Published: Monitoring aerobic capacity in cancer survivors using self-reported questionnaires: criterion validity and responsiveness

Hits: 27
  • Publication status: Gepubliceerd
  • Type of study: Clinimetrics
  • Journal: Springer Open - Journal of Patient-Reported Outcomes

  • Weemaes, A. ORCID iD

    Meijer, R. ORCID iD

    Beelen, M. ORCID iD

    Hooff van, M. ORCID iD

    Weijenberg, M. ORCID iD

    Lenssen, A. ORCID iD

    Pol van de - Franse, L ORCID iD

    Savelberg, H. ORCID iD

    Schep, G. ORCID iD

  • Affiliations: Maastricht University, Maastricht University Medical Center, Máxima Medical Centre, The Netherlands Cancer Institute, Tilburg University
  • Population: Oncology, Cardiac, Pulmonary
  • DOI: https://doi.org/10.1186/s41687-023-00613-8
  • PMID: 37466784
  • BibTex: 
      
@article{Weemaes2023FitMax,
  author  = {Anouk T. R. Weemaes and Renske Meijer and Milou Beelen and Martijn van Hooff and Matty P. Weijenberg and Antoine F. Lenssen and Lonneke V. van de Poll-Franse and Hans H. C. M. Savelberg and Goof Schep},
  title   = {Monitoring aerobic capacity in cancer survivors using self-reported questionnaires: criterion validity and responsiveness},
  journal = {Journal of Patient-Reported Outcomes},
  volume  = {7},
  pages   = {Article number: 73},
  year    = {2023},
  doi     = {10.1186/s41687-023-00613-8},
  url     = {https://jpro.springeropen.com/articles/10.1186/s41687-023-00613-8}
}

Background: Evaluating the criterion validity and responsiveness of the self-reported FitMáx©-questionnaire, Duke Activity Status Index (DASI) and Veterans Specific Activity Questionnaire (VSAQ) to monitor aerobic capacity in cancer survivors.

Methods: Cancer survivors participating in a 10-week supervised exercise program were included. The FitMáx©-questionnaire, DASI, VSAQ and a cardiopulmonary exercise test (CPET) were completed before (T0) and after (T1) the program. Intraclass correlation coefficients (ICC) were calculated between VO2peak estimated by the questionnaires (questionnaire-VO2peak) and VO2peak measured during CPET (CPET-VO2peak), at T0 to examine criterion validity, and between changes in questionnaire-VO2peak and CPET-VO2peak (ΔT0-T1) to determine responsiveness. Receiver operating characteristic (ROC) analyses were performed to examine the ability of the questionnaires to detect true improvements (≥ 6%) in CPET-VO2peak.

Results: Seventy participants were included. Outcomes at T1 were available for 58 participants (83%). Mean CPET-VO2peak significantly improved at T1 (Δ1.6 mL·kg- 1·min- 1 or 8%). Agreement between questionnaire-VO2peak and CPET-VO2peak at T0 was moderate for the FitMáx©-questionnaire (ICC = 0.69) and VSAQ (ICC = 0.53), and poor for DASI (ICC = 0.36). Poor agreement was found between ΔCPET-VO2peak and Δquestionnaire-VO2peak for all questionnaires (ICC 0.43, 0.19 and 0.18 for the FitMáx©-questionnaire, VSAQ and DASI, respectively). ROC analysis showed that the FitMáx©-questionnaire was able to detect improvements in CPET-VO2peak (area under the curve, AUC = 0.77), when using a cut-off value of 1.0 mL·kg- 1·min- 1, while VSAQ (AUC = 0.66) and DASI (AUC = 0.64) could not.

Conclusion: The self-reported FitMáx©-questionnaire has sufficient validity to estimate aerobic capacity in cancer survivors at group level. The responsiveness of the FitMáx©-questionnaire for absolute change is limited, but the questionnaire is able to detect whether aerobic capacity improved. The FitMáx©-questionnaire showed substantial better values of validity and responsiveness compared to DASI and VSAQ.