External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors

D. Revesz; S.M.J. van Kuijk; F. Mols; F.J.B. van Duijnhoven; R.M. Winkels; Ijmert Kant; P.A. van den Brandt; L.J. Smits; S.O. Breukink; E. Kampman; S. Beijer; M.P. Weijenberg; M.J.L. Bours

doi:10.1016/j.jclinepi.2022.09.019

External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors

D. Revesz
, S.M.J. van Kuijk
, F. Mols
, F.J.B. van Duijnhoven
, R.M. Winkels
, Ijmert Kant
, P.A. van den Brandt
, L.J. Smits
, S.O. Breukink
, E. Kampman
, S. Beijer
, M.P. Weijenberg
, M.J.L. Bours

Medical and Clinical Psychology

Research output: Contribution to journal › Article › Scientific › peer-review

6 Citations (Scopus)

334 Downloads (Pure)

Abstract

Objectives
Timely identification of colorectal cancer (CRC) survivors at risk of experiencing low health-related quality of life (HRQoL) in the near future is important for enabling appropriately tailored preventive actions. We previously developed and internally validated risk prediction models to estimate the 1-year risk of low HRQoL in long-term CRC survivors. In this article, we aim to externally validate and update these models in a population of short-term CRC survivors.

Study Design and Setting
In a pooled cohort of 1,596 CRC survivors, seven HRQoL domains (global QoL, cognitive/emotional/physical/role/social functioning, and fatigue) were measured prospectively at approximately 5 months postdiagnosis (baseline for prediction) and approximately 1 year later by a validated patient-reported outcome measure (European Organization for Research and Treatment of Cancer Quality of life Questionnaire–Core 30). For each HRQoL domain, 1-year scores were dichotomized into low vs. normal/high HRQoL. Performance of the previously developed multivariable logistic prediction models was evaluated (calibration and discrimination). Models were updated to create a more parsimonious predictor set for all HRQoL domains.

Results
Updated models showed good calibration and discrimination (AUC ≥0.75), containing a single set of 15 predictors, including nonmodifiable (age, sex, education, time since diagnosis, chemotherapy, radiotherapy, stoma, and comorbidities) and modifiable predictors (body mass index, physical activity, smoking, anxiety/depression, and baseline fatigue and HRQoL domain scores).

Conclusion
Externally validated and updated prediction models performed well for estimating the 1-year risk of low HRQoL in CRC survivors within 6 months postdiagnosis. The impact of implementing the models in oncology practice to improve HRQoL outcomes in CRC survivors needs to be evaluated.

Original language	English
Pages (from-to)	127-139
Journal	Journal of Clinical Epidemiology
Volume	152
DOIs	https://doi.org/10.1016/j.jclinepi.2022.09.019
Publication status	Published - 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 5 Gender Equality

Access to Document

10.1016/j.jclinepi.2022.09.019Licence: CC BY

MCP Mols external validation and updating of prediction models JoCE 2022Final published version, 497 KBLicence: CC BY

Cite this

Revesz, D., van Kuijk, S. M. J., Mols, F., van Duijnhoven, F. J. B., Winkels, R. M., Kant, I., van den Brandt, P. A., Smits, L. J., Breukink, S. O., Kampman, E., Beijer, S., Weijenberg, M. P., & Bours, M. J. L. (2022). External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors. Journal of Clinical Epidemiology, 152, 127-139. https://doi.org/10.1016/j.jclinepi.2022.09.019

@article{47a8806d4c0b4f6885d541194205dc75,

title = "External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors",

abstract = "Objectives Timely identification of colorectal cancer (CRC) survivors at risk of experiencing low health-related quality of life (HRQoL) in the near future is important for enabling appropriately tailored preventive actions. We previously developed and internally validated risk prediction models to estimate the 1-year risk of low HRQoL in long-term CRC survivors. In this article, we aim to externally validate and update these models in a population of short-term CRC survivors. Study Design and Setting In a pooled cohort of 1,596 CRC survivors, seven HRQoL domains (global QoL, cognitive/emotional/physical/role/social functioning, and fatigue) were measured prospectively at approximately 5 months postdiagnosis (baseline for prediction) and approximately 1 year later by a validated patient-reported outcome measure (European Organization for Research and Treatment of Cancer Quality of life Questionnaire–Core 30). For each HRQoL domain, 1-year scores were dichotomized into low vs. normal/high HRQoL. Performance of the previously developed multivariable logistic prediction models was evaluated (calibration and discrimination). Models were updated to create a more parsimonious predictor set for all HRQoL domains. Results Updated models showed good calibration and discrimination (AUC ≥0.75), containing a single set of 15 predictors, including nonmodifiable (age, sex, education, time since diagnosis, chemotherapy, radiotherapy, stoma, and comorbidities) and modifiable predictors (body mass index, physical activity, smoking, anxiety/depression, and baseline fatigue and HRQoL domain scores). Conclusion Externally validated and updated prediction models performed well for estimating the 1-year risk of low HRQoL in CRC survivors within 6 months postdiagnosis. The impact of implementing the models in oncology practice to improve HRQoL outcomes in CRC survivors needs to be evaluated.",

author = "D. Revesz and \{van Kuijk\}, S.M.J. and F. Mols and \{van Duijnhoven\}, F.J.B. and R.M. Winkels and Ijmert Kant and \{van den Brandt\}, P.A. and L.J. Smits and S.O. Breukink and E. Kampman and S. Beijer and M.P. Weijenberg and M.J.L. Bours",

note = "Funding: This work was supported by a grant from the Alpe d{\textquoteright}HuZes Foundation within the research program “Leven met kanker” of the Dutch Cancer Society (Grant number UM-2012-5653 ), and also partly by the Kankeronderzoekfonds Limburg as part of Health Foundation Limburg (Grant number 00005739 ). ",

year = "2022",

doi = "10.1016/j.jclinepi.2022.09.019",

language = "English",

volume = "152",

pages = "127--139",

journal = "Journal of Clinical Epidemiology",

issn = "0895-4356",

publisher = "Elsevier Inc.",

}

Revesz, D, van Kuijk, SMJ, Mols, F, van Duijnhoven, FJB, Winkels, RM, Kant, I, van den Brandt, PA, Smits, LJ, Breukink, SO, Kampman, E, Beijer, S, Weijenberg, MP & Bours, MJL 2022, 'External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors', Journal of Clinical Epidemiology, vol. 152, pp. 127-139. https://doi.org/10.1016/j.jclinepi.2022.09.019

TY - JOUR

T1 - External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors

AU - Revesz, D.

AU - van Kuijk, S.M.J.

AU - Mols, F.

AU - van Duijnhoven, F.J.B.

AU - Winkels, R.M.

AU - Kant, Ijmert

AU - van den Brandt, P.A.

AU - Smits, L.J.

AU - Breukink, S.O.

AU - Kampman, E.

AU - Beijer, S.

AU - Weijenberg, M.P.

AU - Bours, M.J.L.

N1 - Funding: This work was supported by a grant from the Alpe d’HuZes Foundation within the research program “Leven met kanker” of the Dutch Cancer Society (Grant number UM-2012-5653 ), and also partly by the Kankeronderzoekfonds Limburg as part of Health Foundation Limburg (Grant number 00005739 ).

PY - 2022

Y1 - 2022

N2 - Objectives Timely identification of colorectal cancer (CRC) survivors at risk of experiencing low health-related quality of life (HRQoL) in the near future is important for enabling appropriately tailored preventive actions. We previously developed and internally validated risk prediction models to estimate the 1-year risk of low HRQoL in long-term CRC survivors. In this article, we aim to externally validate and update these models in a population of short-term CRC survivors. Study Design and Setting In a pooled cohort of 1,596 CRC survivors, seven HRQoL domains (global QoL, cognitive/emotional/physical/role/social functioning, and fatigue) were measured prospectively at approximately 5 months postdiagnosis (baseline for prediction) and approximately 1 year later by a validated patient-reported outcome measure (European Organization for Research and Treatment of Cancer Quality of life Questionnaire–Core 30). For each HRQoL domain, 1-year scores were dichotomized into low vs. normal/high HRQoL. Performance of the previously developed multivariable logistic prediction models was evaluated (calibration and discrimination). Models were updated to create a more parsimonious predictor set for all HRQoL domains. Results Updated models showed good calibration and discrimination (AUC ≥0.75), containing a single set of 15 predictors, including nonmodifiable (age, sex, education, time since diagnosis, chemotherapy, radiotherapy, stoma, and comorbidities) and modifiable predictors (body mass index, physical activity, smoking, anxiety/depression, and baseline fatigue and HRQoL domain scores). Conclusion Externally validated and updated prediction models performed well for estimating the 1-year risk of low HRQoL in CRC survivors within 6 months postdiagnosis. The impact of implementing the models in oncology practice to improve HRQoL outcomes in CRC survivors needs to be evaluated.

AB - Objectives Timely identification of colorectal cancer (CRC) survivors at risk of experiencing low health-related quality of life (HRQoL) in the near future is important for enabling appropriately tailored preventive actions. We previously developed and internally validated risk prediction models to estimate the 1-year risk of low HRQoL in long-term CRC survivors. In this article, we aim to externally validate and update these models in a population of short-term CRC survivors. Study Design and Setting In a pooled cohort of 1,596 CRC survivors, seven HRQoL domains (global QoL, cognitive/emotional/physical/role/social functioning, and fatigue) were measured prospectively at approximately 5 months postdiagnosis (baseline for prediction) and approximately 1 year later by a validated patient-reported outcome measure (European Organization for Research and Treatment of Cancer Quality of life Questionnaire–Core 30). For each HRQoL domain, 1-year scores were dichotomized into low vs. normal/high HRQoL. Performance of the previously developed multivariable logistic prediction models was evaluated (calibration and discrimination). Models were updated to create a more parsimonious predictor set for all HRQoL domains. Results Updated models showed good calibration and discrimination (AUC ≥0.75), containing a single set of 15 predictors, including nonmodifiable (age, sex, education, time since diagnosis, chemotherapy, radiotherapy, stoma, and comorbidities) and modifiable predictors (body mass index, physical activity, smoking, anxiety/depression, and baseline fatigue and HRQoL domain scores). Conclusion Externally validated and updated prediction models performed well for estimating the 1-year risk of low HRQoL in CRC survivors within 6 months postdiagnosis. The impact of implementing the models in oncology practice to improve HRQoL outcomes in CRC survivors needs to be evaluated.

UR - https://www.scopus.com/pages/publications/85141654136

U2 - 10.1016/j.jclinepi.2022.09.019

DO - 10.1016/j.jclinepi.2022.09.019

M3 - Article

SN - 0895-4356

VL - 152

SP - 127

EP - 139

JO - Journal of Clinical Epidemiology

JF - Journal of Clinical Epidemiology

ER -

External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors

Abstract

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this