Journal Article Epublish
PubMed: 42730830 DOI: 10.1007/s00520-026-11187-8
Data-driven biopsychosocial profiles to inform early psycho-oncology triage in head and neck cancer : A cross-sectional cluster analysis integrating patient-reported outcomes, medical complexity, and early psychosocial care utilization in an interdisciplinary fast-track diagnostic program.
Support Care Cancer 34(10)
Authors: Jan Ben Schulze, Sebastian Euler, Roland von Känel, Martina A Broglie-Däppen, Christian Thüring, Simon Andreas Mueller, Gregoire B Morand, Cosima Eleanor Riemenschnitter
Affiliations
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland.
- Bethanien, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland.
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland.
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland.
Abstract
PURPOSE
Rapid head and neck cancer (HNC) diagnostic pathways compress assessment and treatment planning into a few days. However, patients differ substantially in their psychological, physical, functional, interpersonal, and medical needs. Single-score distress screening may not capture this heterogeneity.
METHODS
We analyzed cross-sectional baseline data from 96 adults assessed within an interdisciplinary 72-h fast-track diagnostic program for suspected or newly diagnosed HNC. Five theory-driven, z-standardized domains (psychological distress, physical burden, functional impairment, interpersonal vulnerability, medical complexity) were derived and clustered with k-means. Psychosocial care contacts within 14 days served as an exploratory external criterion and were not used as clustering inputs.
RESULTS
A three-cluster solution yielded (i) low burden (n = 58, 60.4%), (ii) psychologically distressed (n = 24, 25.0%) with elevated distress and comparatively low medical complexity, and (iii) somatic/functional high burden (n = 14, 14.6%) characterized by prominent physical and functional burden. Psychosocial care utilization differed only modestly across clusters.
CONCLUSIONS
Multidimensional profiling in this 72-h HNC pathway yielded clinically interpretable subgroups that may inform needs-based supportive and psychosocial care allocation. Because observed utilization did not map strongly onto profiles, prospective validation is required before clinical implementation.
MeSH
Triage, Neoplasms, Psycho-Oncology, Cluster Analysis, Patient Reported Outcome Measures, Head And Neck Neoplasms, Palliative Care