Reliability and between-group stability of a health-related quality of life symptom index for persons with anal high-grade squamous intraepithelial lesions: an AIDS Malignancy Consortium Study (AMC-A03)

Qual Life Res. 2019 May;28(5):1265-1269. doi: 10.1007/s11136-018-2089-8. Epub 2019 Jan 7.

Abstract

Purpose: The Anal Cancer HSIL Outcomes Research (ANCHOR) trial aims to determine whether treating precancerous anal high-grade squamous intraepithelial lesions (HSIL), versus active surveillance, is effective in reducing anal cancer incidence in HIV-infected individuals. We evaluated the reliability (i.e., internal consistency, test-retest) and between-group stability of a 25-item ANCHOR Health-Related Symptom Index (A-HRSI).

Methods: ANCHOR participants at least 1-month post-randomization to treatment or active surveillance completed the A-HRSI via telephone. Participants were contacted 7-10 days later to complete the A-HRSI and a participant global impression of change (PGIC) item.

Results: Participants (n = 100) were enrolled (mean age = 51.4, 79% cisgender-male, 73% African American, 9% Hispanic) from five ANCHOR sites. Cronbach's α was good for the physical symptoms (0.82) domain and fair for the physical impacts (0.79) and psychological symptoms (0.73) domains. Intraclass correlation coefficients were good for each of respective domains (i.e., 0.80, 0.85, and 0.82). There were no significant differences in PGIC between the treatment (n = 56) and active surveillance (n = 44) groups (F(1,98) = 2.03, p = 0.16).

Conclusions: The A-HRSI is able to reliably assess participant-reported symptoms and impacts of anal HSIL across a 7-10 days of timeframe. Future work will involve the establishment of construct and discriminant validity prior to inclusion in the full ANCHOR trial.

Keywords: ANCHOR trial; Clinical outcome assessments; Health-related quality of life; Neoplasms; Patient-reported outcomes.

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications
  • Adult
  • Anus Neoplasms / prevention & control*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Reproducibility of Results
  • Self Report*
  • Squamous Intraepithelial Lesions of the Cervix / pathology
  • Squamous Intraepithelial Lesions of the Cervix / psychology*
  • Squamous Intraepithelial Lesions of the Cervix / therapy*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Watchful Waiting / methods*