TY - JOUR
T1 - Use of a Single-Item Screening Tool to Detect Clinically Significant Fatigue, Pain, Distress, and Anorexia in Ambulatory Cancer Practice
AU - Butt, Zeeshan
AU - Wagner, Lynne I.
AU - Beaumont, Jennifer L.
AU - Paice, Judith A.
AU - Peterman, Amy H.
AU - Shevrin, Dan
AU - Von Roenn, Jamie H.
AU - Carro, George
AU - Straus, Joshua L.
AU - Muir, J. Cameron
AU - Cella, David
PY - 2008/1
Y1 - 2008/1
N2 - Fatigue, pain, distress, and anorexia are four commonly encountered symptoms in cancer. To evaluate the usefulness of a single-item screening for these symptoms, 597 ambulatory outpatients with solid tumors were administered a self-report screening instrument within the first 12 weeks of chemotherapy. Patients rated the severity of each symptom on a 0-10 scale, at its worst over the past three days, with higher ratings associated with higher symptom levels. From this sample, 148 patients also completed a more comprehensive assessment of these symptoms. Two criteria were used to determine optimal cut-off scores on the screening items: 1) the sensitivity and specificity of each screening item to predict clinical cases using receiver-operating characteristics analysis and 2) the proportion of patients at each screening score who reported that some relief of the target symptom would significantly improve their life. Optimal cut-off scores ranged from 4 to 6 depending on the target symptom (area under the curve range = 0.68-0.88). Use of single-item screening instruments for fatigue, pain, distress, and anorexia may assist routine clinical assessment in ambulatory oncology practice. In turn, such assessments may improve identification of those at risk of morbidity and decreased quality of life due to excess symptom burden.
AB - Fatigue, pain, distress, and anorexia are four commonly encountered symptoms in cancer. To evaluate the usefulness of a single-item screening for these symptoms, 597 ambulatory outpatients with solid tumors were administered a self-report screening instrument within the first 12 weeks of chemotherapy. Patients rated the severity of each symptom on a 0-10 scale, at its worst over the past three days, with higher ratings associated with higher symptom levels. From this sample, 148 patients also completed a more comprehensive assessment of these symptoms. Two criteria were used to determine optimal cut-off scores on the screening items: 1) the sensitivity and specificity of each screening item to predict clinical cases using receiver-operating characteristics analysis and 2) the proportion of patients at each screening score who reported that some relief of the target symptom would significantly improve their life. Optimal cut-off scores ranged from 4 to 6 depending on the target symptom (area under the curve range = 0.68-0.88). Use of single-item screening instruments for fatigue, pain, distress, and anorexia may assist routine clinical assessment in ambulatory oncology practice. In turn, such assessments may improve identification of those at risk of morbidity and decreased quality of life due to excess symptom burden.
KW - Screening
KW - assessment
KW - clinical significance
KW - patient-reported outcomes
UR - http://www.scopus.com/inward/record.url?scp=37449032903&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=37449032903&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2007.02.040
DO - 10.1016/j.jpainsymman.2007.02.040
M3 - Article
C2 - 17959345
AN - SCOPUS:37449032903
SN - 0885-3924
VL - 35
SP - 20
EP - 30
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 1
ER -