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Identification of Patient-Reported Outcome Phenotypes Among Oncology Patients With Palliative Care Needs.

Publication ,  Journal Article
Kaufmann, TL; Getz, KD; Hsu, JY; Bennett, AV; Takvorian, SU; Kamal, AH; DeMichele, A
Published in: JCO Oncol Pract
October 2021

PURPOSE: Despite evidence-based guidelines recommending early palliative care, it remains unclear how to identify and refer oncology patients, particularly in settings with constrained access to palliative care. We hypothesize that patient-reported outcome (PRO) data can be used to characterize patients with palliative care needs. To determine if PRO data can identify latent phenotypes that characterize indications for specialty palliative care referral. METHODS: We conducted a retrospective study of self-reported symptoms on the Edmonton Symptom Assessment System collected from solid tumor oncology patients (n = 745) referred to outpatient palliative care. Data were collected as part of routine clinical care from October 2012 to March 2018 at eight community and academic sites. We applied latent profile analysis to identify PRO phenotypes and examined the association of phenotypes with clinical and demographic characteristics using multinomial logistic regression. RESULTS: We identified four PRO phenotypes: (1) Low Symptoms (n = 295, 39.6%), (2) Moderate Pain/Fatigue + Mood (n = 180, 24.2%), (3) Moderate Pain/Fatigue + Appetite + Dyspnea (n = 201, 27.0%), and (4) High Symptoms (n = 69, 9.3%). In a secondary analysis of 421 patients, we found that two brief items assessing social and existential needs aligned with higher severity symptom and psychological distress phenotypes. CONCLUSION: Oncology patients referred to outpatient palliative care in a real-world setting can be differentiated into clinically meaningful phenotypes using brief, routinely collected PRO measures. Latent modeling provides a mechanism to use patient-reported data on a population level to identify distinct subgroups of patients with unmet palliative needs.

Duke Scholars

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Published In

JCO Oncol Pract

DOI

EISSN

2688-1535

Publication Date

October 2021

Volume

17

Issue

10

Start / End Page

e1473 / e1488

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Phenotype
  • Patient Reported Outcome Measures
  • Palliative Care
  • Neoplasms
  • Humans
  • 3211 Oncology and carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kaufmann, T. L., Getz, K. D., Hsu, J. Y., Bennett, A. V., Takvorian, S. U., Kamal, A. H., & DeMichele, A. (2021). Identification of Patient-Reported Outcome Phenotypes Among Oncology Patients With Palliative Care Needs. JCO Oncol Pract, 17(10), e1473–e1488. https://doi.org/10.1200/OP.20.00849
Kaufmann, Tara L., Kelly D. Getz, Jesse Y. Hsu, Antonia V. Bennett, Samuel U. Takvorian, Arif H. Kamal, and Angela DeMichele. “Identification of Patient-Reported Outcome Phenotypes Among Oncology Patients With Palliative Care Needs.JCO Oncol Pract 17, no. 10 (October 2021): e1473–88. https://doi.org/10.1200/OP.20.00849.
Kaufmann TL, Getz KD, Hsu JY, Bennett AV, Takvorian SU, Kamal AH, et al. Identification of Patient-Reported Outcome Phenotypes Among Oncology Patients With Palliative Care Needs. JCO Oncol Pract. 2021 Oct;17(10):e1473–88.
Kaufmann, Tara L., et al. “Identification of Patient-Reported Outcome Phenotypes Among Oncology Patients With Palliative Care Needs.JCO Oncol Pract, vol. 17, no. 10, Oct. 2021, pp. e1473–88. Pubmed, doi:10.1200/OP.20.00849.
Kaufmann TL, Getz KD, Hsu JY, Bennett AV, Takvorian SU, Kamal AH, DeMichele A. Identification of Patient-Reported Outcome Phenotypes Among Oncology Patients With Palliative Care Needs. JCO Oncol Pract. 2021 Oct;17(10):e1473–e1488.

Published In

JCO Oncol Pract

DOI

EISSN

2688-1535

Publication Date

October 2021

Volume

17

Issue

10

Start / End Page

e1473 / e1488

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Phenotype
  • Patient Reported Outcome Measures
  • Palliative Care
  • Neoplasms
  • Humans
  • 3211 Oncology and carcinogenesis