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Type of Paper: Original research article
Tentative Title: A Cross-Disciplinary Analysis of Personalized Outcomes and Prioritized Areas of Concern in a Pragmatic Intervention Trial
Authors: Christina Gundgaard Pedersen (Corresponding author) (1), Nina Nissen (2), Marzcia Techau (2), Helle Johannessen (2), Jacob v.B. Hjelmborg (3), Rita Agdal (2), Robert Zachariae (1), Jan Sørensen (4), Anders Green (5), Anita Lunde (2), Ann Ostenfeldt-Rosenthal (2)
Affiliations:1 Unit of Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital & Department of Psychology, Aarhus University, Bartholins Allé 9, 8000 Aarhus C
2 Health, Man and Society, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000 Odense C, Denmark3 Department of Biostatistics, Institute of Public Health, University of Southern Denmark, J.B.Winsløws Vej 9B, 5000 Odense C, Denmark
4 Centre for Applied Health Services Research, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000 Odense C, Denmark
5 Odense Patient Data Explorative Network (OPEN), Institute of Clinical Research, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
Abstract: Purpose: The objective was to explore a cross-disciplinary analysis of personalized outcomes and prioritized areas of concern in a manner that acknowledged all disciplines equally in a pragmatic healing intervention trial among patients treated for colorectal cancer. Specifically, it was examined: 1) if there was consistency between personalized outcome areas and prioritized areas of concern identified in questionnaires and interviews respectively, and, 2) if there was consistency between the disciplines in the type and observed change reported in interviews or on measures related to the identified personalized outcome areas and/or prioritized areas of concern.
Methods: 29 patients treated for colorectal cancer and part of a pragmatic healing intervention trial were interviewed and completed questionnaires assessing quality of life (QoL), depressive symptoms, mood, sleep quality, physical activity (supplemented by physical activity), physical fitness, and late effects at baseline, 1 week, and 2 months post-intervention. They also indicated personalized outcome areas and prioritized areas of concern. Reliable change indices were calculated for relevant outcome data to promote a cross-disciplinary analysis process emphasizing equality between disciplines. A multidisciplinary, interdisciplinary, and transdisciplinary iterative process sought to inform patterns and continued until no new information was gained from the process.
Results: Consistency in topics in focus was found for the majority of participants (N=20/68.9 ). A total of 4 (20 %) of those in intervention group experienced significant reliable changes in their personal outcome areas and 7 (35 %) experienced changes in relation to their prioritized areas of concern. Inconsistency between disciplines (psychology, biology, and anthropology) in type and observed change in personalized outcome areas and/or prioritized areas of concern was found for 10 (41.4 %) in intervention group and 3 (10.3) in control. Inconsistencies were related to only interviews observing changes identified as soft non-specific changes.
Conclusion: A cross-disciplinary iterative process with equality between disciplines was found useful but time consuming method for analyzing experienced changes in relation to personalized outcomes and/or prioritized areas of concern and for identifying patterns of experienced changes in relation to individualized treatment. However, implementation of personalized outcomes requires that participants are guided to realistic expectations in relation to outcomes of unfamiliar interventions, where prioritizing areas of concern was found a useful method in relation to identifying relevant standardized measures. Calculation of reliable change indices was found a useful means of qualitizing quantitative outcomes for triangulation at the individual level.