Identification and prediction of health-related quality of life trajectories

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Title: Identification and prediction of health-related quality of life trajectories after a prostate cancer diagnosis.

Speaker: Megan Farris, Research Associate at the MEDLIOR Health Outcomes Research Ltd.


Background: Group-based trajectory models (GBTM) are becoming increasingly popular in health research. In this presentation, GBTM are used to understand health-related quality of life (HRQoL) after prostate cancer diagnosis.

Objective: The aim of our study was to identify physical and mental HRQoL trajectories after a prostate cancer diagnosis and systematically characterize trajectories by behaviours and prognostic factors.

Methods: Prostate cancer survivors (n = 817) diagnosed between 1997 and 2000 were recruited between 2000 and 2002 into a prospective repeated measurements study. Behavioural/prognostic data were collected through in-person interviews and questionnaires. HRQoL was collected at three post-diagnosis time-points, approximately two years apart using the Short Form (SF)-36 validated questionnaire. To identify physical and mental HRQoL trajectories, GBTM was undertaken. Differences between groups were evaluated by assessing influential dropouts (mortality/poor health), behavioural/prognostic factors at diagnosis or during the follow-up.

Results: Three trajectories of physical HRQoL were identified including: average-maintaining HRQoL (32.2%), low-declining HRQoL (40.5%) and very low-maintaining HRQoL (27.3%). In addition, three trajectories for mental HRQoL were identified: average-increasing HRQoL (66.5%), above average-declining HRQoL (19.7%) and low-increasing HRQoL (13.8%). In both physical and mental HRQoL, dropout from mortality/poor health differed between trajectories, thus confirming HRQoL and mortality were related. Furthermore, increased Charlson comorbidity index score was consistently associated with physical and mental HRQoL group membership relative to average maintaining groups, while behaviours such as time-varying physical activity was associated with physical HRQoL trajectories but not mental HRQoL trajectories.

Conclusion: It was possible to define three trajectories of physical and mental HRQoL after prostate cancer. These data provide insights regarding means for identifying subgroups of prostate cancer survivors with lower or declining HRQoL after diagnosis whom could be targeted for interventions aimed at improving HRQoL.

Biography: Megan has over 5 years of research experience. She joined MEDLIOR Health Outcomes Research Ltd. in 2017 as a Epidemiology Research Associate, primarily supporting the real-world data analytics projects. She uses her expertise in epidemiologic and biostatistical research methodologies to deliver complex RWE initiatives for both public and private sector organizations. Megan’s skills include both quantitative research methodology (data analysis, biostatistics, epidemiological study design) as well as qualitative research (systematic literature search and analysis as well as manuscript writing). Megan has authored several oncology, women’s health and psychiatry journal publications and a book chapter. Before joining MEDLIOR, Megan gained experience as a Research Associate in the Department of Cancer Epidemiology and Prevention Research at Alberta Health Services. She received her MSc in epidemiology from the University of Calgary and BSc from California State University, Fullerton.

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