Rm. Ness et al., OUTCOME STATES OF COLORECTAL-CANCER - IDENTIFICATION AND DESCRIPTION USING PATIENT FOCUS GROUPS, The American journal of gastroenterology, 93(9), 1998, pp. 1491-1497
Objective: Utilities for the outcome states of colorectal cancer must
be measured to evaluate the cost-utility of screening and surveillance
strategies for this disease, We sought to identify these outcome stat
es, define their associated areas of morbidity, and construct represen
tative descriptions of them for use in a utilities assessment instrume
nt, Methods: We identified candidate colorectal cancer outcome states
based on a review of the literature and interviews with health care pr
ofessionals. We organized patient focus groups from each of the candid
ate outcome states to examine their homogeneity and define their assoc
iated areas of morbidity, After analyzing the focus group transcripts,
we identified and described outcome states of colorectal cancer for f
uture incorporation into a utilities assessment instrument. Results: S
ix candidate outcome states of cotorectal cancer were identified based
on disease stage and location at diagnosis. Thirty-eight patients the
n participated in six focus groups. Analysis of the focus group transc
ripts revealed seven areas of morbidity associated with colorectal can
cer. These areas included problems with social interaction and cogniti
on, fear of cancer recurrence, pain, fatigue, changes in bowel habits,
and sexual dysfunction, Based on differences in the intensity and fre
quency of the symptoms reported in each of these areas, seven distinct
outcome states of colorectal cancer were identified and described. Co
nclusion: Clinically distinct outcome states of colorectal cancer are
determined by the stage and location of the cancer at the time of diag
nosis, Descriptions of these outcome states were created using data co
llected from patient focus groups. These descriptions can be incorpora
ted into a utilities assessment instrument. (Am J Gastroenterol 1998;9
3:1491-1497, (C) 1998 by Am, Cell. of Gastroenterology).