BACKGROUND Many colorectal cancer (CRC) survivors experience persisting health problems post-treatment that compromise their health-related quality of life (HRQoL). Prediction models are useful tools for identifying survivors at risk of low HRQoL in the future and for taking preventive action. Therefore, we developed prediction models for CRC survivors to estimate the 1-year risk of low HRQoL in multiple domains. METHODS In 1458 CRC survivors, seven HRQoL domains (EORTC QLQ-C30: global QoL; cognitive, emotional, physical, role, social functioning; fatigue) were measured prospectively at study baseline and 1 year later. For each HRQoL domain, scores at 1-year follow-up were dichotomized into low versus normal/high. Separate multivariable logistic prediction models including biopsychosocial predictors measured at baseline were developed for the seven HRQoL domains, and internally validated using bootstrapping. RESULTS Average time since diagnosis was 5 years at study baseline. Prediction models included both non-modifiable predictors (age, sex, socio-economic status, time since diagnosis, tumor stage, chemotherapy, radiotherapy, stoma, micturition, chemotherapy-related, stoma-related and gastrointestinal complaints, comorbidities, social inhibition/negative affectivity, and working status) and modifiable predictors (body mass index, physical activity, smoking, meat consumption, anxiety/depression, pain, and baseline fatigue and HRQoL scores). Internally validated models showed good calibration and discrimination (AUCs: 0.83-0.93). CONCLUSIONS The prediction models performed well for estimating 1-year risk of low HRQoL in seven domains. External validation is needed before models can be applied in practice.

中文翻译：

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结直肠癌幸存者预测模型的开发和内部验证，以评估多个领域与健康相关的低生活质量的1年风险。

背景技术许多结直肠癌（CRC）幸存者在治疗后经历持续存在的健康问题，这损害了他们与健康相关的生活质量（HRQoL）。预测模型是有用的工具，可用于识别将来存在低HRQoL风险的幸存者并采取预防措施。因此，我们为CRC幸存者开发了预测模型，以估计多个领域中低HRQoL的1年风险。方法在1458名CRC幸存者中，分别在研究基线和1年后对七个HRQoL域（EORTC QLQ-C30：整体QoL；认知，情感，身体，作用，社会功能，疲劳）进行了测量。对于每个HRQoL域，在1年随访中的得分分为低分与正常/高分。针对七个HRQoL域开发了包括在基线时测得的生物心理社会预测因素在内的单独的多变量逻辑预测模型，并使用自举进行了内部验证。结果自研究开始诊断以来平均时间为5年。预测模型包括不可修改的预测因子（年龄，性别，社会经济状况，诊断时间，肿瘤分期，化学疗法，放疗，造口，排尿，与化学疗法有关，与造口有关和胃肠道疾病，合并症，社会抑制/阴性情感和工作状态）和可更改的预测指标（体重指数，体育锻炼，吸烟，吃肉，焦虑/抑郁，疼痛，基线疲劳和HRQoL得分）。内部验证的模型显示出良好的校准和区分度（AUC：0.83-0.93）。结论预测模型在估计七个领域的低HRQoL的一年风险方面表现良好。在实际应用模型之前，需要外部验证。