Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-03-11 Cooperative journals: 《中国全科医学》
Abstract： Background Cardiotoxicity is a leading cause of mortality among breast cancer survivors and patients，making early risk assessment vital for the clinical prevention and treatment of cardiac toxicity. However，there is currently a lack of recognized tools for assessing the risk of cardiotoxicity in breast cancer chemotherapy patients in China. Objective To develop a cardiotoxic risk assessment scale for breast cancer patients undergoing chemotherapy and test its reliability and validity. Methods To develop a risk assessment scale for cardiotoxicity in breast cancer chemotherapy patients and to test its reliability and validity. Results Twenty medical staff experts were included in the semi-structured interviews. After two rounds of expert consultations，a 19-item risk assessment scale for cardiotoxicity in breast cancer chemotherapy patients was developed. In this study，there were 79 patients in the low-score group and 83 in the high-score group. Comparisons of endocrine treatment history and immunotherapy history showed no statistically significant differences between the two groups（P>0.05）. Correlation analysis showed that smoking history and immunotherapy history were not significantly correlated with total scores（P>0.05）. Eventually，three items-"smoking history，"endocrine treatment history" and "immunotherapy history"-were removed，resulting in a 16-item scale. The scale's Cronbach's alpha coefficient was 0.739; test-retest reliability was 0.983; inter-rater reliability was 0.984. The content validity results showed: I-CVI ranged from 0.83 to 1.00; S-CVI was 0.98. Predictive validity results showed: the scale's AUC was 0.887（95%CI=0.827-0.947，P<0.001），with a cut-off value of 32.50 points，Youden's index was 0.649，specificity was 89.1%，and sensitivity was 75.9%. Exploratory factor analysis results showed a KMO value of 0.700，and Bartlett's test of sphericity χ2value was 1037.898（df=120，P<0.001）. The study extracted five common factors with a cumulative variance contribution rate of 61.991%. Risk stratification results indicated scores of 32-38 points as low risk，39-56 points as medium risk，and ≥ 57 points as high risk. Conclusion The cardiotoxicity risk assessment scale for breast cancer patients undergoing chemotherapy has good reliability and validity，which can better predict the high-risk population of cardiotoxicity and provide an effective assessment tool for clinicians and nurses to effectively identify the high-risk population of breast cancer patients undergoing chemotherapy.
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