Core set of patient-reported outcomes for myelodysplastic syndromes: an EUMDS Delphi study involving patients and hematologists

Author:

Stojkov Igor1,Conrads-Frank Annette1ORCID,Rochau Ursula1,Koinig Karin A.2ORCID,Arvandi Marjan1ORCID,Puntscher Sibylle1ORCID,van Marrewijk Corine3ORCID,Fenaux Pierre4,Symeonidis Argiris5ORCID,Chermat Fatiha6,Garelius Hege7,Bowen David8,Mittelman Moshe9,Mora Elvira1011ORCID,de Witte Theo12,Efficace Fabio13,Siebert Uwe11415,Stauder Reinhard2ORCID

Affiliation:

1. Institute of Public Health, Medical Decision Making, and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics, and Technology, Hall in Tirol, Austria;

2. Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria;

3. Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands;

4. Service d'Hématologie, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris (AP-HP) and Université Paris 7, Paris, France;

5. Department of Medicine, Division Hematology, University of Patras Medical School, Patras, Greece;

6. Groupe Francophone des Myélodysplasies (GFM), Paris, France;

7. Section of Hematology and Coagulation, Department of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden;

8. St James's Institute of Oncology, Leeds Teaching Hospitals, Leeds, United Kingdom;

9. Department of Medicine A, Tel Aviv Sourasky (Ichilov) Medical Center and Sackler Medical Faculty, Tel Aviv University, Tel Aviv, Israel;

10. Hospital Universitario y Politécnico La Fe;

11. Instituto de Investigación Sanitaria La Fe, Valencia, Spain;

12. Department of Tumor Immunology, Nijmegen Center for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands;

13. Health Outcomes Research Unit, Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA), Rome, Italy;

14. Center for Health Decision Science, Department of Health Policy and Management, Harvard Chan School of Public Health, Boston, MA; and

15. Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA

Abstract

Abstract Patient-reported outcomes (PROs) are relevant and valuable end points in the care of patients with myelodysplastic syndromes (MDS). However, a consensus-based selection of PROs for MDS, derived by both patients and hematologists, is lacking. We aimed to develop a core set of PROs for patients with MDS as part of the prospective European LeukemiaNet MDS (EUMDS) Registry. According to international guidelines, candidate PROs were identified from a comprehensive literature search of MDS studies. Overall, 40 PROs were selected and evaluated in a two-round Delphi survey by 40 patients with MDS and 38 hematologists in the first round and 38 patients and 32 hematologists in the second round. Based on an agreement scale and predefined inclusion criteria, both patients and hematologists selected “general quality of life” as a core PRO. Hematologists also selected “transfusion-dependency burden” and “ability to work/activities of daily living” as core PROs. The second Delphi round increased PRO rating agreements. Statistically significant rating differences between patients and hematologists were observed for 28 PROs (Mann-Whitney U test; P < .05) in the first round and for 19 PROs in the second round, with “disease knowledge” and “confidence in health care services” rated notably higher by patients. The overall mean PRO ratings correlation between the 2 groups was moderate (Spearman’s rank correlation coefficient = 0.5; P < .05). This first consensus on a core set of PROs jointly developed by patients and hematologists forms the basis for patient-centered care in daily practice and clinical research.

Publisher

American Society of Hematology

Subject

Hematology

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