Establishing mild, moderate, and severe scores for cancer-related symptoms: How consistent and clinically meaningful are interference-based severity cut-points?
Establishing mild, moderate, and severe scores for cancer-related symptoms: How consistent and clinically meaningful are interference-based severity cut-points?
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DOI：
10.1016/j.jpainsymman.2007.03.012
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发表时间：
2008-02-01
影响因子：
4.7
通讯作者：
Decker, David
中科院分区：
文献类型：
--
作者：
Given, Barbara;Given, Charles W.;Decker, David
提出了将16种常见的癌症症状按10分症状严重程度评定量表分为轻度、中度和重度类别的方法，这些类别在临床上可解释，并对肿瘤学实践环境具有重要意义。在他们最初的干预接触中，588名接受化疗的实体瘤癌症患者报告了16种症状的标准11分评定量表的严重程度。所有报告1分或更高的人都被要求在11分制量表上评估症状对生活享受、与他人的关系、一般日常活动和情绪的干扰程度。因素分析显示，这些项目进入同一个维度，并将这些项目相加，形成一个干扰量表。通过比较与每种症状严重程度的每次连续增加相对应的干扰评分差异，定义轻度、中度和重度症状严重程度类别的临界点。不同症状的临界点不同。与其他症状相比，疼痛、疲劳、虚弱、咳嗽、记忆困难和抑郁症的每一类别的临界点较低。每种症状的临界点与癌症的部位或阶段、年龄或性别无关，但与总体抑郁指标相关。切割点与身体功能的限制有关，表明患者生活质量的差异。由此产生的临界点将严重程度评级总结为临床上显著和有用的类别，临床医生可以在实践中使用这些类别来评估症状。
Methods are presented to separate 16 frequently occurring cancer symptoms measured on 10-point symptom severity rating scales into mild, moderate, and severe categories that are clinically interpretable and significant for use in oncology practice settings. At their initial intervention contact, 588 solid tumor cancer patients undergoing chemotherapy reported severity on a standard 11-point rating scale for 16 symptoms. All reporting a one or higher were asked to rate on an 11-point scale how much the symptom interfered with enjoyment of life, relationship with others, general daily activities, and emotions. Factor analysis revealed that these items tapped into the same dimension, and the items were summed to form an interference scale. Cut-points for mild, moderate, and severe categories of symptom severity were defined by comparing the differences in interference scores corresponding to each successive increases in severity for each symptom. The cut-points differed among symptoms. Pain, fatigue, weakness, cough, difficulty remembering; and depression had lower cut-points for each category compared to other symptoms. Cut-points for each symptom were not related to site or stage of cancer, age, or gender but were associated with a global depression measure. Cut-points were related to limitations in physical function, suggesting differences in the quality of patients' lives. The resulting cut points summarize severity ratings into clinically significant and useful categories that clinicians can use to assess symptoms in their practices.