Automated interviews to validate distress measures in cancer survivors

描述(由申请人提供)：除了对身体健康的影响外，已知癌症幸存者面临各种长期心理社会影响的风险增加，最常见的是抑郁和焦虑。3、7-12青年成人(YA)幸存者是一个特别脆弱的群体，因为癌症破坏了他们的身体和情感发育，他们将在治疗后生活多年。12、15-18对YA幸存者的研究显示，心理苦恼的比率很高，10、19以及接受适当的心理社会护理的许多障碍。12、20、21为了解这些心理后遗症的病因并确定和治疗受影响的幸存者的研究受益于为精神病人群编制的自我报告症状清单12-14，但几乎没有开展研究来验证这些措施在癌症幸存者中的有效性。事实上，对YA幸存者护理的审查始终注意到，研究和患者护理都受到缺乏患者报告结果(PRO)衡量标准的阻碍，这些衡量标准已被证实适用于这些人群。15、20、21为了满足这一关键需求，本研究调查了现有焦虑和抑郁衡量标准的有效性 通过对200名YA癌症幸存者(年龄18-40岁)的样本进行比较，将它们与有效的精神评估进行比较。使用结构化的DSM障碍临床访谈(SCID)22作为“金标准”，将评估简明症状清单-18(BSI-18)、23和PROMIS倡议24、25焦虑和抑郁简表的有效性。以前的研究支持BSI-18和PROMIS测量的可靠性，13，24和25，27，但没有研究根据精神病学诊断标准来验证它们。除了核对表的措施，有效性和实用性的创新诊断面谈，初级保健评估精神疾病(PRIME-MD)，管理使用计算机化的自动电话面谈(ATI)也将被调查。研究已经在28-31岁的精神病患者和内科患者中验证了Prime-MD的面对面和ATI版本，但这将是第一次研究其在癌症幸存者中的有效性。分析将侧重于确定研究措施的案例规则，以优化对患有临床上严重抑郁和焦虑的SCID幸存者的识别。这项研究还将评估幸存者是否比书面形式更愿意使用ATI披露关于性和自杀症状的敏感信息，目的是确定ATI是否加强了对这些重要但经常被忽视的症状的报告。通过检验这些测量方法的效标效度，并找出用于检测有临床显著心理症状的幸存者的最佳方法，本研究将极大地提高这些测量的价值，并为YA幸存者的研究和临床护理提供新的途径。虽然这项研究是在YA癌症存活率的背景下进行的，但结果将为开发最佳实践提供参考，以加强对其他人群的心理痛苦和敏感行为的预测量。

DESCRIPTION (provided by applicant): In addition to physical health effects, cancer survivors are known to be at increased risk for a variety of long- term psychosocial effects, most commonly depression and anxiety.3, 7-12 Young adult (YA) survivors are a particularly vulnerable group, as cancer disrupts their physical and emotional development, and they will live with late-effects for many years after treatment.12, 15-18 Studies of YA survivors show high rates of psychological distress,10, 19 as well as many barriers to receiving appropriate psychosocial care.12, 20, 21 Research to understand the etiology of these psychological late-effects and to identify and treat affected survivors has benefited from the use of self-report symptom checklists developed for psychiatric populations,12-14 but almost no research has been done to validate these measures in cancer survivors. In fact, reviews of YA survivor care consistently note that both research and patient care are hampered by a lack of patient reported outcome (PRO) measures that have been validated for this population.15, 20, 21 To address this critical need, this study investigates validity of existing measures of anxiety and depression by comparing them to a validated psychiatric assessment in a sample of 200 YA cancer survivors (age 18-40). Using the Structured Clinical Interview for DSM Disorders (SCID) 22 as a "gold standard," the validity of the Brief Symptom Inventory-18 (BSI- 18), 23 and PROMIS initiative 24, 25 anxiety and depression short forms will be assessed. Previous research supports reliability of the BSI-18 and PROMIS measures, 13, 24, and 25, 27 but no studies have validated them against a psychiatric diagnostic criterion. In addition to checklist measures, validity and utility of an innovative diagnostic interview, the Primary Care Evaluation of Mental Disorders (PRIME-MD), administered using computerized automated telephone interview (ATI) will also be investigated. Studies have validated both in-person and ATI versions of PRIME-MD in psychiatric and medical patients, 28-31 but this will be the first to study its utility in cance survivors. Analysis will focus on identifying case-rules for study measures to optimize identification of survivors with clinically significant depression and anxiety on the SCID. The study will also assess whether survivors are more comfortable disclosing sensitive information regarding sexual and suicidal symptoms using ATI compared to written forms, with the goal of determining if ATI enhances reporting of these important but often neglected symptoms. By examining the criterion validity of these measures, and identifying best methods for using them to detect survivors with clinically significant psychological symptoms, this study will greatly enhance the value of these measures and provide new approaches for research and clinical care of YA survivors. Although this research takes place in the context of YA cancer survivorship, results will be informative for developing best practices for enhancing PRO measures of psychological distress and sensitive behaviors in other populations.