A comprehensive multiattribute system for classifying the health status of survivors of childhood cancer

J Clin Oncol. 1992 Jun;10(6):923-8. doi: 10.1200/JCO.1992.10.6.923.

Abstract

Purpose: A multiattribute health status classification system was devised to describe comprehensively the health status of survivors of childhood cancer.

Methods: The system consists of seven attributes: sensation, mobility, emotion, cognition, self-care, pain, and fertility. Three to five levels of functioning are defined for each attribute. Any specific combination of seven attribute levels constitutes a health state. In the first survey, the system was used to classify the health status of 20 children currently undergoing therapy for high-risk acute lymphoblastic leukemia (ALL), Wilms' tumor, or neuroblastoma, and eight who had completed treatment. A second survey consisted of 13 children with brain tumors on active treatment.

Results: In general, independent ratings by clinicians were in agreement, and consensus was readily achieved in 1 to 2 minutes per patient. Children on therapy experienced a higher burden of morbidity than those off treatment. Brain tumor patients experienced more morbidity than patients in the first survey.

Conclusion: The multiattribute system provides a compact but comprehensive tool for long-term follow-up of survivors of childhood cancer. It captures both multiple sequelae and varying levels of severity. By using a mathematical utility function, a single summary score of health-related quality of life may be assigned to each health state. Additional studies to establish reproducibility, validity, responsiveness, and generalizability are indicated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Brain Neoplasms / complications
  • Child
  • Emotions
  • Fertility
  • Health Status*
  • Humans
  • Kidney Neoplasms / complications
  • Learning
  • Locomotion
  • Neoplasms / complications*
  • Neoplasms / psychology
  • Neoplasms / therapy
  • Neuroblastoma / complications
  • Pain
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Sensation
  • Wilms Tumor / complications