Validity of Patient-Reported Outcome Measures in Evaluating Nerve Damage Following Chemotherapy

Tiffany Li ^1,2, Hannah C Timmins ^1,3,2, Fawaz M Mahfouz ^1,2

¹School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
²Brain and Mind Centre, University of Sydney, Australia.
³Neuroscience Research Australia, Sydney, Australia.
⁴School of Clinical Medicine, University of New South Wales, Sydney, Australia.
⁵The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, Australia.
⁶Chris O'Brien Lifehouse, Sydney, Australia.
⁷Sydney Medical School, University of Sydney, Sydney, Australia.
⁸Prince of Wales Hospital, Sydney, Australia.
⁹Sydney Adventist Hospital, Sydney, Australia.
¹⁰School of Medicine and Psychology, The Australian National University, Canberra, Australia.
¹¹Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital, Sydney, Australia.
¹²Cancer Care Services, Royal Brisbane and Women's Hospital, Faculty of Medicine, University of Queensland, Brisbane, Australia.
¹³Faculty of Medicine, University of Queensland, Brisbane, Australia.
¹⁴Department of Neurology, Royal Brisbane & Women's Hospital, Brisbane, Australia.
¹⁵Institute of Haematology, Royal Prince Alfred Hospital, Sydney, Australia.
¹⁶Faculty of Medicine and Health, Cancer Care Research Unit, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia.
¹⁷Department of Medical Oncology, Royal North Shore Hospital, Sydney, Australia.
¹⁸Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia.

⁰School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.

Jama Network Open +

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August 9, 2024

View abstract on PubMed

Summary

Patient-reported outcome measures (PROMs) effectively assess chemotherapy-induced peripheral neuropathy (CIPN). PROMs demonstrated superior validity and responsiveness compared to neurophysiological and sensory measures in a large cohort study.

Area Of Science

Oncology
Neuroscience
Clinical Trials

Background

Chemotherapy-induced peripheral neuropathy (CIPN) is a significant adverse effect of cancer treatment, necessitating accurate assessment methods in clinical and research settings.
Evaluating the optimal assessment strategy for CIPN is crucial for patient care and treatment efficacy.

Purpose Of The Study

To compare the validity and responsiveness of various patient-reported outcome measures (PROMs) against neurophysiological and sensory functional measures for assessing CIPN.
To determine the most effective method for evaluating CIPN in patients undergoing neurotoxic chemotherapy.

Main Methods

A dual-study design cohort study involving 1033 participants treated with neurotoxic chemotherapy.
Prospective and cross-sectional assessments using multiple PROMs (EORTC-CIPN20, FACT/GOG-Ntx, PRO-CTCAE), neurological, neurophysiological, and sensory measures.
Evaluation of core measurement properties including convergent validity, known-groups validity, and responsiveness.

Main Results

Patient-reported outcome measures (PROMs) demonstrated superior convergent validity, known-groups validity, and responsiveness in assessing CIPN compared to other methods.
The PRO-CTCAE composite score and EORTC-CIPN20 showed the highest accuracy and ability to detect changes in CIPN.
Neurophysiological and sensory measures did not meet the criteria for acceptable responsiveness.

Conclusions

Patient-reported outcome measures (PROMs) are the most reliable tools for assessing chemotherapy-induced peripheral neuropathy (CIPN), meeting all core measurement property criteria.
The findings support the integration of PROMs into clinical practice for improved CIPN assessment and patient management.

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