Abstract
OBJECTIVE: The aim of this study was to determine which cognitive patient reported outcome measure (PROM) best represents self-reported cognitive functioning in real-world environments among breast cancer survivors (BCS) as measured by ecological momentary assessments (EMA), and to compare their ability to predict future everyday functioning. METHODS: One-hundred twenty-four BCS (ages 24-88) completed self-report measures of cognitive functioning (FACT-Cog PCI, PROMIS Cog, CFQ, EORTC-CF) and everyday functioning (SDI, FACT-G Functional Well-being subscale) at baseline (Time 1) and at 9 weeks follow up (Time 2). Between assessments, EMA protocols (including one item to assess cancer-related cognitive symptoms) were administered every other day for 8 weeks. Person-specific means and standard deviations were calculated for EMA data. Hierarchical linear regression models were used to model cognitive PROM predictors of person-specific averages and variability in EMAs, SDI, and FACT-G functional well-being, and model parameters (R(2), AIC, BIC, semi-partial R) were compared. RESULTS: Follow-up FACT-Cog PCI most accurately predicted both the average (ΔR(2) = 0.213, p < 0.001) and variability (ΔR(2) = 0.071, p < 0.001) in EMA CRCI symptoms. For future functional outcomes, the PROMIS Cog and FACT-Cog PCI at baseline demonstrated similar predictive power for Time 2 Functional Well-being (ΔR(2) = 0.210, p < 0.001). Additionally, baseline FACT-Cog PCI was the strongest predictor of social dysfunction (SDI; ΔR(2) = 0.205, p < 0.001). CONCLUSIONS: These findings support the ecological validity of cognitive PROMs in BCS and indicate that both FACT-Cog PCI and PROMIS Cog effectively capture real-world cognitive symptoms and predict future everyday functioning, including social function and well-being.