A limitation of the present study is that the
checklist of symptom assessment is a relatively
short instrument, which assesses only 15 symptoms.
It should be considered to use a more
comprehensive tool to assess symptoms when
exploring symptom clustering. In addition,
the study design is cross-sectional, whereas patients’
symptoms are dynamic over time along
the disease trajectory. Studies on longitudinal
follow-up should be designed to explore symptom
clustering at different time points.