Abstract for: Health-Related Quality of Life in Cancer Immunotherapy: Construction of Causal Loop Diagram

Immunotherapy represents a significant innovation in cancer treatment. Though objective clinical measures of cancer immunotherapy outcomes are apparent, other aspects of patients’ wellbeing which may be captured by studying their health-related quality of life (HRQoL) has received less research attention. Because the HRQoL of these patients exists within a complex system affected by and affecting many variables across multiple dimensions, the development of a systems-level model can provide a powerful framework to aid understanding of this complexity. We apply a literature-based approach to construct a causal loop diagram (CLD) for patients following immunotherapy. The CLD is presented sequentially at individual, immediate-social-circle, and community-levels. We identify feedback loops and demonstrate how changing just one variable has the potential to produce system-wide effects. The CLD identifies gaps in the literature and offers a powerful communication tool for diverse stakeholders involved in any part of the system. The CLD also provides the foundation for a quantified simulation model which could be used to forecast effects of policies and optimize resource allocation. Quality of life data for patients following immunotherapy are currently lacking, but research efforts to collect data are active which should facilitate the development of the simulation model in the near future.