Screening for psychologic distress in ambulatory cancer patients - A multicenter evaluation of the distress thermometer
Screening for psychologic distress in ambulatory cancer patients - A multicenter evaluation of the distress thermometer
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DOI：
10.1002/cncr.20940
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发表时间：
2005-04-01
期刊：
影响因子：
6.2
通讯作者：
Holland, JC
中科院分区：
文献类型：
--
作者：
Jacobsen, PB;Donovan, KA;Holland, JC
背景根据证据表明，心理困扰往往不被承认，虽然它是常见的癌症患者，临床实践指南建议常规筛查的困扰。在这项研究中，作者试图确定单项痛苦温度计（DT）是否优于目前用于筛查痛苦的较长测量方法。从5个研究中心招募的患者（n = 380）完成DT，并使用标准化列表确定是否存在34个问题。参与者还完成了14项医院焦虑和抑郁量表（HADS）和18项简短症状量表（BSI-18），两者都建立了识别临床显著痛苦的截止评分。DT评分的受试者工作特征（ROC）曲线分析得出了相对于HADS临界评分（0.80）和BSI-18临界评分（0.78）的曲线下面积估计值，表明总体准确性良好。ROC分析还表明，DT临界评分为4具有相对于HADS和BSI-18临界评分的最佳灵敏度和特异性。其他分析表明，与DT评分< 4的患者相比，DT评分< 4的患者更可能是女性，表现状况较差，并报告实际，家庭，情感和身体问题（P
BACKGROUND. Based on evidence that psychologic distress often goes unrecognized although it is common among cancer patients, clinical practice guidelines recommend routine screening for distress. For this study, the authors sought to determine whether the single-item Distress Thermometer (DT) compared favorably with longer measures currently used to screen for distress.METHODS. Patients (n = 380) who were recruited from 5 sites completed the DT and identified the presence or absence of 34 problems using a standardized list. Participants also completed the 14-item Hospital Anxiety and Depression Scale (HADS) and an 18-item version of the Brief Symptom inventory (BSI-18), both of which have established cutoff scores for identifying clinically significant distress.RESULTS. Receiver operating characteristic (ROC) curve analyses of DT scores yielded area under the curve estimates relative to the HADS cutoff score (0.80) and the BSI-18 cutoff scores (0.78) indicative of good overall accuracy. ROC analyses also showed that a DT cutoff score of 4 had optimal sensitivity and specificity relative to both the HADS and BSI-18 cutoff scores. Additional analyses indicated that, compared with patients who had DT scores < 4, patients who had DT scores < 4 were more likely to be women, have a poorer performance status, and report practical, family, emotional, and physical problems (P