PRO-CTCAE reveals under-recognition of dermatologic symptom burden in hospitalized cancer patients Journal Article
| Authors: | Gu, S.; Menzer, C.; Hay, J. L.; Pena, C.; Dusza, S.; Lacouture, M. E.; Markova, A. |
| Article Title: | PRO-CTCAE reveals under-recognition of dermatologic symptom burden in hospitalized cancer patients |
| Abstract: | Purpose: Dermatologic adverse events (dAEs) occur frequently in hospitalized patients and can significantly reduce quality of life. Physicians grade dAEs using the Common Terminology Criteria of Adverse Events (CTCAE). However, they often underestimate symptom frequency and severity. The patient-reported outcomes (PRO) version of the CTCAE (PRO-CTCAE) was developed to assess symptoms from the patient's perspective. In this study, we assessed the patient-reported burden of dAEs via the PRO-CTCAE questionnaire and compared results with dAE assessment by treating oncologists and dermatologists. Methods: Patients admitted to Memorial Sloan Kettering Cancer Center from 6/1/2018 to 4/30/2019 and received a dermatology consultation were eligible. Once enrolled, participants completed a PRO-CTCAE questionnaire on 14 dermatologic symptoms. CTCAE grades assigned by oncology and dermatology were obtained from clinical notes, and kappa statistics were calculated to evaluate the level of agreement between physician and patient evaluations. Results: A total of 100 patients (mean age 59.4, 55% male) were prospectively enrolled. The most common patient-reported dAEs were rash (72%), swelling (67%), pruritus (64%), bruising (53%), and hives (37%). Oncologists and dermatologists underreported dAEs except for rash (median kappa values 0.3 [0.02-0.84] and 0.32 [0.02-0.87], respectively). Oncologists and dermatologists were concordant with each other’s documented assessment of dAEs (median kappa value 0.985 [0.55-1]). Conclusion: Oncology patient-reported dAEs in a tertiary academic oncologic referral center were under-recognized by providers. PRO-CTCAE may be a useful tool to optimize inpatient dermatologic care for cancer patients by detecting and allowing management of patient-reported dAEs. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. |
| Keywords: | adult; controlled study; middle aged; major clinical study; note; skin manifestation; cancer patient; outcome assessment; prospective study; neoplasm; neoplasms; quality of life; pruritus; rash; questionnaire; clinical evaluation; physician; consultation; patient reported outcome measures; dermatology; patient referral; urticaria; exanthema; dermatologist; swelling; kappa statistics; patient-reported outcome; oncologist; contusion; Common Terminology Criteria for Adverse Events; disease burden; humans; human; male; female; surveys and questionnaires |
| Journal Title: | Supportive Care in Cancer |
| Volume: | 31 |
| Issue: | 6 |
| ISSN: | 0941-4355 |
| Publisher: | Springer Verlag |
| Date Published: | 2023-06-01 |
| Start Page: | 337 |
| Language: | English |
| DOI: | 10.1007/s00520-023-07793-5 |
| PUBMED: | 37183206 |
| PROVIDER: | scopus |
| PMCID: | PMC10547098 |
| DOI/URL: | |
| Notes: | Note -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Alina Markova -- Export Date: 1 June 2023 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work