Impact of an Artificial Intelligence-Based Management Model on Psychological and Behavioral Outcomes in Breast Cancer Patients Undergoing Home CDK4/6 Inhibitor Therapy

Depression is evaluated using the Self-rating Depression Scale (SDS). The SDS consists of 20 items, with each item scored on a 4-point scale ranging from 1 to 4. The raw total score is calculated by summing the scores of all items and is then converted into a standard score. The cutoff value for the standard score is set at 50. Higher scores indicate a greater severity of depression.

Anxiety is evaluated using the Self-rating Anxiety Scale (SAS). The scale consists of 20 items, with each item scored on a 4-point scale ranging from 1 to 4. The raw total score is obtained by summing the scores of all individual items and is subsequently converted into a standard score. The threshold for the standard score is 50. Higher scores reflect a greater severity of anxiety.

The EORTC QLQ-C30 consists of five functional scales (physical, role, cognitive, emotional, and social), a global QoL scale, three symptom scales (fatigue, nausea and vomiting, and pain), single items assessing common symptoms (dyspnoea, loss of appetite, insomnia, constipation, and diarrhoea), and a single item assessing the perceived financial impact. After linear transformation, all scales and single-item measures range in score from 0 to 100. A higher score for a functional scale and the global QoL scale represents a higher level of functioning and a higher level of HRQoL. Conversely, a higher score for a symptom scale or item and the financial impact item indicates a higher level of symptom burden or financial impact.

The PRO-CTCAE is a validated library of patient-reported items designed to measure 78 distinct symptomatic adverse events (AEs). For each AE, up to three separate attribute items assess the frequency, severity, and interference with daily activities over the past 7 days. Scores for each attribute can be reported individually or integrated into a single composite score ranging from 0 to 3 for each symptom using established algorithms. Higher individual or composite scores indicate greater symptom severity. Relevant PRO-CTCAE items are typically selected for a specific clinical trial based on prior evidence and/or the mechanism of action, and then compiled into a survey. In this trial, investigators selected 10 PRO-CTCAE symptoms based on CDK4/6 inhibitor-related side effects reported in the literature. The selected symptoms include: decreased appetite, nausea, constipation, diarrhea, dizziness, pain, insomnia, fatigue, dejection, and sadness.

This study utilizes the Proportion of Days Covered (PDC) as a quantitative indicator of medication adherence. The formula is as follows: PDC = Number of days covered by medication during the observation period/Total number of days in the observation period× 100%.In this study, "high adherence" is defined as a PDC≥80%.