Prospective development of a patient-reported outcomes instrument for desmoid tumors or aggressive fibromatosis Journal Article


Authors: Gounder, M. M.; Maddux, L.; Paty, J.; Atkinson, T. M.
Article Title: Prospective development of a patient-reported outcomes instrument for desmoid tumors or aggressive fibromatosis
Abstract: Background: Desmoid tumors (or aggressive fibromatosis) are locally infiltrative connective-tissue tumors that can arise in any anatomic location; they can be asymptomatic, or they can result in pain, deformity, swelling, and loss of mobility and/or threaten visceral organs with bowel perforation, hydronephrosis, neurovascular damage, and other complications. Existing clinical trial endpoints such as the Response Evaluation Criteria in Solid Tumors (version 1.1) and progression-free survival are inadequate in capturing treatment efficacy. This study was designed to develop a novel clinical trial endpoint by capturing patient-reported outcomes (PROs). Methods: Following best practices in qualitative methodology, this study used concept elicitation (CE) interviews to explore desmoid patients' perspectives on key disease-related symptoms and impacts. Qualitative analysis was performed to determine the relative frequency and disturbance of symptoms and impacts as well as other characteristics of these concepts. A draft PRO scale was then developed and tested with cognitive interviewing. Information from the interviews was subsequently incorporated into the refined PRO scale. Results: CE interviews with desmoid patients (n = 31) helped to identify salient concepts and led to a draft scale that included symptom and impact scales. Cognitive interviews were completed with additional patients (n = 15) across 3 phases. Patient input was used to refine instructions, revise and/or remove items, and modify the response scale. This resulted in an 11-item symptom scale and a 17-item impact scale. Conclusions: This is the first disease-specific PRO instrument developed for desmoid tumors. The instrument is available as an exploratory endpoint in clinical trials. This study highlights the feasibility and challenges of developing PRO instruments for rare diseases. © 2019 American Cancer Society
Keywords: adult; clinical article; controlled study; aged; cancer patient; prospective study; clinical practice; neoplasms; cohort analysis; interview; qualitative research; desmoid tumor; qualitative analysis; fibromatosis; concept analysis; patient-reported outcome; human; male; female; priority journal; article; patient-centered outcomes; clinical outcome assessments; drug development tool; food and drug administration (fda) patient-reported outcome (pro) guidance; concept elicitation interview
Journal Title: Cancer
Volume: 126
Issue: 3
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2020-02-01
Start Page: 531
End Page: 539
Language: English
DOI: 10.1002/cncr.32555
PUBMED: 31691276
PROVIDER: scopus
PMCID: PMC6980244
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Thomas Michael Atkinson
    155 Atkinson
  2. Mrinal M Gounder
    230 Gounder