Published thresholds for clinical importance (TCIs) for the European Organisation for Research and Treatment of Cancer CAT Core were derived using domain-specific relevance anchors, which are not routinely collected. We estimated EQ-VAS-associated cut-points for EORTC CAT Core short-form scores in patients with metastatic breast cancer, compared them with published TCIs, and examined patient-reported Eastern Cooperative Oncology Group (ECOG) performance status as a secondary reference classification. This post hoc cross-sectional analysis used data from the PRO B trial. EQ-VAS ≤ 70 was used to define lower global health status, with EQ-VAS ≤ 65 examined in sensitivity analysis; patient-reported ECOG ≥ 2 defined impaired performance status in secondary analysis. Receiver operating characteristic (ROC) analyses based on continuous CAT Core T-scores identified Youden-optimal cut-points with 5,000 bootstrap replications for estimating confidence intervals and optimism-corrected performance. Among 855 patients with CAT Core data available for the baseline analysis (mean age 51 years, SD 11), 841 had EQ-VAS and 854 had ECOG data. Using EQ-VAS ≤ 70, AUCs ranged from 0.57 to 0.82; eight of 14 domains had AUC ≥ 0.70, five had AUC 0.60–0.69, and diarrhea had AUC 0.57. Four domains did not meet the criterion used for interpretation of |ρ| ≥0.30 and were therefore interpreted as exploratory. Published TCIs showed different sensitivity-specificity profiles when evaluating against the EQ-VAS reference classification, illustrating the dependence of cut-point performance on the reference construct. This study identified EQ-VAS-associated cut-points for EORTC CAT Core short-form scores in metastatic breast cancer. Their performance varied by domain, and they should be interpreted as context-specific reference values rather than replacements for published relevance-based TCIs.
Abstract Background Health-related quality of life (HRQOL) assessment is an important component of chronic disease management, providing insights beyond clinical parameters. In obstructive sleep apnea (OSA), no comprehensive German-language patient-reported outcome measure (PROM) is currently available for routine clinical use. This study aims to adapt the Patient-Reported Apnea Questionnaire (PRAQ), a validated OSA-specific HRQOL instrument, for German-speaking patients. Methodology The German adaptation of the PRAQ followed a forward-backward translation process involving three translators. After harmonization, content validity was assessed through cognitive interviews with 20 OSA patients and an online survey among 14 sleep medicine experts. Feedback from both groups was incorporated into the final version of the questionnaire. Results The translation and adaptation process was conducted between April 2025 and March 2026. Two forward translations, one back-translation, and a final harmonization were performed. Patients identified issues mainly related to item relevance, conceptual overlap and response formats in the domains of daily activity, emotions and social interactions. Experts confirmed overall good comprehensibility but highlighted some concerns regarding item relevance and response scales. Based on patient and expert feedback, eight modifications were implemented, including clarifications of OSA-related terms, response options, and specific item wording, resulting in the final German PRAQ version. Conclusion The German version of the PRAQ demonstrates decent content validity and comprehensibility, while reflecting the heterogeneous experiences of patients with OSA. Although some items were considered less relevant by certain patients, no essential domains were identified as missing. The study was approved by the ethics committee of the University of Duisburg-Essen (25-12560-BO), and all participants provided written informed consent.
Patient-reported outcome measures (PROMs) are essential tools in cancer care, capturing patient perspectives on their physical, psychological, and social well-being while enhancing communication and clinical decision-making. Despite strong international advocacy, uptake remains inconsistent due to limited awareness, training, and perceived applicability. This mixed-methods study assessed knowledge, familiarity, and confidence regarding PROMs among multidisciplinary healthcare professionals (HPs), and explored barriers, facilitators, and perspectives on PROM implementation within Western Sydney Local Health District (WSLHD) Cancer Services. A cross-sectional online survey was distributed to HPs at WSLHD Cancer Services, with consent and data collection managed through REDCap. Following this, semi-structured interviews were conducted with interested HPs across medical, nursing, and allied health staff, exploring PROMs use, experiences, barriers, facilitators, and training needs. Interviews were transcribed verbatim and analysed using thematic analysis; descriptive statistics were applied to survey data. Fifty-nine participants (41 females) completed the survey, representing radiation oncology (25
This study aimed to translate and evaluate the Preparedness for Caregiving Scale, Caregiver Competence Scale, and Rewards of Caregiving in Korean family caregivers cohabiting with advanced cancer patients. Linguistic validation and cultural adaptation of the Preparedness for Caregiving Scale, Caregiver Competence Scale, and Rewards of Caregiving Scale were performed according to a standardized forward-backward translation protocol. We conducted a psychometric evaluation of a total of 200 family caregivers at one oncologic clinic. Cronbach’s α for the the Preparedness for Caregiving Scale, Caregiver Competence Scale, and Rewards of Caregiving Scale was 0.94, 0.86, and 0.94, respectively. Through exploratory factor analysis, three factors were identified in the combined model that corresponded to the three scales. The combined model was found to account for 71.6
The importance of clinical outcome assessments (COA) in healthcare decision making is increasingly recognised. However, evidence on associations between non-mandatory COA inclusion, health technology assessment (HTA) decision making, pricing, and sales of medicinal products is scarce. This study aimed to generate new insights into these associations. HTA reports published in 2012–2022 by bodies in Germany (G-BA), France (HAS), and England (NICE) were retrieved and combined with pricing and sales data. Multiclassification machine learning models were built to analyse the associations between non-mandatory COA inclusion and HTA-related decision making and sales against other relevant features. For Germany, the association with pricing was analysed in addition. Of 1506 identified HTA reports, 40.5
