3.5 months with the research group of Karin Piil, Senior Researcher at Copenhagen University Hospital Associate Professor at Aarhus University, where she investigated symptom science among brain tumor patients.
Last October, I went to Copenhagen for a 3.5 month visit with the team of Karin Piil, an associate professor specializing in symptom science among brain tumor patients. Our goal was to combine data from Copenhagen and Amsterdam to improve our ability to predict depressive symptoms in brain tumor patients.
My daily work routine was similar to that in Amsterdam. On weekdays, I rode my bicycle to work, engaging in collaborative efforts and research team meetings. I was impressed by their holistic approach to patient care, emphasizing patient participation in trial development and evaluation, as well as the role of caregivers.
On Monday mornings I attended the oncology PhD/MD meeting, where various researchers presented their projects, ranging from sexual function in cancer patients to proteomics.
More power through collaboration
The core of our joint project was to create a larger dataset to better understand mood dysfunction, such as depressive symptoms in glioma (brain tumor) patients. Our dataset included both preoperative measurements of depression and various functioning parameters.
Harmonizing the data from Copenhagen, Amsterdam, and Trondheim proved both challenging and rewarding. For example, the Trondheim dataset was not amenable to harmonization and we made the tough decision to exclude it. Certain parameters such as education or performance status, which initially appear straightforward, sparked extensive discussion on the compatibility of schooling systems in different countries.
Our focus then shifted to depressive symptoms, revealing differences in the measurement methods used by Amsterdam and Copenhagen. To create a unified scale, we used the PROsetta stone method, a form of Item Response Theory (IRT). This approach mapped questions from various instruments onto a single scale, allowing us to harmonize the data effectively. These insights hold the potential to guide patient education and inform healthcare providers about crucial symptoms requiring attention.
Predictors of depressive symptoms in patients with brain cancer
Our primary goal was to understand the predictors of depressive symptoms at follow-up. As little is known about the predictors, we decided to assess a wide variety of possible risk factors, resulting in the inclusion of 23 variables. We employed a backward regression model to identify the optimal baseline model, in consultation with Copenhagen's statistician. Then, we tested the robustness of the model through best subset selection, which resulted in the identification of three risk factors at baseline. The findings allowed us to gain a deeper understanding about of risk factors for developing or maintaining depressive symptoms. These insights hold the potential to guide patient education and inform healthcare providers about crucial symptoms requiring attention. By combining data from Copenhagen and Amsterdam patients, we have created a more robust, multinational dataset, enhancing the predictive power and generalizability of our findings. The success of this collaboration led to an invitation to explore the relationship between sexual complaints and depressive symptoms in adolescents and young adults with cancer, a subject often neglected by health care providers. Our research found a significant correlation between sexual complaints and depressive symptoms, potentially raising awareness among healthcare professionals.
Outlook
I am very grateful to the Cancer Center Amsterdam Foundation for the opportunity to visit to Copenhagen. Both from a personal and academic standpoint, this visit has been very enriching. I have gained valuable new statistical skills and insights into the quality of life for brain tumor patients and others dealing with cancer. I look forward to sharing my new skills and insights with my colleagues here in the Netherlands. As we prepare publications on both projects, I also look forward to sharing these insights with the world.
"On the weekends, I loved walking around and visited some highlights such as the Little Mermaid."
For more information contact Vera Belgers.
Text by Vera Belgers.
This article was created for Cancer Center Amsterdam.