Landscape Assessment of the Perceptions of Distress and Symptom Burden in Patients with Monoclonal Gammopathy of Unknown Significance (MGUS) and Smoldering Multiple Myeloma (SMM)
Notice bibliographique
Résumé
Background: Multiple myeloma (MM) is a fatal plasma cell malignancy that is proceeded by the asymptomatic precursor conditions of monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). These conditions have been historically considered benign, and thus the standard clinical paradigm consists of watchful waiting until progression to clinically symptomatic MM - a paradigm that is anecdotally reported as a source of distress in this patient population. Despite well-documented evidence that patients with MM experience substantial emotional distress and symptom burden,(1) little is known about psychological distress and symptom burden in the setting of MGUS and SMM. Methods: We conducted a cross-sectional analysis of patients with MGUS and SMM participating in a longitudinal study of plasma cell precursor disease. Between February and May 2024, patients with MGUS and SMM were offered the opportunity to complete validated questionnaires to assess anxiety (Hospital Anxiety and Depression Scale (HADS)), depression (HADS), post-traumatic stress disorder (PTSD) (PTSD Checklist Civilian Version (PCL-C)), symptom burden (Edmonton Symptom Assessment System Revised (ESAS-r)) and fatigue (Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F)). We used histograms and Q-Q plots to check for normality and the Mann-Whitney U test to detect unadjusted associations between sociodemographic factors and each subscale. Quantile regression was used in adjusted models to estimate the median scores for each subscale conditional on age, sex, and income. Results: A total of 423 adults with MGUS (n=228) and SMM (n=195) completed the study questionnaires. The mean age was 64.9 years (range: 32 to 88 years), 40.7% were male, and nearly 90% were White, non-Hispanic. The prevalence of clinically significant anxiety, depression, PTSD symptoms, symptom burden, and fatigue was 27%, 13%, 24%, 29%, and 20% respectively. Mean subscale scores for aspects of psychological distress and symptom burden were not significantly different between MGUS and SMM patients. Overall, there were statistically significant differences between sociodemographic factors and the perceptions of psychological distress, symptom burden, and fatigue. In adjusted models, those with lower income had higher levels of depression (p<0.02), PTSD (p<0.05), symptom burden (p<0.02), and fatigue (p<0.02). Females had higher anxiety (p=0.01), and marginally higher symptom burden (p=0.05) compared to males. Older age was associated with lower anxiety (p<0.001), lower PTSD (p=0.03), lower symptom burden (p<0.001), and higher fatigue (p=0.02). Race, ethnicity, and education level were not associated with any subscale in adjusted models. Conclusions: Patients with MGUS and SMM experience substantial psychological distress prior to developing MM. Certain sociodemographic subgroups of patients had higher rates of psychological distress, symptom burden and fatigue for reasons that remain to be elucidated. It is essential that we develop a more comprehensive understanding of the supportive care needs of patients to improve their quality of life and care throughout their illness course. 1. O'Donnell EK, Shapiro YN, Yee AJ, Nadeem O, Hu BY, Laubach JP, et al. Quality of life, psychological distress, and prognostic perceptions in patients with multiple myeloma. Cancer. 2022;128(10):1996-2004.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».