{"slug":"instruments","tag":"instruments","variants":["instruments"],"description":"No description yet","count":14,"kinds":{"technology":14},"related":[{"slug":"rejuvenation","tag":"rejuvenation","shared":14},{"slug":"survivorship","tag":"survivorship","shared":14},{"slug":"measurement","tag":"measurement","shared":13},{"slug":"cognition","tag":"cognition","shared":1},{"slug":"mind","tag":"mind","shared":1},{"slug":"policy","tag":"policy","shared":1}],"records":[{"id":"rejuv-measure-patient-reported-outcomes","kind":"technology","name":"How recovery is measured: the questionnaires behind the numbers","route":"/technologies/rejuv-measure-patient-reported-outcomes/","status":"standard-of-care","tldr":"Nearly every figure about recovery after cancer, for fatigue, for quality of life, for how a body works after treatment, comes from a questionnaire somebody filled in about themselves. That is a strength, because nobody else can report how a person feels, and a limit, because a questionnaire only measures what it asks about and only from the people who answered it."},{"id":"rejuv-measure-eortc-qlq-c30","kind":"technology","name":"EORTC QLQ-C30: the questionnaire most cancer trials use","route":"/technologies/rejuv-measure-eortc-qlq-c30/","status":"standard-of-care","tldr":"Thirty questions, answered about the past week, that produce separate scores out of 100 for how the body works, how the mind is, and for fatigue, pain and sickness. It is the questionnaire behind most European cancer trial results about quality of life, and there are add-on modules for individual cancers."},{"id":"rejuv-measure-fact-and-facit","kind":"technology","name":"FACT-G and the FACIT family: the other main questionnaire","route":"/technologies/rejuv-measure-fact-and-facit/","status":"standard-of-care","tldr":"Twenty-seven questions about the past week, in four areas: the body, family and friends, feelings, and being able to do ordinary things. Dozens of add-ons exist for particular cancers and particular symptoms, including the fatigue scale used in most anaemia and fatigue trials."},{"id":"rejuv-measure-promis","kind":"technology","name":"PROMIS: the item banks that let a short questionnaire be precise","route":"/technologies/rejuv-measure-promis/","status":"established","tldr":"Instead of a fixed questionnaire, PROMIS is a library of calibrated questions for things like fatigue, pain, anxiety, depression and physical function, built so that a computer can pick the next question based on the last answer and reach a precise score in a handful of items. Scores are set against the general population, not against other cancer patients."},{"id":"rejuv-measure-pro-ctcae","kind":"technology","name":"PRO-CTCAE: side effects graded by the person having them","route":"/technologies/rejuv-measure-pro-ctcae/","status":"established","tldr":"Clinicians have always graded side effects themselves, and they systematically under-record them. PRO-CTCAE is the matching set of questions asked of the patient instead, in plain language, about how often a symptom happened, how bad it was and how much it got in the way."},{"id":"rejuv-measure-eq-5d","kind":"technology","name":"EQ-5D: health reduced to one number, and what that number is for","route":"/technologies/rejuv-measure-eq-5d/","status":"standard-of-care","tldr":"Five questions and a thermometer-style scale from worst to best imaginable health. The five answers are converted into a single index value using a country-specific value set, and that index is what health systems use to decide whether a treatment is worth paying for."},{"id":"rejuv-measure-breast-q","kind":"technology","name":"BREAST-Q and the Q-portfolio: measuring what an operation left behind","route":"/technologies/rejuv-measure-breast-q/","status":"established","tldr":"A questionnaire built from what women actually said matters after breast surgery: satisfaction with how the breasts look and feel, and psychological, physical and sexual well-being, each scored separately. It is the reason reconstruction techniques can be compared on something other than complication rates."},{"id":"rejuv-measure-cognitive-function","kind":"technology","name":"Measuring memory and concentration after treatment","route":"/technologies/rejuv-measure-cognitive-function/","status":"established","tldr":"What a person notices about their own memory and what a formal test measures are two different things, and they agree only weakly. The questionnaire most used for the first is FACT-Cog; the tests used for the second were standardised by an international task force so that studies could be compared."},{"id":"rejuv-measure-fear-of-recurrence-inventory","kind":"technology","name":"Measuring fear of recurrence: the FCRI and its cut-off","route":"/technologies/rejuv-measure-fear-of-recurrence-inventory/","status":"established","tldr":"The most commonly reported unmet need after cancer treatment has a questionnaire of its own. The full version has 42 questions across seven components; the nine-question short form is the one used to screen, and a score of 22 or more marks a level of fear that merits help."},{"id":"rejuv-measure-lymphoedema","kind":"technology","name":"Measuring lymphoedema: tape, bioimpedance and the quality of life scales","route":"/technologies/rejuv-measure-lymphoedema/","status":"established","tldr":"There are two separate questions, how big the limb is and how much it affects the person, and they need different instruments. Limb volume is measured by tape, by water displacement or by a device that passes a small current through the tissue; the effect on living is measured by a questionnaire such as LYMQOL."},{"id":"rejuv-measure-minimally-important-difference","kind":"technology","name":"What a difference has to be before a person would notice it","route":"/technologies/rejuv-measure-minimally-important-difference/","status":"established","tldr":"A trial can report a statistically significant change in a quality of life score that no person would notice. The minimally important difference is the attempt to say how much a score has to move to correspond to something a patient would call a change, and it differs by questionnaire, by scale, by cancer and by direction."},{"id":"rejuv-measure-missing-data-and-who-is-not-asked","kind":"technology","name":"The questionnaires that were never returned, and the people never asked","route":"/technologies/rejuv-measure-missing-data-and-who-is-not-asked/","status":"established","tldr":"In a trial measuring how people feel, the forms go missing exactly when people are most unwell. That makes the remaining scores look better than the truth. The same thing happens on a larger scale when whole groups are not asked at all."},{"id":"rejuv-measure-epro-as-treatment","kind":"technology","name":"Asking people how they are, every week, as a treatment in its own right","route":"/technologies/rejuv-measure-epro-as-treatment/","status":"established","tldr":"Several randomised trials tested asking patients to report symptoms every week, with a nurse alerted when something is bad or getting worse. It reliably improves how people feel and function and cuts emergency visits. Whether it lengthens life did not hold up: two trials found a survival benefit and the largest trial, designed to test exactly that, found none."},{"id":"rejuv-measure-epro-implementation","kind":"technology","name":"What has actually been implemented since those trials, and what has not","route":"/technologies/rejuv-measure-epro-implementation/","status":"emerging","tldr":"The trials finished years ago and most people being treated for cancer are still not asked their symptoms between appointments. The clearest thing that changed is a United States payment model that now requires practices to collect them."}]}