Skip to main content

Advertisement

Log in

Electronic versus paper-pencil methods for assessing chemotherapy-induced peripheral neuropathy

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to examine and compare with the validated, paper/pencil European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy Scale (QLQ-CIPN20), the psychometric properties of three electronically administered patient reported outcome (PRO) measures of chemotherapy-induced peripheral neuropathy (CIPN): (1) the two neuropathy items from the National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), (2) the QLQ-CIPN20, and (3) the 0–10 Neuropathy Screening Question (NSQ).

Methods

We employed a descriptive, cross-sectional design and recruited 25 women with breast cancer who were receiving neurotoxic chemotherapy at an academic hospital. Participants completed the paper/pencil QLQ-CIPN20 and electronic versions of the QLQ-CIPN20, PRO-CTCAE, and NSQ. Internal consistency reliability, intraclass correlation, and concurrent and discriminant validity analyses were conducted.

Results

The alpha coefficients for the electronic QLQ-CIPN20 sensory and motor subscales were 0.76 and 0.75. Comparison of the electronic and paper/pencil QLQ-CIPN20 subscales supported mode equivalence (intraclass correlation range >0.91). Participants who reported the presence of numbness/tingling via the single-item NSQ reported higher mean QLQ-CIPN20 sensory subscale scores (p < 0.001). PRO-CTCAE neuropathy severity and interference items correlated well with the QLQ-CIPN20 electronic and paper/pencil sensory (r = 0.76; r = 0.70) and motor (r = 0.55; r = 0.62) subscales, and with the NSQ (r = 0.72; r = 0.44).

Conclusion

These data support the validity of the electronically administered PRO-CTCAE neuropathy items, NSQ, and QLQ-CIPN20 for neuropathy screening in clinical practice. The electronic and paper/pencil versions of the QLQ-CIPN can be used interchangeably based on evidence of mode equivalence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Argyriou AA, Bruna J, Marmiroli P, Cavaletti G (2012) Chemotherapy-induced peripheral neurotoxicity (CIPN): an update. Crit Rev Oncol Hematol 82(1):51–77. doi:10.1016/j.critrevonc.2011.04.012

    Article  PubMed  Google Scholar 

  2. Cavaletti G, Cornblath DR, Merkies IS et al (2013) The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings. Ann Oncol 24(2):454–462

    Article  CAS  PubMed  Google Scholar 

  3. Hershman DL, Lacchetti C, Dworkin RH et al (2014) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 32(18):1941–1967. doi:10.1200/JCO.2013.54.0914

    Article  CAS  PubMed  Google Scholar 

  4. Kautio AL, Haanpaa M, Kautiainen H, Kalso E, Saarto T (2011) Burden of chemotherapy-induced neuropathy—a cross-sectional study. Support Care Cancer 19(12):1991–1996. doi:10.1007/s00520-010-1043-2

    Article  PubMed  Google Scholar 

  5. Mols F, Beijers T, Vreugdenhil G, van de Poll-Franse L (2014) Chemotherapy-induced peripheral neuropathy and its association with quality of life: a systematic review. Support Care Cancer 22(8):2261–2269

    Article  PubMed  Google Scholar 

  6. Seretny M, Currie GL, Sena ES et al (2014) Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. Pain 155(12):2461–2470

    Article  PubMed  Google Scholar 

  7. Saif MW, Reardon J (2005) Management of oxaliplatin-induced peripheral neuropathy. Ther Clin Risk Manag 1(4):249–258

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Smith EML, Bridges CM, Kanzawa G et al (2014) Cancer treatment-related neuropathic pain syndromes—epidemiology and treatment: an update. Curr Pain Headache Rep 18(11):459. doi:10.1007/s11916-014-0459-7

    Article  PubMed  Google Scholar 

  9. Speck RM, Sammel MD, Farrar JT et al (2013) Impact of chemotherapy-induced peripheral neuropathy on treatment delivery in nonmetastatic breast cancer. J Oncol Pract 9(5):e234–e240. doi:10.1200/JOP.2012.000863

    Article  PubMed  Google Scholar 

  10. Stubblefield MD, Burstein HJ, Burton AW et al (2009) NCCN task force report: management of neuropathy in cancer. J Natl Compr Canc Netw 7(Suppl 5):S1-NaN-8

    Google Scholar 

  11. Smith EM, Beck SL, Cohen J (2008) The total neuropathy score: a tool for measuring chemotherapy-induced peripheral neuropathy. Oncol Nurs Forum 35(1):96–102. doi:10.1188/08.ONF.96-102

    Article  PubMed  Google Scholar 

  12. Smith EML, Bakitas MA, Homel P et al (2009) Using quality improvement methodology to improve neuropathic pain screening and assessment in patients with cancer. J Cancer Educ 24(2):135–140. doi:10.1080/08858190902854715

    Article  Google Scholar 

  13. Bakitas MA Background noise: the experience of chemotherapy-induced peripheral neuropathy. Nurs Res 56(5):323–331. doi:10.1097/01.NNR.0000289503.22414.79

    Article  PubMed  Google Scholar 

  14. Binner M, Ross D, Browner I (2011) Chemotherapy-induced peripheral neuropathy: assessment of oncology nurses’ knowledge and practice. Oncol Nurs Forum 38(4):448–454

    Article  PubMed  Google Scholar 

  15. Smith EM (2013) Current methods for the assessment and management of taxane-related neuropathy. Clin J Oncol Nurs 17(Suppl):22–34

    Article  PubMed  Google Scholar 

  16. Griffith KA, Merkies IS, Hill EE, Cornblath DR (2010) Measures of chemotherapy-induced peripheral neuropathy: a systematic review of psychometric properties. J Peripher Nerv Syst 15(4):314–325. doi:10.1111/j.1529-8027.2010.00292.x

    Article  PubMed  Google Scholar 

  17. Cavaletti G, Frigeni B, Lanzani F et al (2010) Chemotherapy-induced peripheral neurotoxicity assessment: a critical revision of the currently available tools. Eur J Cancer 46(3):479–494. doi:10.1016/j.ejca.2009.12.008

    Article  CAS  PubMed  Google Scholar 

  18. Postma TJ, Aaronson NK, Heimans JJ et al (2005) The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: the QLQ-CIPN20. Eur J Cancer 41(8):1135–1139

    Article  CAS  PubMed  Google Scholar 

  19. Smith EML, Barton DL, Qin R, Steen PD, Aaronson NK, Loprinzi CL (2013) Assessing patient-reported peripheral neuropathy: the reliability and validity of the European Organization for Research and Treatment of cancer QLQ-CIPN20 questionnaire. Qual Life Res 22(10):2787–2799

    Article  PubMed  PubMed Central  Google Scholar 

  20. National Cancer Institute (2010) Common Terminology Criteria for Adverse Events v 4.3 (CTCAE)

  21. Basch E, Jia X, Heller G et al (2009) Adverse symptom event reporting by patients vs clinicians: relationships with clinical outcomes. J Natl Cancer Inst 101(23):1624–1632. doi:10.1093/jnci/djp386

    Article  PubMed  PubMed Central  Google Scholar 

  22. Postma TJ, Heimans JJ, Muller MJ, Ossenkoppele GJ, Vermorken JB, Aaronson NK (1998) Pitfalls in grading severity of chemotherapy-induced peripheral neuropathy. Ann Oncol 9(7):739–744

    Article  CAS  PubMed  Google Scholar 

  23. Alberti P, Rossi E, Cornblath DR et al (2014) Physician-assessed and patient-reported outcome measures in chemotherapy-induced sensory peripheral neurotoxicity: two sides of the same coin. Ann Oncol 25(1):257–264. doi:10.1093/annonc/mdt409

    Article  PubMed  PubMed Central  Google Scholar 

  24. Atkinson TM, Ryan SJ, Bennett AV et al (2016) The association between clinician-based common terminology criteria for adverse events (CTCAE) and patient-reported outcomes (PRO): a systematic review. Support Care Cancer. doi:10.1007/s00520-016-3297-9

    Article  PubMed  PubMed Central  Google Scholar 

  25. Atkinson TM, Li Y, Coffey CW et al (2012) Reliability of adverse symptom event reporting by clinicians. Qual Life Res 21(7):1159–1164. doi:10.1007/s11136-011-0031-4

    Article  PubMed  Google Scholar 

  26. Kotronoulas G, Kearney N, Maguire R et al (2014) What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials. J Clin Oncol 32(14):1480–1501. doi:10.1200/JCO.2013.53.5948

    Article  PubMed  Google Scholar 

  27. Dueck AC, Mendoza TR, Mitchell SA et al (2015) Validity and reliability of the US National Cancer Institute’s Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). JAMA Oncol 1(8):1051–1059. doi:10.1001/jamaoncol.2015.2639

    Article  PubMed  PubMed Central  Google Scholar 

  28. Basch E, Reeve BB, Mitchell SA, et al (2014) Development of the National Cancer Institute’s patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). J Natl Cancer Inst 106(9). doi:10.1093/jnci/dju244

    Article  PubMed  PubMed Central  Google Scholar 

  29. Hay JL, Atkinson TM, Reeve BB et al (2014) Cognitive interviewing of the US National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Qual Life Res 23(1):257–269. doi:10.1007/s11136-013-0470-1

    Article  PubMed  Google Scholar 

  30. Fayers P, Aaronson N, Bjordal K, et al (2001) EORTC QLQ-C30 Scoring Manual. 3rd ed. Brussels; file:///Users/rjknoerl1/Downloads/EORTC_QLQ_C30 _scoring_Manual (1).pdf

  31. Knoerl R, Dudley WN, Smith G, Bridges C, Kanzawa-Lee G, Lavoie Smith EM (2016) Pilot testing a web-based system for the assessment and management of chemotherapy-induced peripheral neuropathy. CIN Comput Informatics Nurs 1. doi:10.1097/CIN.0000000000000320

    PubMed  Google Scholar 

  32. Eisinga R, Grotenhuis M, Pelzer B (2013) The reliability of a two-item scale: Pearson, Cronbach, or Spearman-Brown? Int J Public Health 58(4):637–642. doi:10.1007/s00038-012-0416-3

    Article  PubMed  Google Scholar 

  33. Ferguson CJ An effect size primer: a guide for clinicians and researchers. doi:10.1037/a0015808

    Article  Google Scholar 

  34. Cohen J (1988) Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Erlbaum Associates, Hillsdale

    Google Scholar 

  35. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428

    Article  CAS  PubMed  Google Scholar 

  36. Nunnally J, Berstein I (1994) Psychometric methods, 3rd edn. McGraw-Hill, New York

    Google Scholar 

  37. Edge SB (2010) American Joint Committee on Cancer. AJCC Cancer Staging Manual. Springer. http://www.springer.com/gp/book/9780387884424. Accessed 12 Apr 2017

  38. Pace A, Nisticò C, Cuppone F et al (2007) Peripheral neurotoxicity of weekly paclitaxel chemotherapy: a schedule or a dose issue? Clin Breast Cancer 7(7):550–554. doi:10.3816/CBC.2007.n.010

    Article  CAS  PubMed  Google Scholar 

  39. Scripture CD, Figg WD, Sparreboom A (2006) Peripheral neuropathy induced by paclitaxel: recent insights and future perspectives. Curr Neuropharmacol 4(2):165–172 http://www.ncbi.nlm.nih.gov/pubmed/18615126. Accessed June 6, 2016

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Ventzel L, Jensen AB, Jensen AR, Jensen TS, Finnerup NB (2016) Chemotherapy-induced pain and neuropathy: a prospective study in patients treated with adjuvant oxaliplatin or docetaxel. Pain 157(3):560–568. doi:10.1097/j.pain.0000000000000404

    Article  CAS  PubMed  Google Scholar 

  41. Eckhoff L, Knoop AS, Jensen M-B, Ejlertsen B, Ewertz M (2013) Risk of docetaxel-induced peripheral neuropathy among 1,725 Danish patients with early stage breast cancer. Breast Cancer Res Treat 142(1):109–118. doi:10.1007/s10549-013-2728-2

    Article  CAS  PubMed  Google Scholar 

  42. Rouquette A, Falissard B (2011) Sample size requirements for the internal validation of psychiatric scales. Int J Methods Psychiatr Res 20(4):235–249. doi:10.1002/mpr.352

    Article  PubMed  PubMed Central  Google Scholar 

  43. Knoerl R, Dudley W, Smith G, Bridges C, Kanzawa G, Smith EML Pilot testing a web-based system for the assessment and management of chemotherapy-induced peripheral neuropathy. Comput Informatics Nurs

Download references

Acknowledgements

We would like to acknowledge the Carevive Systems, Inc. for allowing us to test these instruments within their computerized care planning system. In addition, we would like to acknowledge Jill Hayden, RN, and Shraddha Pardesi, MS, BPharm for their assistance with patient accrual; James P. Kelly, IV, BS, Deborah Lee, MSN, FNP, ACNP-BC, and Grace Kanzawa, BSN, RN for their assistance with data collection; Megan Williams, PA-C, Anne Clotfelter, MS, NP-C, Tamara Ghormley, MS, NP-C, and Joan Armstrong, MS, NP-C for participating in the study as the clinical providers; Kelly Scheu, MS, NP-C, for her assistance with facilitating use of the technology within the clinical practice setting; and Celia Bridges, BA, BSN for her assistance with editing the final manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert Knoerl.

Ethics declarations

Source of funding

Dr. Carrie Stricker is the CCO of Carevive® Systems Inc., which provided the Care Planning System used in this study without cost. Dr. Stricker reports grants from Genentech, Inc., personal fees from Carevive Systems, Inc., during the conduct of the study; personal fees from Carevive Systems, Inc. and other from Carevive Systems, Inc., outside the submitted work; . Mr. Evan Gray reports personal fees from Centerpoint Human Services, personal fees from Cardinal Innovations Healthcare, personal fees from Piedmont Research Strategies, Inc., outside the submitted work. Dr. Ellen Smith reports receiving a grant from Genentech Inc., during the conduct of the study; personal fees from American Society of Clinical Oncology, grants from National Institute of Health, outside the submitted work. Dr. William Dudley reports personal fees from Piedmont Research Strategies, Inc., during the conduct of the study; personal fees from Piedmont Research Strategies, Inc., outside the submitted work.

This study was conducted with oversight from the University of Michigan IRBMED: HUM00084475 Written informed consent was obtained from all enrolled participants.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Knoerl, R., Gray, E., Stricker, C. et al. Electronic versus paper-pencil methods for assessing chemotherapy-induced peripheral neuropathy. Support Care Cancer 25, 3437–3446 (2017). https://doi.org/10.1007/s00520-017-3764-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-017-3764-y

Keywords

Navigation