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dc.contributor.authorMills, J
dc.contributor.authorHaviland, JS
dc.contributor.authorMoynihan, C
dc.contributor.authorBliss, JM
dc.contributor.authorHopwood, P
dc.contributor.authorSTART Trial Management Group
dc.date.accessioned2018-05-08T10:58:10Z
dc.date.issued2018-07
dc.identifier.citationClinical oncology (Royal College of Radiologists (Great Britain)), 2018, 30 (7), pp. 433 - 441
dc.identifier.issn0936-6555
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1671
dc.identifier.eissn1433-2981
dc.identifier.doi10.1016/j.clon.2018.03.007
dc.description.abstractAims Exploratory analysis of patients' unsolicited written comments in the first 2 years of the Standardisation of Breast Radiotherapy (START) trial quality of life study highlighted a potential effect of non-treatment-related problems on the ratings and interpretation of patient self-reported questionnaires. At 5 years of follow-up all eligible subjects were invited to write comments to further explore these findings.Materials and methods Using inductive qualitative methods informed by the exploratory analysis, comments were allocated to relevant themes. Key patient-reported outcome measures (PROMs), clinical and demographic factors were collated for patients who did and did not comment at 5 years and comparisons between the groups explored.Results Of 2208 women completing baseline PROMs, 482 proffered comments from 0 to 24 months, forming nine distinct themes, including chronic conditions, life events and psychosocial concerns. At 5 years, 1041/1727 (60.3%) women contributed comments, of whom 500 randomly selected participants formed the sample for analysis. Findings revealed comorbidity, impaired physical functioning and psychosocial problems as key themes, with prevalent adverse effects from local and systemic treatments. Eight new themes emerged at 5 years, including ageing, concerns about future cancer and positive aspects of care. Women commenting were better educated, slightly older and more likely to have had chemotherapy compared with non-commenters. They had significantly worse PROM scores for global health and key quality of life domains relevant to the difficulties they revealed.Conclusions Difficult personal circumstances and other health concerns affected many women's PROM ratings at 5 years of follow-up, in addition to ongoing cancer treatment effects. Greater attention to multiple sources of distress and adversity could facilitate personalised care and aid interpretation of PROMs.
dc.formatPrint-Electronic
dc.format.extent433 - 441
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectSTART Trial Management Group
dc.subjectHumans
dc.subjectBreast Neoplasms
dc.subjectQuality of Life
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectRandomized Controlled Trials as Topic
dc.subjectSurveys and Questionnaires
dc.subjectUnited Kingdom
dc.subjectPatient Reported Outcome Measures
dc.titleWomen's Free-text Comments on their Quality of Life: An Exploratory Analysis from the UK Standardisation of Breast Radiotherapy (START) Trials for Early Breast Cancer.
dc.typeJournal Article
dcterms.dateAccepted2018-03-06
rioxxterms.versionofrecord10.1016/j.clon.2018.03.007
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2018-07
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfClinical oncology (Royal College of Radiologists (Great Britain))
pubs.issue7
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.publication-statusPublished
pubs.volume30
pubs.embargo.termsNot known
icr.researchteamClinical Trials & Statistics Uniten_US
dc.contributor.icrauthorBliss, Judithen
dc.contributor.icrauthorHaviland, Joanneen
dc.contributor.icrauthorYarnold, Johnen


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