NCOG-09. THE LEVEL OF REPORTING OF NEUROCOGNITIVE OUTCOMES IN RANDOMIZED CONTROLLED TRIALS OF BRAIN TUMOR PATIENTS: A SYSTEMATIC REVIEW. (5th November 2018)

• Record Type: Journal Article
• Authors: Habets, Esther; Taphoorn, Martin; Klein, Martin; Vissers, Thomas; Dirven, Linda
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 6
• Page Start: vi174
• Page End: vi174
• Publication Date: 2018-11-05
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy148.724
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: INTRODUCTION: Neurocognitive impairment is frequently present in brain tumor patients and is therefore considered an important outcome in brain tumor research. To use neurocognitive outcomes (NCO) in clinical decision-making, neurocognitive evidence should be of sufficiently high quality. One important aspect in the generation of high quality evidence is the level of reporting. We aimed to investigate the level of neurocognitive functioning reporting in randomized controlled trials (RCTs) in brain tumor patients. METHODS: We conducted a systematic literature search in several databases up to August 2017. Of the selected relevant RCTs, the following data were retrieved: basic trial demographics and NCO characteristics, quality of NCO reporting, and risk of bias. We also analyzed studies that should impact clinical decision-making based on their quality of reporting. RESULTS: We identified 65 RCTs, of which NCO was the primary endpoint in 14 (22%). The included brain tumour types varied, with 20 RCTs studying glioma patients (31%) and 17 studying brain metastatic patients (26%) only. Radiotherapy and chemotherapy were the most studied treatments (both in 31% of studies). In five studies (8%), rehabilitation of neurocognitive impairments was investigated. Important methodological limitations were related to the documentation of statistical approaches for dealing with missing data, and to discussing limitations and generalizability issues uniquely related to the NCO components. Risk of bias was high regarding blinding of personnel and incomplete outcome data. Twenty RCTs (31%), eight with NCO as primary endpoint and 12 as secondary endpoint, satisfied a sufficient number of criteria to be classified as high-quality NCO evidence. Most of these studies did contribute to clinical decision-making. CONCLUSION: Investigators involved in brain tumor research should give attention to methodological challenges related to NCO reporting as identified in this review, as high-quality reporting of NCO evidence can be of value in clinical decision-making.