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Bryce B Reeve

Publications and source records attributed to Bryce B Reeve.

12 recordsLinked to original sources

Should function and bother be measured and reported separately for prostate cancer quality-of-life domains?

OBJECTIVES: To evaluate the psychometric properties of the three domains bowel, urinary, and sexual function as they were measured in the Prostate Cancer Outcomes Study and examine their use in different research and practice settings. Leading prostate cancer health-related quality-of-life questionnaires include questions that measure patients' bowel, urinary, and sexual function and their perceived annoyance (or bother) caused by limited functioning. The published results are mixed on reporting function and bother independently or together as a single domain. METHODS: Statistical tools from classical measurement theory and factor analytic methods were used to evaluate the psychometric properties of the Prostate Cancer Outcomes Study disease-specific scales. The findings from studies of other prostate cancer outcomes scales and clinical input were included to formulate the conclusions. RESULTS: Factor analysis results uncovered a multidimensional structure within two of the three domains. The urinary domain consisted of items measuring two factors: incontinence and urinary obstructive symptoms. Sexual dysfunction consisted of two dimensions: interest in sexual activity and erectile function. CONCLUSIONS: These empirical results suggest that bowel dysfunction and urinary incontinence can each be combined with measures of bother to produce overall measures of function; however, evidence was present for the need for separate measures of sexual function, sexual interest, and perceived bother with sexual function. For informing patient-doctor communications, function and bother on all three domains should be reported separately, because treatment decisions or symptom management may vary depending on a patient's perceived concern about their health-related quality-of-life.

Humans↗

Psychometric evaluation of the Brief Cancer Impact Assessment among breast cancer survivors.

OBJECTIVES: The increasing number of cancer survivors brings greater attention to the biopsychosocial impact of surviving cancer. Instruments exist that measure quality of life (QOL), symptoms, and specific types of functioning after cancer; however, a reliable and valid assessment of the perceived impact of cancer (IOC) on the life plans and activities of cancer survivors has been missing. This study evaluated the psychometric properties of the 16-item Brief Cancer Impact Assessment (BCIA). METHODS: Factor analysis with Promax oblique rotation established the factor structure of the BCIA in 783 ethnically diverse breast cancer survivors, >or=2 years after diagnosis. Construct validity was assessed by comparing factor-based scale means by demographic and treatment characteristics, and correlating scales with psychosocial and health-related QOL scales. RESULTS: Factor analysis revealed four factors measuring the IOC on caregiving and finances, exercise and diet behaviors, social and emotional functioning, and religiosity. Scale scores differed by demographic and treatment characteristics according to expectations, and the pattern of correlations with psychosocial and health-related QOL generally supported the construct validity of the scales. CONCLUSION: Including the BCIA with measures of QOL, symptoms, and functioning will allow researchers to gain a more comprehensive assessment of the biopsychosocial IOC in survivors.

Adult↗

Psychometric properties of a tool for measuring hormone-related symptoms in breast cancer survivors.

Hormone-related symptoms are common in breast cancer survivors and many aspects of these symptoms are currently under study. Reliable and valid assessment tools are needed to successfully study hormone-related symptoms in breast cancer survivors; however, no gold standard currently exists for measuring these symptoms. This study evaluated the psychometric properties of a shortened version of the Breast Cancer Prevention Trial (BCPT) symptom checklist in a sample of 803 breast cancer survivors. Principal factor analysis with Promax oblique rotation revealed a five-factor structure, identifying five separate hormone-related symptoms scales: vasomotor symptoms, urinary incontinence, cognitive/mood changes, vaginal symptoms, and weight gain/appearance concern. Hormone-related symptom scale scores differed by demographic and clinical characteristics according to expectations, suggesting that these five scales from the shortened BCPT checklist are reasonably reliable and valid. Symptom scale scores were only weakly correlated with health-related quality of life scores; however, the pattern of results generally supported the validity of the symptom scales. This study adds to the evidence that breast cancer survivors experience a significant number of hormone-related symptoms. Future clinical trials and quality of life and symptom management intervention studies would benefit from accurate assessment of hormone-related symptoms with the five scales from the shortened BCPT checklist.

Adult↗

Physical activity and acculturation among adult Hispanics in the United States.

Understanding the prevalence and demographic correlates of physical activity is important for public health and epidemiological research. This analysis examines the association between acculturation and physical activity in a large (approximately 5,000) sample of Hispanic adults from the 2000 National Health Interview Survey. Scores for eight questions concerning language use were summed to produce an acculturation index. Factor analysis indicated that these questions assessed a single underlying construct. Self-reported adherence to recommendations concerning leisure time physical activity increased from 22. 6% in the least acculturated tertile to 47% in the most acculturated tertile. In contrast, prevalence of walking or bicycling for errands decreased from 25.2 to 18.2%, and prevalence of standing or walking during most of the day decreased from 82.8 to 65.6% as acculturation increased. Thus, patterns of physical activity associated with leisure versus nonleisure time differed among Hispanics with varying acculturation levels. Alternatively, cultural factors may have differential effects on responses to questions concerning leisure and nonleisure time physical activity. In either case, assessing both types of activity is important for monitoring and understanding Hispanic health behaviors and interpreting epidemiological studies that involve physical activity in Hispanics.

Acculturation↗

An item response theory-based pain item bank can enhance measurement precision.

Cancer-related pain is often under-recognized and undertreated. This is partly due to the lack of appropriate assessments, which need to be comprehensive and precise yet easily integrated into clinics. Computerized adaptive testing (CAT) can enable precise-yet-brief assessments by only selecting the most informative items from a calibrated item bank. The purpose of this study was to create such a bank. The sample included 400 cancer patients who were asked to complete 61 pain-related items. Data were analyzed using factor analysis and the Rasch model. The final bank consisted of 43 items which satisfied the measurement requirement of factor analysis and the Rasch model, demonstrated high internal consistency and reasonable item-total correlations, and discriminated patients with differing degrees of pain. We conclude that this bank demonstrates good psychometric properties, is sensitive to pain reported by patients, and can be used as the foundation for a CAT pain-testing platform for use in clinical practice.

Adult↗

Do patients consistently report comorbid conditions over time?: results from the prostate cancer outcomes study.

BACKGROUND: Comorbidity is an important dimension of patient health status. However, limited attention has been given to assessing the reliability of patient-reported data on comorbid conditions. OBJECTIVES: We sought to evaluate the consistency of self-report of 12 comorbid conditions at 3 distinct time points and examine the sociodemographic, clinical, health status, and survey factors associated with reliability. STUDY DESIGN: We undertook a longitudinal cohort analysis of survey and medical record abstract data obtained from a population-based sample of 3095 prostate cancer survivors. METHODS: Consistent and inconsistent response patterns were assessed using descriptive statistics and regression modeling. RESULTS: More than half of the cohort demonstrated consistent responses to all comorbid condition questionnaire items. Arthritis had the highest (13%) and liver disease the lowest (1%) proportion of inconsistent responses. Older age, lower income, and poorer general and mental health status were significant predictors of inconsistent responses. Subset analyses of the 4 most prevalent comorbid conditions (ie, arthritis, diabetes, hypertension, and depression) showed that respondents who reported that they were limited by, or taking prescription medicine for, the condition were more likely to provide consistent responses than those neither limited nor taking medicine. Response consistencies of 92% or better were obtained for 11 of the 12 conditions. CONCLUSIONS: Men with a relatively recent prostate cancer diagnosis are generally able to provide reliable reports of their concomitant health conditions. To increase the likelihood of obtaining reliable data, investigators should consider ascertaining condition severity and current medical management when querying subjects about comorbid conditions in surveys.

Adult↗

Data pooling and analysis to build a preliminary item bank: an example using bowel function in prostate cancer.

Assessing bowel function (BF) in prostate cancer can help determine therapeutic trade-offs. We determined the components of BF commonly assessed in prostate cancer studies as an initial step in creating an item bank for clinical and research application. We analyzed six archived data sets representing 4,246 men with prostate cancer. Thirty-one items from validated instruments were available for analysis. Items were classified into domains (diarrhea, rectal urgency, pain, bleeding, bother/distress, and other) then subjected to conventional psychometric and item response theory (IRT) analyses. Items fit the IRT model if the ratio between observed and expected item variance was between 0.60 and 1.40. Four of 31 items had inadequate fit in at least one analysis. Poorly fitting items included bleeding (2), rectal urgency (1), and bother/distress (1). A fifth item assessing hemorrhoids was poorly correlated with other items. Our analyses supported four related components of BF: diarrhea, rectal urgency, pain, and bother/distress.

Adult↗

Item response theory and its applications to patient-reported outcomes measurement.

This article provides an overview of item response theory (IRT) models and how they can be appropriately applied to patient-reported outcomes (PROs) measurement. Specifically, the following topics are discussed: (a) basics of IRT, (b) types of IRT models, (c) how IRT models have been applied to date, and (d) new directions in applying IRT to PRO measurements.

Health Services Research↗

Quality of life following localized prostate cancer treated initially with androgen deprivation therapy or no therapy.

BACKGROUND: Many men diagnosed with clinically localized prostate cancer are initially treated conservatively, receiving neither surgery nor radiotherapy for the first year. Treatment patterns and quality-of-life outcomes have not been previously reported for a population-based sample of such men. METHODS: A population-based random sample of men (n = 661) from six geographic regions who had been newly diagnosed with clinically localized prostate cancer from 1994 through 1995 were followed for up to 1 year. Eligible subjects received neither surgery nor radiotherapy within 1 year of initial diagnosis. We assessed disease-specific and generic quality-of-life outcomes in men receiving androgen deprivation therapy (ADT) compared with men receiving no therapy. All statistical tests were two-sided. RESULTS: Two hundred and forty-five study patients received ADT and the remaining 416 patients received no therapy. Approximately two thirds of the patients (n = 159) receiving ADT had either baseline Gleason scores greater than six or serum prostate-specific antigen values above 20 ng/mL. Among men who were sexually potent before diagnosis (ADT = 88 patients; no therapy = 223 patients), 80% of those on ADT reported being impotent after 1 year compared with 30% of those receiving no treatment (P < .001). Patients receiving ADT reported more physical discomfort 1 year after diagnosis than did men who had received no therapy. However, patients receiving ADT, compared with those receiving no therapy, were more likely to be satisfied with their treatment decision (56% pleased versus 45.3%; P =.001). Patients on ADT also experienced a statistically significant decline in vitality, but not in physical function, after adjustment for the confounding factors (P =.05). CONCLUSION: ADT is a commonly used primary therapy for clinically localized prostate cancer. Therefore, men considering ADT as an initial treatment should be aware that sexual function and some aspects of physical well-being are likely to be affected in the first year following this treatment.

Adult↗

Assessing tobacco beliefs among youth using item response theory models.

Successful intervention research programs to prevent adolescent smoking require well-chosen, psychometrically sound instruments for assessing smoking prevalence and attitudes. Twelve thousand eight hundred and ten adolescents were surveyed about their smoking beliefs as part of the Teenage Attitudes and Practices Survey project, a prospective cohort study of predictors of smoking initiation among US adolescents. Item response theory (IRT) methods are used to frame a discussion of questions that a researcher might ask when selecting an optimal item set. IRT methods are especially useful for choosing items during instrument development, trait scoring, evaluating item functioning across groups, and creating optimal item subsets for use in specialized applications such as computerized adaptive testing. Data analytic steps for IRT modeling are reviewed for evaluating item quality and differential item functioning across subgroups of gender, age, and smoking status. Implications and challenges in the use of these methods for tobacco onset research and for assessing the developmental trajectories of smoking among youth are discussed.

Adolescent↗