190 - Clinical Utility of a Brief Validated Patient-Reported Quality-of-Life (QoL) Tool in Routine Oncology Care: Results of a Randomized Controlled Trial

10:45am - 10:55am ET

Room 109

Presenter(s)

Revathy Krishnamurthy, MD - Tata Memorial Centre, Mumbai, Mumbai, Maharashtr

R. Krishnamurthy, S. Nair, G. Yadav, M. Dhuri, S. Adak, R. Pathak, S. Karbelkar, G. Keluskar, M. Pillai, D. Makwana, N. Mer, T. Wadasadawala, J. Ghosh, P. Patil, J. Agarwal, S. Ghosh Laskar, S. Kannan, and R. Sarin; Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India

Purpose/Objective(s): The (redacted) Mini Quality of Life (TMQ) is a brief 15-item questionnaire developed using established guidelines & validated for routine oncology care in curative & palliative settings. Items are scored on a 4-point Likert scale (0–4) & include 13 general & 2 site-specific domains across 5 cancer subsites. We conducted a prospective randomized controlled trial to test whether real-time access to TMQ scores improved clinician recognition & management of moderate-to-severe symptoms & concerns.

Materials/Methods:

In this two-arm randomized controlled trial conducted at a tertiary cancer center, 642 adults with breast, head & neck, gastrointestinal, gynecological, or thoracic cancers on treatment or follow-up, completed the TMQ prior to clinic encounter. Patients were randomized (1:1), stratified by cancer subsite, to TMQ-guided (scores available to treating clinician) or standard care (scores withheld). Treating clinicians were blinded to allocation; TMQ scores released only for patients in intervention arm. Items assessing patient–provider relationship & global quality of life were excluded a priori. Documentation & redressal by treating oncologist was assessed within 24 hours of clinical encounter through structured review of case files & electronic medical records. Primary endpoint was proportion of patients with any moderate-to-severe symptom or concern (defined as TMQ score 3-4) that was documented &/or redressed; site-adjusted effects estimated using Cochran–Mantel–Haenszel analysis.

Results: 642 patients were enrolled (321 per arm); median age 50 years (SD 11.6) & median KPS 90 (SD 8), with 81% receiving curative-intent treatment. Overall symptom burden was low (median item score 0–1); highest mean scores were for financial burden (1.48), worry about future (1.37) & pain (1.16). Among patients with scores 3-4, action rates were higher with TMQ-guided care: physical 84.5% vs 68.2% (p=0.003); psychosocial/financial 45.7% vs 30.5% (p=0.012). Any concern was documented &/or redressed in 84.5% vs 68.0% (absolute difference 16.5%; p<0.001). Effect remained significant after site adjustment (common OR 3.03, 95% CI 1.75–5.26; p<0.001). One additional patient received appropriate action for every 6 patients assessed. (NNT = 6)

Abstract 190 – Table 1

Conclusion: Real-time availability of a brief patient-reported QoL tool significantly improves clinician recognition & management of moderate-to-severe patient symptoms & concerns across multiple cancer subsites, despite a low baseline event rate.These findings support routine integration of Patient-Reported QoL tools into oncology workflows, with potentially greater impact expected in low-resource settings.

Clinical Trial Information: CTRI/2019/12/022442

Domain	Test n/N (%)	Control n/N (%)	Absolute Difference	p value
Physical	98 / 116 (84.5%)	90 / 132 (68.2%)	+16.3%	0.003
Psychosocial + financial	59 / 129 (45.7%)	39 / 128 (30.5%)	+15.2%	0.012
Total (any domain)	147 / 174 (84.5%)	123 / 181 (68.0%)	+16.5%	<0.001