TY - JOUR
T1 - Congruence Between Latent Class and K-Modes Analyses in the Identification of Oncology Patients With Distinct Symptom Experiences
AU - Papachristou, Nikoloas
AU - Barnaghi, Payam
AU - Cooper, Bruce A.
AU - Hu, Xiao
AU - Maguire, Roma
AU - Apostolidis, Kathi
AU - Armes, Jo
AU - Conley, Yvette P.
AU - Hammer, Marilyn
AU - Katsaragakis, Stylianos
AU - Kober, Kord M.
AU - Levine, Jon D.
AU - McCann, Lisa
AU - Patiraki, Elisabeth
AU - Paul, Steven M.
AU - Ream, Emma
AU - Wright, Fay
AU - Miaskowski, Christine
N1 - Publisher Copyright:
© 2017 American Academy of Hospice and Palliative Medicine
PY - 2018/2
Y1 - 2018/2
N2 - 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.
AB - 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.
KW - Symptom clusters
KW - cancer
KW - chemotherapy
KW - clustering
KW - k-modes analysis
KW - latent class analysis
KW - machine learning
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U2 - 10.1016/j.jpainsymman.2017.08.020
DO - 10.1016/j.jpainsymman.2017.08.020
M3 - Article
C2 - 28859882
AN - SCOPUS:85038880921
SN - 0885-3924
VL - 55
SP - 318-333.e4
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 2
ER -