. Patients who had refused TUGT at discharge reported a significantly worse “MDASI-general activity” score compared to patients who completed TUGT (mean score of 7.00 vs. 5.38, P = 0.020). Patient-reported “Walking” on MDASI-I significantly differentiated patients with prolonged vs. those with frail/normal TUGT at discharge (mean score of 4.89 vs. 2.79, Cohen's d effect size = 0.82, P < 0.001). MDASI-I demonstrated excellent known-group validity per performance status and for the EuroQoL-5D subscales. Conclusion: Patient-reported physical functioning impairment after GYN surgery correspond with observed worse scores of the objective functioning measure test (TUGT). MDASI-I assessment represents a feasible and valid tool to evaluate functional status and warrants further implementation in the perioperative setting.
AB - Objective: To evaluate the utility of patient-reported outcomes (PROs) to measure physical functioning in perioperative care for patients with gynecological (GYN) tumors. Methods: 180 patients with GYN tumors undergoing open surgery participated in this longitudinal study. The physical functioning was measured by a subjective PRO tool, the Interference subscales of the MD Anderson Symptom Inventory (MDASI-I); as well as by an objective tool, the Timed Up & Go test (TUGT), perioperatively. Longer time (>20 s) needed to complete the TUGT was defined as “Prolonged”. Patients completed EuroQoL-5D as well. The association between the scores of MDASI-I items and TUGT was assessed via the Spearman correlation coefficient. The known-group validity was assessed using the t-test and Cohen's D effect size. Results: Compliance rates at preoperative, discharge and postoperative time points of MDASI-I were 98%, 95%, 96%; while TUGT completion rates were 92%, 75%, and 80%, respectively. Patients who had refused TUGT at discharge reported a significantly worse “MDASI-general activity” score compared to patients who completed TUGT (mean score of 7.00 vs. 5.38, P = 0.020). Patient-reported “Walking” on MDASI-I significantly differentiated patients with prolonged vs. those with frail/normal TUGT at discharge (mean score of 4.89 vs. 2.79, Cohen's d effect size = 0.82, P < 0.001). MDASI-I demonstrated excellent known-group validity per performance status and for the EuroQoL-5D subscales. Conclusion: Patient-reported physical functioning impairment after GYN surgery correspond with observed worse scores of the objective functioning measure test (TUGT). MDASI-I assessment represents a feasible and valid tool to evaluate functional status and warrants further implementation in the perioperative setting.
KW - Functioning measure
KW - Get up & go test (TUGT)
KW - Gynecological
KW - MDASI
KW - PRO
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UR - http://www.scopus.com/inward/citedby.url?scp=85100428050&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2021.01.021
DO - 10.1016/j.ygyno.2021.01.021
M3 - Article
C2 - 33536127
AN - SCOPUS:85100428050
SN - 0090-8258
VL - 161
SP - 83
EP - 88
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -