587 PATIENT-REPORTED SYMPTOMS FOR ESOPHAGEAL CANCER PATIENTS UNDERGOING CURATIVE INTENT TREATMENT

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Vaibhav Gupta ◽  
Catherine Allen-Ayodabo ◽  
Laura Davis ◽  
Haoyu Zhao ◽  
Julie Hallet ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Clinical Care ◽  
Symptom Burden ◽  
Population Level ◽  
Symptom Assessment ◽  
Assessment System ◽  
Curative Intent ◽  
Cancer Symptoms ◽  
Patient Reported ◽  
Symptom Scores

Abstract   Esophageal cancer (EC) patients experience considerable symptom burden from treatment. This study utilized population-level patient-reported Edmonton Symptom Assessment System (ESAS) scores collected as part of standard clinical care to describe symptom trajectories and characteristics associated with severe symptoms for patients undergoing curative intent EC treatment. Methods EC patients treated with curative intent at regional cancer centers and affiliates between 2009–2016 and assessed for symptoms in the 12 months following diagnosis were included. ESAS measures nine common patient-reported cancer symptoms. The outcome was reporting of severe (≥7/10) symptom scores. Multivariable analyses were used to identify characteristics associated with severe symptom scores. Results 1,751 patients reported a median of 7 (IQR 4–12) ESAS assessments in the year following diagnosis, for a total of 14,953 unique ESAS assessments included in the analysis. The most frequently reported severe symptoms were lack of appetite (n = 918, 52%), tiredness (n = 787, 45%) and poor wellbeing (713, 40.7%). The highest symptom burden is within the first five months following diagnosis, with moderate improvement in symptom burden in the second half of the first year. Characteristics associated with severe scores for all symptoms included female sex, high comorbidity, lower socioeconomic status, urban residence, and symptom assessment temporally close to diagnosis. Conclusion This study demonstrates a high symptom burden for EC patients undergoing curative intent therapy. Targeted treatment of common severe symptoms, and increased support for patients at risk for severe symptoms, may enhance patient quality of life.

Creation of On-PROST: The Ontario patient-reported outcomes of symptoms and toxicity applied clinical research unit.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 47-47
Author(s):  
Geoffrey Liu ◽  
Doris Howell ◽  
Andrea Perez Cosio ◽  
Monika K. Krzyzanowska ◽  
Madeline Li ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Clinical Care ◽  
Population Level ◽  
Symptom Assessment ◽  
Research Unit ◽  
Assessment System ◽  
Services Research ◽  
Disease Treatment ◽  
Patient Reported ◽  
Specific Symptoms

47 Background: The 14 Ontario Regional Cancer Centers serve a catchment of 13 million people, centrally coordinated by Cancer Care Ontario. Since 2009, computer kiosks collect the Edmonton Symptom Assessment System (ESAS) patient reported outcomes (PROs). At specific centers, additional PROs such as the Distress Assessment and Response Tool (DART) have been integrated. On-PROST was created in 2011 to customize PROs for disease-, treatment- and phase-specific symptoms and toxicities, and to address core multidimensional impacts of cancer. On-PROST aims to improve patient experience and quality of care through routine collection of standardized sets of PROs for combined use in clinical care and research. Methods: On-PROST structure has five research pillars, each dependent on quality PROs: Health Services Research; Biomarker Research; Radiation Oncology; Palliative/Supportive Care; and the PROs-Cancer Core items. National/international partnerships are being established to develop, standardize and implement PROs relevant across the entire cancer continuum. Results: National consensus was generated for the implementation of the Canadian PROMs-Cancer Core. Key domains on physical, emotional and social health were included, and implementation testing has begun. In parallel, specific On-PROST sub-projects have focused on identifying, validating, and standardizing logic-based sets of PROs for disease-, treatment- and phase-specific symptoms and toxicities. On-PROST projects have focused on topics that complement existing research by other groups (PROMIS, PRO-CTCAE). Initial projects have included: (i) assessment of dysphagia and related symptoms in head and neck and esophageal cancer populations; (ii) short/long term sexual function in prostate and testicular cancers; (iii) a lung cancer radiogenetic toxicity study; and (iv) patient reported outcomes related to physical activity and other modifiable behaviors after cancer diagnosis. Conclusions: The multi-pronged structure of On-PROST will systematically collect disease-, treatment-, and phase-specific PROs at a population level.

scholarly journals Prescreening of Patient-reported Symptoms using the Edmonton Symptom Assessment System (ESAS) in Outpatient Palliative Cancer Care

2019 ◽  
Author(s):  
Garden Lee ◽  
Han Sang Kim ◽  
Si Won Lee ◽  
Eun Hwa Kim ◽  
Bori Lee ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Care ◽  
Severe Symptom ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Assessment System ◽  
Advanced Cancer Patients ◽  
Edmonton Symptom Assessment System ◽  
Patient Reported

Abstract Background: Although early palliative care is associated with a better quality of life and improved outcomes in end-of-life cancer care, the criteria of palliative care referral are still elusive. Methods: We collected patient-reported symptoms using the Edmonton Symptom Assessment System (ESAS) at the baseline, first, and second follow-up visit. The ESAS evaluates ten symptoms: pain, fatigue, nausea, depression, anxiety, drowsiness, dyspnea, sleep disorder, appetite, and wellbeing. A total of 71 patients were evaluable, with a median age of 65 years, male (62%), and the Eastern Cooperative Oncology Group (ECOG) performance status distribution of 1/2/3 (28%/39%/33%), respectively. Results: Twenty (28%) patients had moderate/severe symptom burden with the mean ESAS ≥5. Interestingly, most of the patients with moderate/severe symptom burdens (ESAS ≥5) had globally elevated symptom expression. While the mean ESAS score was maintained in patients with mild symptom burden (ESAS<5; 2.7 at the baseline; 3.4 at the first follow-up; 3.0 at the second follow-up; P =0.117), there was significant symptom improvement in patients with moderate/severe symptom burden (ESAS≥5; 6.5 at the baseline; 4.5 at the first follow-up; 3.6 at the second follow-up; P <0.001). Conclusions: Advanced cancer patients with ESAS ≥5 may benefit from outpatient palliative cancer care. Prescreening of patient-reported symptoms using ESAS can be useful for identifying unmet palliative care needs in advanced cancer patients.

scholarly journals Implementing a Patient-Reported Outcome Measure for Hemodialysis Patients in Routine Clinical Care

2020 ◽  
Vol 15 (9) ◽  
pp. 1299-1309 ◽  
Author(s):  
Jenna M. Evans ◽  
Alysha Glazer ◽  
Rebecca Lum ◽  
Esti Heale ◽  
Marnie MacKinnon ◽  
...  
Keyword(s):  
Outcome Measure ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Patient Reported Outcome ◽  
Assessment System ◽  
Edmonton Symptom Assessment System ◽  
Patient Reported Outcome Measure ◽  
Symptom Screening ◽  
Patient Reported ◽  
Patient Provider Communication

Background and objectivesThe Edmonton Symptom Assessment System Revised: Renal is a patient-reported outcome measure used to assess physical and psychosocial symptom burden in patients treated with maintenance dialysis. Studies of patient-reported outcome measures suggest the need for deeper understanding of how to optimize their implementation and use. This study examines patient and provider perspectives of the implementation process and the influence of the Edmonton Symptom Assessment System Revised: Renal on symptom management, patient-provider communication, and interdisciplinary communication.Design, setting, participants, & measurements Eight in-facility hemodialysis programs in Ontario, Canada, assessed patients using the Edmonton Symptom Assessment System Revised: Renal every 4–6 weeks for 1 year. Screening and completion rates were tracked, and pre- and postimplementation surveys and midimplementation interviews were conducted with patients and providers. A chart audit was conducted 12 months postimplementation.ResultsIn total, 1459 patients completed the Edmonton Symptom Assessment System Revised: Renal; 58% of eligible patients completed the preimplementation survey (n=718), and 56% of patients who completed the Edmonton Symptom Assessment System Revised: Renal at least once completed the postimplementation survey (n=569). Provider survey response rates were 71% (n=514) and 54% (n=319), respectively. Nine patients/caregivers from three sites and 48 providers from all sites participated in interviews. A total of 1207 charts were audited. Seven of eight sites had mean screening rates over 80%, suggesting that routine use of the Edmonton Symptom Assessment System Revised: Renal in clinical practice is feasible. However, the multiple data sources painted an inconsistent picture of the value and effect of the Edmonton Symptom Assessment System Revised: Renal. The Edmonton Symptom Assessment System Revised: Renal standardized symptom screening processes across providers and sites; improved patient and provider symptom awareness, particularly for psychosocial symptoms; and empowered patients to raise issues with providers. Yet, there was little, if any, statistically significant improvement in the metrics used to assess symptom management, patient-provider communication, and interdisciplinary communication.ConclusionsThe Edmonton Symptom Assessment System Revised: Renal patient-reported outcome measure may be useful to standardize symptom screening, enhance awareness of psychosocial symptoms among patients and providers, and empower patients rather than to reduce symptom burden.

Performance Status and Symptom Scores of Women With Gynecologic Cancer at the End of Life

2013 ◽  
Vol 23 (5) ◽  
pp. 971-978 ◽  
Author(s):  
Lori Spoozak ◽  
Hsien Seow ◽  
Ying Liu ◽  
Jason Wright ◽  
Lisa Barbera
Keyword(s):  
Cervical Cancer ◽  
End Of Life ◽  
Performance Status ◽  
Gynecologic Cancer ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Well Being ◽  
Assessment System ◽  
Edmonton Symptom Assessment System ◽  
Symptom Scores

ObjectiveThe Palliative Performance Scale (PPS), which measures performance status (100 = best performance to 0 = dead), and the Edmonton Symptom Assessment System (ESAS), which measures severity of 9 symptoms, are routinely collected at ambulatory cancer visits in Ontario. This study describes the trajectory of scores in patients with gynecologic cancer in the last 6 months of life.MethodsAn observational study was conducted between 2007 and 2010. Patients had ovarian/fallopian tube, uterine, and cervical cancer and required 1 or more PPS or ESAS assessment in the 6 months before death. Outcomes were the average PPS and ESAS scores per week before death. Using logistic regression, we analyzed the odds ratio of reporting a moderate to severe score for each symptom.ResultsSeven hundred ninety-five (PPS) and 1299 (ESAS) patients were included. The average PPS score started at 70 and ended at 30, rapidly declining in the last 2 months. For ESAS symptoms, drowsiness, decreased well-being, lack of appetite, and tiredness increased in severity closer to death and were prevalent in more than 70% of patients in the last week of life. Patients with cervical cancer had increased odds of moderate to severe pain (1.74; 95% confidence interval, 1.30–2.32) compared with ovarian cancer.ConclusionsTrajectories of mean performance status had not reached the “end-of-life” phase until 1 week before death. A large proportion of the gynecologic cancer patients reported moderate to severe symptom scores as death approached. Pain was uniquely elevated in the cervical cancer cohort as death approached. Adequately managing the symptom burden appears to be a significant issue in end-of-life gynecologic care.

Impact of baseline symptom burden as assessed by patient-reported outcomes (PROs) on overall survival (OS) of patients with metastatic cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12020-12020
Author(s):  
Atul Batra ◽  
Colleen Ann Cuthbert ◽  
Andrew Harper ◽  
Lin Yang ◽  
Devon J. Boyne ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metastatic Cancer ◽  
Metastatic Breast ◽  
Symptom Burden ◽  
Assessment System ◽  
Clinical Practices ◽  
Cox Regression Analysis ◽  
Symptom Intensity ◽  
Patient Reported ◽  
Symptom Scores

12020 Background: Patients with metastatic cancer experience variable symptom burden, but serial symptom assessments using PROs may be challenging to implement in routine clinical practices. We aimed to determine if a single measurement of symptom burden at the time of metastatic diagnosis is associated with survival. Methods: We examined prospectively collected baseline PROs of patients newly diagnosed with metastatic breast, lung, colorectal, or prostate cancer using the revised Edmonton Symptom Assessment System (ESASr) questionnaire from a large province (Alberta, Canada) between 2016 and 2019. The ESASr was categorized into physical (PH), psychosocial (PS), and total symptom (TS) domains whereby scores were classified as mild (0-3), moderate (4-6), or severe (7-10). Multivariable Cox proportional hazards models were constructed to evaluate the effect of baseline symptom scores on OS. Results: We identified 1,315 patients, of whom 57% were men and median age was 66 (IQR, 27-93) years. There were 180, 601, 240, and 294 patients with breast, lung, colorectal, and prostate cancer, respectively. Approximately one-quarter of all patients reported moderate to severe PH, PS, and TS scores, with lung cancer patients experiencing the highest symptom intensity across all domains ( P<0.0001). While age did not affect symptom scores, women were more likely to report severe PH, PS, and TS scores as compared to men ( P=0.02, 0.002, and 0.007, respectively). On multivariable Cox regression analysis, older age (HR 1.02, 95% CI, 1.02-1.03, P<0.0001) and female sex (HR 1.67, 95% CI, 1.39-1.99, P<0.0001) were predictive of worse OS as were severe baseline PH and TS scores (see Table) . However, baseline PS scores were not related to OS. Conclusions: A single assessment of baseline symptom burden using the ESASr in patients with metastatic cancer has significant prognostic value. This may represent a feasible first step toward routine collection of PROs in real-world settings where serial symptom measurements can be challenging to implement. [Table: see text]

scholarly journals Initial Pain Management Plans in Response to Severe Pain Indicators on Oncology Clinic Previsit Questionnaires

2014 ◽  
Vol 19 (6) ◽  
pp. 309-312
Author(s):  
Michael S Sanatani ◽  
Maan Kattan ◽  
Dwight E Moulin
Keyword(s):  
Pain Management ◽  
Cancer Treatment ◽  
Severe Pain ◽  
Clinical Care ◽  
Symptom Assessment ◽  
Assessment System ◽  
Care Plan ◽  
Care Plans ◽  
Patient Reported ◽  
Management Plans

BACKGROUND: The issue of how to address patient pain in the outpatient setting remains challenging. At the London Regional Cancer Program (London, Ontario), patients complete the Edmonton Symptom Assessment System (ESAS) before most visits.OBJECTIVES:To perform a chart review assessing the frequency and, if applicable, the type of a clinical care plan that was developed if a patient indicated pain ≥7 on a 10-point scaleMETHODS: The charts of 100 eligible sequential outpatient visits were reviewed and the initial pain management approaches were documented.RESULTS: Between December 2011 and May 2012, visits by 7265 unique patients included 100 eligible visits (pain ≥7 of 10). In 83 cases, active pain management plans, ranging from counselling to hospital admission, were proposed. Active pain management plans were more likely if the cause was believed to be cancer/treatment related: 63 of 65 (96.9%) versus 20 of 35 (57.1%, noncancer/unknown pain cause); P<0.001. There were no differences depending on cancer treatment intent or medical service.CONCLUSIONS: Active pain management plans were documented in 83% of visits. However, patients who reported severe pain that was assessed as benign or unknown in etiology received intervention less frequently, perhaps indicating that oncologists either consider themselves less responsible for noncancer pain, or believe that pain chronicity may lead to a higher ESAS pain score without indicating a need for acute intervention. Further study is needed to determine the subsequent effect of the care plans on patient-reported ESAS pain scores at future clinic visits.

scholarly journals Baseline Edmonton Symptom Assessment System and survival in metastatic renal cell carcinoma

2018 ◽  
Vol 25 (4) ◽  
Author(s):  
J. Graham ◽  
J. Gingerich ◽  
P. Lambert ◽  
A. Alamri ◽  
P. Czaykowski
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Assessment System ◽  
Prognostic Information ◽  
Edmonton Symptom Assessment System ◽  
Patient Reported

Background Baseline symptom burden as measured using the Edmonton Symptom Assessment System (esas), a patient-reported, validated, and reliable tool measuring symptom severity in 9 separate domains, might yield prognostic information in patients receiving treatment for metastatic renal cell carcinoma (mrcc) and might add to the existing prognostic models.Methods In this retrospective single-centre cohort study, we included patients receiving first-line sunitinib therapy for mrcc between 2008 and 2012. Baseline variables included information relevant to the pre-existing prognostic models and pre-treatment esas summation scores (added together across all 9 domains), with higher scores representing greater symptom burden. We used Kaplan–Meier curves and Cox regression modelling to determine if symptom burden can provide prognostic information with respect to overall survival.Results We identified 68 patients receiving first-line therapy for mrcc. Most had intermediate- or poor-risk disease based on both the Memorial Sloan Kettering Cancer Center (mskcc) and the International Metastatic Renal Cell Carcinoma Database Consortium (imdc) models. The median baseline esas summation score was 16 (range: 6–57). In univariable analysis, the hazard ratio for overall survival was 1.270 (p = 0.0047) per 10-unit increase in summation esas. In multivariable analysis, the hazard ratio was 1.208 (p = 0.0362) when controlling for mskcc risk group and 1.240 (p = 0.019) when controlling for imdc risk group.Conclusions Baseline symptom burden as measured by esas score appears to provide prognostic information for survival in patients with mrcc. Those results should encourage the investigation of patient-reported symptom scales as potential prognostic indicators for patients with advanced cancer.

scholarly journals Potentially Avoidable Hospital Readmissions in Patients With Advanced Cancer

2019 ◽  
Vol 15 (5) ◽  
pp. e420-e427 ◽  
Author(s):  
P. Connor Johnson ◽  
Yian Xiao ◽  
Risa L. Wong ◽  
Sara D'Arpino ◽  
Samantha M.C. Moran ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Odds Ratio ◽  
Hospital Readmissions ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Physical Symptom ◽  
Assessment System ◽  
Primary Reason ◽  
Nonlinear Mixed Effects Models ◽  
Patient Reported

PURPOSE: Patients with cancer often prefer to avoid time in the hospital; however, data are lacking on the prevalence and predictors of potentially avoidable readmissions (PARs) among those with advanced cancer. METHODS: We enrolled patients with advanced cancer from September 2, 2014, to November 21, 2014, who had an unplanned hospitalization and assessed their patient-reported symptom burden (Edmonton Symptom Assessment System) at the time of admission. For 1 year after enrollment, we reviewed patients’ health records to determine the primary reason for every hospital readmission and we classified readmissions as PARs using adapted Graham’s criteria. We examined predictors of PARs using nonlinear mixed-effects models with binomial distribution. RESULTS: We enrolled 200 (86.2%) of 232 patients who were approached. For these 200 patients, we reviewed 277 total hospital readmissions and identified 108 (39.0%) of these as PARs. The most common reasons for PARs were premature discharge from a prior hospitalization (30.6%) and failure of timely follow-up (28.7%). PAR hospitalizations were more likely than non-PAR hospitalizations to experience symptoms as the primary reason for admission (28.7% v 13.0%; P = .001). We found that married patients were less likely to experience PARs (odds ratio, 0.30; 95% CI, 0.15 to 0.57; P < .001) and that those with a higher physical symptom burden were more likely to experience PARs (odds ratio, 1.03; 95% CI, 1.01 to 1.05; P = .012). CONCLUSION: We observed that a substantial proportion of hospital readmissions are potentially avoidable and found that patients’ symptom burdens predict PARs. These findings underscore the need to assess and address the symptom burden of hospitalized patients with advanced cancer in this highly symptomatic population.

Comparison of prevalence of pain symptoms and completion rates using a patient-reported outcomes (PRO) tool of pain in palliative and curative patients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 78-78
Author(s):  
Sabrina Yeung ◽  
Catherine Brown ◽  
Andrea Perez Cosio ◽  
Yvonne Leung ◽  
Mindy Liang ◽  
...  
Keyword(s):  
Brief Pain Inventory ◽  
Symptom Assessment ◽  
Assessment System ◽  
Assessment Tools ◽  
Completion Rates ◽  
Curative Intent ◽  
Wide Range ◽  
Patient Reported ◽  
Prevalence Of Pain ◽  
Pain Symptoms

78 Background: Regular self-reporting of symptoms using validated computerized assessment tools can improve individualized symptom management. Yet there are concerns that palliative patients who may benefit most from such self-reporting may be reluctant to adopt such approaches or have barriers to proper reporting. We compared actual prevalence and completion rates of a PRO-tool between patients being managed with a palliative (PAL) or curative intent (CUR). Methods: A pain PRO-tool was administered cross-sectionally using tablet technology across outpatient clinics in a comprehensive cancer centre. Questions were adapted from the Brief Pain Inventory (BPI) and Edmonton Symptom Assessment System (ESAS), recording responses on pain severity and interference in life. PRO-tool completion rates and prevalence of pain symptoms were compared between CUR and PAL. Results: Of 200 patients, 82 were PAL and 118 were CUR; median age was 60 (21-86) years; 48% were female. A greater proportion of PAL were found with gastrointestinal, gynecological and lung cancers than CUR (p = 0.04). Each question had greater than 95% completion rates for both groups, capturing a wide range of scores. 16% of PAL reported no pain as their worst pain in the last 24 hours as opposed to 31% of CUR (p = 0.02). 82% (PAL) and 68% (CUR) reported their average pain as being at least “some pain” (p = 0.03), and there were no differences in the proportion of patients reporting interference with their general activity between PAL and CUR (p > 0.05). Presence of current pain was equivocal when assessed via the ESAS adapted question (76% PAL vs 66% CUR, p = 0.16), but was significantly different when assessed using the BPI adapted question (72% PAL vs 56% CUR; p = 0.02). Conclusions: A Pain PRO-tool was completed with similarly high rates in PAL and CUR patients. As expected, prevalence of recent and current pain was high in both groups, and in some instances, higher in PAL than CUR patients. These results suggest that a Pain PRO-tool could be implemented with ease in the palliative setting, and would capture pain comprehensively.

scholarly journals Combined cancer patient–reported symptom and health utility tool for routine clinical implementation: a real-world comparison of the ESAS and EQ-5D in multiple cancer sites

2019 ◽  
Vol 26 (6) ◽  
Author(s):  
M. Moskovitz ◽  
K. Jao ◽  
J. Su ◽  
M. C. Brown ◽  
H. Naik ◽  
...  
Keyword(s):  
Correlation Coefficients ◽  
Health Utility ◽  
Symptom Assessment ◽  
Assessment System ◽  
Clinical Implementation ◽  
Multiple Cancer ◽  
Cancer Symptoms ◽  
Patients With Cancer ◽  
Incurable Disease ◽  
Patient Reported

Background We assessed whether the presence and severity of common cancer symptoms are associated with the health utility score (hus) generated from the EQ-5D (EuroQol Research Foundation, Rotterdam, Netherlands) in patients with cancer and evaluated whether it is possible pragmatically to integrate routine hus and symptom evaluation in our cancer population.Methods Adult outpatients at Princess Margaret Cancer Centre with any cancer were surveyed cross-sectionally using the Edmonton Symptom Assessment System (esas) and the EQ-5D-3L, and results were compared using Spearman correlation coefficients and regression analyses.Results Of 764 patients analyzed, 27% had incurable disease. We observed mild-to-moderate correlations between each esas symptom score and the hus (Spearman coefficients: –0.204 to –0.416; p < 0.0001 for each comparison), with the strongest associations being those for pain (R = –0.416), tiredness (R = –0.387), and depression (R =-0.354). Multivariable analyses identified pain and depression as highly associated (both p < 0.0001) and tiredness as associated (p = 0.03) with the hus. The ability of the esas to predict the hus was low, at 0.25. However, by mapping esas pain, anxiety, and depression scores to the corresponding EQ-5D questions, we could derive the hus using partial esas data, with Spearman correlations of 0.83–0.91 in comparisons with direct EQ-5D measurement of the hus.Conclusions The hus derived from the EQ-5D-3L is associated with all major cancer symptoms as captured by the esas. The esas scores alone could not predict EQ-5D scores with high accuracy. However, esas-derived questions assessing the same domains as the EQ-5D-3L questions could be mapped to their corresponding EQ-5D questions to generate the hus, with high correlation to the directly measured hus. That finding suggests a potential approach to integrating routine symptom and hus evaluations after confirmatory studies.

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