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Patient reported outcomes can improve performance status assessment: a pilot study.

Joan E Broderick1, Marcella May2, Joseph E Schwartz3

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Patient-reported outcomes (PROs) like PROMIS® Physical Function and Fatigue better assess oncology patient physical functioning than traditional performance status ratings. Further research is needed to improve assessment accuracy for female patients.

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Area of Science:

  • Oncology
  • Clinical Assessment
  • Patient-Reported Outcomes

Background:

  • Patient performance status is crucial for oncology treatment decisions and clinical trial eligibility.
  • Current methods for assessing performance status lack optimal validity and reliability.
  • This study explored objective and patient-reported measures to enhance performance status assessment.

Purpose of the Study:

  • To evaluate the feasibility of using actigraphy and patient-reported outcomes (PROs) to assess physical functioning in oncology patients.
  • To compare the accuracy of PROs against traditional performance status ratings in predicting physical activity levels.
  • To determine if PROs can improve the accuracy of performance status assessment.

Main Methods:

  • Oncologists and patients provided performance status ratings.
  • Patients wore actigraphy devices to measure physical activity (steps/hour).
  • Patients completed weekly PROs via a smartphone app, including PROMIS® Physical Function and Fatigue.

Main Results:

  • Neither oncologist nor patient performance status ratings correlated with actigraphy-measured steps/hour.
  • PROMIS® Physical Function showed moderate to high association with steps/hour, particularly in men.
  • PROMIS® Fatigue was associated with steps/hour in men but not women; unexpected medical events were not predicted by performance status or activity levels.

Conclusions:

  • PROMIS® Physical Function and Fatigue PROs offer a more accurate and practical method for assessing physical functioning in oncology patients, especially men.
  • Current performance status ratings are insufficient for capturing objective physical activity levels.
  • Further research is needed to refine performance status assessment in women, potentially by incorporating pre-morbid activity levels.