Randomized trial of dyadic-report vs. proxy-report/self-report symptom assessment for pediatric patients receiving cancer treatments
Mené sur 420 dyades constituées d'un aidant et d'un patient pédiatrique atteint d'un cancer ou ayant reçu une greffe de cellules souches hématopoïétiques, cet essai randomisé compare l'intérêt de 3 outils permettant de déclarer les symptômes du patients pendant les traitements (un outil renseigné par la dyade, un outil renseigné par l'aidant, un outil renseigné par le patient)
Background: We validated different approaches to symptom assessment for pediatric cancer patients based on Symptom Screening in Pediatrics Tool (SSPedi) for self-report (SSPedi and mini-SSPedi), proxy-report (proxy-SSPedi) and a structured dyadic-report (co-SSPedi). Objective was to compare co-SSPedi scores vs proxy-report (proxy-SSPedi) and self-report (SSPedi/mini-SSPedi) scores for pediatric patients receiving cancer treatments. Methods: This was a single center, randomized cross-over study enrolling English-speaking dyads of pediatric patients with cancer or hematopoietic cell transplant recipients 4-18 years old and their guardians. Dyads were randomized to first complete dyadic-report (co-SSPedi) or self-report (patients: SSPedi or mini-SSPedi) and proxy-report (guardians: proxy-SSPedi). Dyads then crossed over to the alternate approach. Primary analysis compared total SSPedi scores between randomized groups. Results: We enrolled 420 dyads that were randomized to co-SSPedi first (n = 213) or proxy-SSPedi and self-report SSPedi first (n = 207). Mean total SSPedi scores (± standard deviation) were: co-SSPedi (9.6 ± 7.1), proxy-SSPedi (9.7 ± 7.5; P = .950 for comparison vs co-SSPedi) and self-report SSPedi (9.7 ± 8.2; P = .981 for comparison vs co-SSPedi). Co-SSPedi scores were significantly different than proxy-SSPedi for feeling disappointed or sad, feeling cranky or angry, feeling tired, mouth sores and changes in taste. Co-SSPedi scores were significantly different than self-report SSPedi scores for problems with thinking or remembering things, feeling tired, mouth sores, tingly or numb hand or feet and diarrhea. Conclusions: Total co-SSPedi scores were not significantly different compared with proxy-report or self-report scores although there were differences in specific symptom scores. If different reporter types are used during clinical implementation, specifying reporter type will be important.