TY - JOUR
T1 - Health-related quality of life in cancer immunotherapy
T2 - a systematic perspective, using causal loop diagrams
AU - Beaulieu, Elizabeth
AU - Spanjaart, Anne
AU - Roes, Ashley
AU - Rachet, Bernard
AU - Dalle, Stéphane
AU - Kersten, Marie José
AU - Maucort-Boulch, Delphine
AU - Jalali, Mohammad S.
N1 - Funding Information: Open Access funding provided by the MIT Libraries. This research was made possible by European Union’s Horizon 2020 research and innovation program under grant agreement No 875171. Publisher Copyright: © 2022, The Author(s).
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Purpose: System science offers a unique set of tools, including causal loop diagrams (CLDs), for stakeholders to better grasp the complexity of factors surrounding quality of life. Because the health-related quality of life (HRQoL) of cancer immunotherapy patients exists within an intricate system affected by and affecting many factors across multiple dimensions, the development of a systems-level model can provide a powerful framework to aid the understanding of this complexity. We developed a CLD for HRQoL of cancer immunotherapy patients. Methods: We first applied a literature-based approach to construct a CLD for patients following immunotherapy. We then iteratively reviewed and enhanced the CLD through interviews with subject matter experts. Results: Based on the reviewed literature and subject matter expert input, we produced a CLD representing the system surrounding cancer immunotherapy patients’ HRQoL. Several feedback loops are identified that span clinical experiences, oncology teams’ perceptions about immunotherapy, social support structures, and further research and development in cancer immunotherapy, in addition to other components. The CLD enables visualization of thought experiments regarding how a change anywhere in the system can ultimately worsen or improve patients’ HRQoL. Conclusion: The CLD illustrates the valuable contribution of a systems perspective to quality-of-life research. This systems-based qualitative representation gives insight on strategies to inhibit harmful effects, enhance beneficial effects, and inherent tradeoffs within the system. The CLD identifies gaps in the literature and offers a communication tool for diverse stakeholders. Our research method provides an example for studying the complexities of quality of life in other health domains.
AB - Purpose: System science offers a unique set of tools, including causal loop diagrams (CLDs), for stakeholders to better grasp the complexity of factors surrounding quality of life. Because the health-related quality of life (HRQoL) of cancer immunotherapy patients exists within an intricate system affected by and affecting many factors across multiple dimensions, the development of a systems-level model can provide a powerful framework to aid the understanding of this complexity. We developed a CLD for HRQoL of cancer immunotherapy patients. Methods: We first applied a literature-based approach to construct a CLD for patients following immunotherapy. We then iteratively reviewed and enhanced the CLD through interviews with subject matter experts. Results: Based on the reviewed literature and subject matter expert input, we produced a CLD representing the system surrounding cancer immunotherapy patients’ HRQoL. Several feedback loops are identified that span clinical experiences, oncology teams’ perceptions about immunotherapy, social support structures, and further research and development in cancer immunotherapy, in addition to other components. The CLD enables visualization of thought experiments regarding how a change anywhere in the system can ultimately worsen or improve patients’ HRQoL. Conclusion: The CLD illustrates the valuable contribution of a systems perspective to quality-of-life research. This systems-based qualitative representation gives insight on strategies to inhibit harmful effects, enhance beneficial effects, and inherent tradeoffs within the system. The CLD identifies gaps in the literature and offers a communication tool for diverse stakeholders. Our research method provides an example for studying the complexities of quality of life in other health domains.
KW - Cancer
KW - Immunotherapy
KW - Quality of life
KW - Systems science
UR - http://www.scopus.com/inward/record.url?scp=85126427547&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11136-022-03110-5
DO - https://doi.org/10.1007/s11136-022-03110-5
M3 - Article
C2 - 35298735
SN - 0962-9343
VL - 31
SP - 2357
EP - 2366
JO - Quality of life research
JF - Quality of life research
IS - 8
ER -