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Published August 30, 2018 | Version v1
Journal article Open

Congruence Between Latent Class and K-Modes Analyses in the Identification of Oncology Patients With Distinct Symptom Experiences

  • 1. School of Health Sciences, University of Surrey
  • 2. School of Nursing, University of California, San Francisco
  • 3. Department of Computer and Information Sciences, University of Strathclyde
  • 4. European Cancer Patient Coalition
  • 5. Florence Nightingale Faculty of Nursing and Midwifery, King's College London
  • 6. School of Nursing, University of Pittsburgh
  • 7. Department of Nursing, Mount Sinai Medical Center
  • 8. Faculty of Nursing, University of Peloponnese
  • 9. School of Medicine, University of California, San Francisco
  • 10. School of Health Sciences, National and Kapodistrian University of Athens
  • 11. School of Nursing, Yale University

Description

Context

Risk profiling of oncology patients based on their symptom experience assists clinicians to provide more personalized symptom management interventions. Recent findings suggest that oncology patients with distinct symptom profiles can be identified using a variety of analytic methods.

Objectives

The objective of this study was to evaluate the concordance between the number and types of subgroups of patients with distinct symptom profiles using latent class analysis and K-modes analysis.

Methods

Using data on the occurrence of 25 symptoms from the Memorial Symptom Assessment Scale, that 1329 patients completed prior to their next dose of chemotherapy (CTX), Cohen's kappa coefficient was used to evaluate for concordance between the two analytic methods. For both latent class analysis and K-modes, differences among the subgroups in demographic, clinical, and symptom characteristics, as well as quality of life outcomes were determined using parametric and nonparametric statistics.

Results

Using both analytic methods, four subgroups of patients with distinct symptom profiles were identified (i.e., all low, moderate physical and lower psychological, moderate physical and higher Psychological, and all high). The percent agreement between the two methods was 75.32%, which suggests a moderate level of agreement. In both analyses, patients in the all high group were significantly younger and had a higher comorbidity profile, worse Memorial Symptom Assessment Scale subscale scores, and poorer QOL outcomes.

Conclusion

Both analytic methods can be used to identify subgroups of oncology patients with distinct symptom profiles. Additional research is needed to determine which analytic methods and which dimension of the symptom experience provide the most sensitive and specific risk profiles.

Files

Papchristou_etal_JPSM_2018_k_modes_analyses_in_the_identification_of_oncology_patients_with_distinct_symptom_experiences.pdf

Additional details

Funding

ESMART – Randomised controlled trial to evaluate electronic Symptom Management using the Advanced Symptom Management System (ASyMS) Remote Technology for patients with cancers 602289
European Commission