Preliminary Normative Standards of the Mayo Clinic Esophagectomy CONDUIT Tool

Nandita N Mahajan; Minji K Lee; Kathleen J Yost; Karlyn E Pierson; Jason K Viehman; Mark S Allen; Stephen D Cassivi; Francis C Nichols; Janani S Reisenauer; K Robert Shen; Dennis A Wigle; Shanda H Blackmon

doi:10.1016/j.mayocpiqo.2019.07.008

Preliminary Normative Standards of the Mayo Clinic Esophagectomy CONDUIT Tool

Mayo Clin Proc Innov Qual Outcomes. 2019 Nov 22;3(4):429-437. doi: 10.1016/j.mayocpiqo.2019.07.008. eCollection 2019 Dec.

Affiliations

¹ Division of General Thoracic Surgery, Mayo Clinic, Rochester, MN.
² Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
³ Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
⁴ Division of Surgery Clinical Research, Mayo Clinic, Rochester, MN.

Abstract

Objective: To collect patient-reported outcomes after esophagectomy to establish a set of preliminary normative standards to aid in symptom-score interpretation.

Patients and methods: Patients undergoing esophagectomy often have little understanding about postoperative symptom management. The Mayo Clinic esophageal CONDUIT tool is a validated questionnaire comprising 5 multi-item symptom-assessment domains and 2 health-assessment domains. A prospective nonrandomized cohort study was conducted on adult patients who have had esophagectomies using the CONDUIT tool from August 17, 2015, to July 30, 2018 (NCT02530983). The Statistical Analysis System v9.4 (SAS Institute Inc., Cary, NC) was used to calculate and analyze the scores.

Results: Over the study period, 569 patients were assessed for eligibility, and 241 patients consented and were offered the tool. Of these, 188 patients (median age: 65 years; range: 24 to 87 years; 80% male patients) had calculable scores. Of the 188 patients, 50 (26.6%) patients were identified as potential beneficiaries for educational intervention to improve symptoms (received moderate scores for a domain), and 131 (69.7%) patients were identified as needing further testing or provider intervention (received poor scores for a domain) based on the tool.

Conclusion: The CONDUIT tool scores, when compared with standardized scales with established preliminary normative scores, could be used to identify and triage patients who need targeted education, further testing, or provider interventions. These score ranges will serve as the first set of normative standards to aid in the interpretation of conduit performance among providers and patients.

Keywords: CONDUIT, Conduit Outcomes Noting Dysphagia/Dumping and Unknown outcomes with Intermittent symptoms over Time after esophageal reconstruction; EORTC, European Organization for Research and Treatment of Cancer; FACT-E, Functional Assessment of Cancer Therapy-Esophageal cancer; PROMIS, Patient-Reported Outcomes Measurement Information System; PROMs, Patient-Reported Outcomes Measures.