When do we need to take action? Cut-off values for the hamburg inventory for measuring quality of life in oncological patients (HELP-6)

Abstract

Results of patient-reported outcome measurements need to be comprehensible and conclusive for a successful integration into treatment in cancer care. The aim of this study was to determine cut-off values for the recently developed “Hamburg Inventory for Measuring Quality of Life in Oncological Patients-6” (HELP-6), a short measurement for Health-related Quality of Life (HrQoL) in routine care in oncological patients. Oncological in- and out-patients with differing cancer entities participated in this study. The survey included the HELP-6 and standardized questionnaires (Distress-Thermometer, PHQ-4, Fact-G, PDI-G). Six receiver operating characteristics analyses were performed, one for each scale of the instrument (Emotional Health, Physical Ailment, Social Functionality, Autonomy, Dignity, Resources). For five of the six scales cut-offs could be determined. Areas under the Curve were between 0.7 and 0.8. However, the Dignity scale demonstrated poor discriminative validity, failing to distinguish adequately between severity levels of patient groups. By applying the HELP-6 with the cut-off values established in this study, clinicians can more readily interpret patients’ HrQoL, thereby supporting effective clinical decision-making. This feature is especially valuable in routine care, where streamlined monitoring of patient quality of life is paramount. Further conceptualization and validation of the Dignity scale, as well as its integration into patient-reported outcome measures, are warranted. The complete study including the development of the instrument was registered at Open Science Framework ***redacted for peer-review***. Clinical trial number: not applicable. Recently, a new questionnaire was developed to measure quality of life in patients with cancer. This questionnaire is intended for the use in clinical practice, where it needs to be easy to interpret. To achieve this, clinicians must be able to distinguish between patients with impaired quality of life and those without. For this reason, we aimed to establish cut-off values that clearly separate these two groups – patients with affected quality of life and those without. Using these cut-off values, clinicians can quickly identify which patients may benefit from additional support or a referral to a psychooncologist. We performed statistical analyses to calculate these cut-off values. The results show, that for five of the original six questions of the questionnaire, the cut-off values successfully differentiate between these two patient groups. However, for one question, the results indicate that no useful cut-off value could be found.