Article
The alternative approach – screening for distress and need for psycho-oncological support in patients with intracranial tumors using an expert rating scale (the basic documentation for psycho-oncology short form – PO-BADO-SF)
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Authors
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Anne-Katrin Hickmann
- Schulthess Klinik, Abteilung für Wirbelsäulen- und Neurochirurgie, Zürich, Schweiz; Klinikum Stuttgart, Katharinenhospital, Klinik für Neurochirurgie, Stuttgart, Deutschland
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Minou Nadji-Ohl
- Klinikum Stuttgart, Katharinenhospital, Klinik für Neurochirurgie, Stuttgart, Deutschland
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Markus Haug
- Klinikum Stuttgart, Katharinenhospital, Klinik für Neurochirurgie, Stuttgart, Deutschland
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Naureen Keric
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Florian Ringel
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Mirjam Renovanz
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
| Published: | June 18, 2018 |
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Outline
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Objective: Assessing psycho-oncological needs in neurooncological patients is challenging, especially when patient reported outcome measures (PROMs) are not feasible due to neurocognitive decline. Yet, these patients may particularly be in need of support. We applied an expert rating scale, the basic documentation for psycho-oncology short form (PO-BADO-SF), in patients with first diagnosis of an intracranial tumor evaluating its comparability to established PROMs.
Methods: For this prospective bi-central study patients with benign and malignant intracranial tumors were recruited postsurgically. Their level of distress (distress thermometer (DT), psycho-oncological burden (Hornheide Screening Instrument (HSI)) and quality of life (EORTC QLQ C30+BN20) were assessed after surgery, at 3 and 6 months. Additionally, the neurooncologist completed the PO-BADO-SF each time, a questionnaire assessing patients' somatic and psychological burden based on the interviewer's impression (6 single items (range 0-4), global burden (GB) (range 0-10)). Demographic and tumor-specific data were collected and analyzed descriptively. Correlation-analysis was performed for DT and EORTC items "health", "quality of life" (QoL) vs. PO-BADO-SF GB. Using ROC-Analysis, PO-BADO-SF GB cut-off values for increased distress (DT>6) and need for psychooncological support (HSI positive screening) were determined.
Results: Data of 140 patients (mean age: 56y; male: 46%) were available for analysis. The majority (37%, n=50) harbored a glioma (WHO°III/IV n=38), followed by meningeomas (31%, n = 42) and metastasis (22 %, n=30). The mean DT score was 4.2±2.6. DT≥6 was seen in 100 of 329 assessments (23%, missing: n=99). A need for psycho-oncological support (HSI) was noticed in 112 of 346 assessments (26.1%, missing: n=84). Means were 4.5±1.5 for EORTC "health", 4.5±1.6 for EORTC "QoL" and 4.1±2.3 for PO-BADO-SF GB. A PO-BADO-SF GB cut-off of 3.5 indicated need for psycho-oncological support with moderate accuracy (AUC 0.749, sensitivity: 81.7%, specificity: 56.4%). A cut-off of 4.5 indicated increased distress (AUC 0.806, sensitivity: 72.2%, specificity: 72.8%). A large correlation was found for GB with DT (r=0.65, p <0.001) as well as GB with EORTC "health" (r=-0.525, p<0.001) and EORTC "QoL" (r=-0.531, p<0.001).
Conclusion: The PO-BADO-SF may serve as reliable assessment tool in neuro-oncological patients incapable of completing PROMs to assess their distress and need for support. However, if feasible it should be combined with PROMs.
