The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Attrition rates, reasons, and predictive factors in supportive care and palliative oncology clinical trials
Open accessAbstract
BACKGROUND: Attrition is common among supportive care/palliative oncology clinical trials. However, to the authors' knowledge, few studies to date have documented the reasons and predictors for dropout. In the current study, the authors' objective was to determine the rate, reasons, and factors associated with attrition both before reaching the primary endpoint and at the end of the study. METHODS: A review of all prospective interventional supportive care/palliative oncology trials conducted in the Department of Palliative Care and Rehabilitation Medicine at The University of Texas MD Anderson Cancer Center in Houston between 1999 and 2011 was performed. Patient and study characteristics and attrition data were extracted. RESULTS: A total of 1214 patients were included in 18 clinical trials. The median age of the patients was 60 years. Approximately 41% had an Eastern Cooperative Oncology Group performance status of ≥ 3, a median Edmonton Symptom Assessment Scale (ESAS) for fatigue of 7 of 10, and a median ESAS for dyspnea of 2 of 10. The attrition rate was 26% (95% confidence interval [95% CI], 23%‐28%) for the primary endpoint and 44% (95% CI, 41%‐47%) for the end of the study. Common reasons for primary endpoint dropout were symptom burden (21%), patient preference (15%), hospitalization (10%), and death (6%). Primary endpoint attrition was associated with a higher baseline intensity of fatigue (odds ratio [OR], 1.10 per point; P = .01) and a longer study duration ( P = .04). End‐of‐study attrition was associated with higher baseline levels of dyspnea (OR, 1.06; P = .01), fatigue (OR, 1.08; P = .01), Hispanic race (OR, 1.87; P = .002), higher level of education ( P = .02), longer study duration ( P = .01), and outpatient studies ( P = 0.05). CONCLUSIONS: The attrition rate was high in supportive care/palliative oncology clinical trials, and was associated with various patient characteristics and a high baseline symptom burden. These findings have implications for future clinical trial design including eligibility criteria and sample size calculation. Cancer 2013. © 2012 American Cancer Society.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Las personas con cáncer avanzado presentan aún mayor riesgo de presentar problemas de salud mental (8-10) , con prevalencias elevadas de trastornos del estado de ánimo y síntomas depresivos, trastornos cognitivos, ansiedad, insomnio e ideas de muerte (11-13) .”
From AVANZACT: protocolo e intervención psicoterapéutica en cáncer avanzado basados en Terapia de Aceptación y Compromiso. (2025) · cites this paper as [13]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“dado que en personas con cáncer avanzado es habitual una alta tasa de rechazo y abandono del tratamiento (13,48,72)”
From AVANZACT: protocolo e intervención psicoterapéutica en cáncer avanzado basados en Terapia de Aceptación y Compromiso. (2025) · cites this paper as [13]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Corbie-Smith, G. M., Thomas, S. B., & George, D. M. M. S. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.21.2458 · Cited by 1,067
Effectiveness of Specialized Palliative Care
Zimmermann, C., Riechelmann, R. P., Krzyzanowska, M. K., Rodin, G., & Tannock, I. F. (2008) · JAMA · doi:10.1001/jama.299.14.1698 · Cited by 468
Seow, H. Y., Barbera, L. C., Sutradhar, R., Howell, D., Dudgeon, D. J., Atzema, C. L., Liu, Y., Husain, A. F., SUSSMAN, J. S., & Earle, C. C. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2010.30.7173 · Cited by 456
Jordhøy, M. S., Kaasa, S., Fayers, P. M., Underland, G., & Ahlner‐Elmqvist, M. (1999) · Palliative Medicine · doi:10.1191/026921699668963873 · Cited by 312
Bruera, E. D., Valero, V., Driver, L., Shen, L. F., Willey, J. S., Zhang, T., & Palmer, J. L. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.02.8506 · Cited by 290
Self-citationMethodologic issues in effectiveness research on palliative cancer care: a systematic review.
Rinck, G., van den Bos, G. A. M., Kleijnen, J., de Haes, J. C. J. M., Schade, E., & Veenhof, C. H. N. (1997) · Journal of Clinical Oncology · doi:10.1200/jco.1997.15.4.1697 · Cited by 268
Braunstein, J. B., Sherber, N., Schulman, S. P., Ding, E. L., & Powe, N. R. (2008) · Medicine · doi:10.1097/md.0b013e3181625d78 · Cited by 256
Evaluation of a palliative care service: problems and pitfalls
McWhinney, I. R., Bass, M. J., & Donner, A. P. (1994) · BMJ · doi:10.1136/bmj.309.6965.1340 · Cited by 253
Why are trials in palliative care so difficult?
Grande, G., & Todd, C. J. (2000) · Palliative Medicine · doi:10.1191/026921600677940614 · Cited by 215
Steinhauser, K. E., Clipp, E. C., Hays, J. C., Olsen, M. K., Arnold, R. M., Christakis, N. A., Lindquist, J. H., & Tulsky, J. A. (2006) · Palliative Medicine · doi:10.1177/0269216306073112 · Cited by 210
Cited by
Sorted by citations
Fogel, D. B. (2018) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2018.08.001 · Cited by 1,035
Benchmarking modern multiprocessors
Li, K., & Bienia, C. (2011) · Cited by 987
The Edmonton Symptom Assessment System 25 years later: past, present, and future developments
Hui, D., & Bruera, E. (2017) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2016.10.370 · Cited by 795
Self-citationNiedzwiedz, C. L., Knifton, L., Robb, K. A., Katikireddi, S. V., & Smith, D. J. (2019) · BMC Cancer · doi:10.1186/s12885-019-6181-4 · Cited by 756
Early palliative care for adults with advanced cancer
Haun, M. W., Estel, S., Rücker, G., Friederich, H.-C., Villalobos, M., Thomas, M., & Hartmann, M. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011129.pub2 · Cited by 757
Metadata
- Authors
- Hui, D., Glitza, I., Chisholm, G., Yennu, S., & Bruera, E.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Corresponding author
- Hui, David
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2012-11-06
- Volume
- 119
- Issue
- 5
- Pages
- 1098-1105
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC3568443
- OpenAlex
- W2052953863
- Cited by
- 250
- References
- 31
- Citations by year
- 2026: 28 · 2025: 19 · 2024: 22 · 2023: 23 · 2022: 22 · 2021: 35 · 2020: 29 · 2019: 17 · 2018: 11 · 2017: 14 · 2016: 8 · 2015: 7 · 2014: 10 · 2013: 3 · 2012: 1
- FWCI
- 6.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01ca124481-03, 5r01nr010162-04)
- National Cancer Institute (R01CA12 4481-01, CA 016672, T32CA009666, R01CA122292, R01 CA124481, P30CA016672)
- National Institute of Nursing Research (R01NR010162-01A1, R01 NR010162)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Keywords
- attrition, trial dropout, palliative oncology, predictive factors, fatigue, dyspnea, symptom burden, patient preferences, study duration, Hispanic patients, clinical trial design, sample size determination
- MeSH terms
- Adult, Aged, Aged, 80 and over, Clinical Trials as Topic, Dyspnea, Fatigue, Female, Hospitalization, Humans, Male, Middle Aged, Neoplasms, Palliative Care, Patient Dropouts, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
