The Oral Symptom Assessment Scale (OSAS): criterion validation with the EORTC QLQ-OH15 and reliability testing.

PURPOSE: The aim of this study was to investigate the criterion validity and reliability of the Oral Symptom Assessment Scale (OSAS) in patients with advanced cancer receiving specialist palliative care. METHODS: To examine criterion validity, participants completed the OSAS, EORTC QLQ-C30 and EORTC QLQ-OH15. Twenty-four hours later participants repeated the OSAS to investigate test-retest reliability. RESULTS: 54 participants were recruited (median age 70; range: 35- 93 years). 51 complete datasets were obtained. Cohen's kappa test was used to evaluate the agreement for the presence / absence of symptoms on the OSAS on the first and second days (test-retest reliability). This analysis showed values of moderate and higher for agreement for all symptoms. All kappa values were statistically significant. The test-retest reliability for symptom severity, frequency and distress was assessed using Intraclass Correlation Coefficient. Spearman's rank correlation coefficients were used to evaluate agreement between similar questions on the OSAS from day one and the EORTC QLQ-OH15 also on day one to examine criterion validity. CONCLUSION: This study supports the validity of the OSAS, and provides evidence for the reliability of this novel oral symptom assessment tool, in patients with advanced cancer. Further research is needed to corroborate the findings of this study. TRIAL REGISTRATION: CancerTrials.gov registry registration no.: PM202166.

Hyaluronidase for localised infusion site reaction during continuous subcutaneous infusion.

Local skin site reactions may occur at continuous subcutaneous infusion (CSCI) sites. Factors that contribute these reactions include the concentration of medications, the pH of the solution, type and duration of cannula insertion and site selection. The case of a patient with advanced metastatic cholangiocarcinoma is described. Medications were delivered subcutaneously via a syringe driver and multiple infusion site reactions occurred. Hyaluronidase temporarily depolymerises hyaluronic acid in connective tissue and been has been shown to increase the dispersion and absorption of coadministered molecules. A single dose of 150 IU hyaluronidase was injected into the subcutaneous site prior to commencement of the syringe driver. Subsequent skin site erythema and tenderness was observed. Hyaluronidase may be indicated for use as an adjunct to increase the absorption and dispersion of injected drugs as well as for subcutaneous fluid rehydration. There is, however. limited evidence to indicate its use in skin site reactions and it may contribute to poor tolerance of a CSCI. To the author's knowledge, this is the first case report of the use of hyaluronidase in the management of infusion site skin reactions.

Oral symptom assessment tools in patients with advanced cancer: a scoping review.

PURPOSE: Oral symptoms are common in patients with advanced cancer. The aim of this scoping review was to identify oral symptom assessment tools that have been specifically utilised in patients with "advanced cancer". METHODS: The review was conducted/reported according to international guidelines for undertaking scoping reviews. PubMed, Embase, and CINAHL were searched for articles involving adult patients with advanced cancer, which involved assessment of ≥ 2 oral symptoms, and which involved patients with > 1 type of cancer. RESULTS: The review identified four validated symptom assessment scales, including one cancer-specific quality of life scale (EORTC QLQ OH-15), one generic tool for assessing the "social impact" of specific oral problems (OHIP), one cancer-specific generic symptom assessment scale (MSAS), and one cancer-specific oral symptom assessment scale (OSAS). CONCLUSION: Symptom assessment tools can facilitate good symptom control in clinical practice, and are an integral component of clinical research. The review identified four validated symptom assessment scales that could be utilised to assess oral symptoms in patients with advanced cancer.