Validation of the Distress Thermometer: A single item screen to detect clinically significant psychological distress in ambulatory oncology patients

• DOI: 10.1200/jco.2004.22.90140.6024
• Publication Date: 2017-04-05T07:17:42Z
• Authors: L. J. Patrick-Miller; T. L. Broccoli; J. K. Much; E. Levine
• Keywords: Depression

6024 Background: Psychosocial distress in ambulatory oncology patients (AOP) is common, and deleterious to treatment decisions, symptoms, adherence outcomes, but easily treated. Recent NCCN guidelines recommend all AOP be screened at initial patient visit (IPV) "appropriate intervals" determine level, nature cause of inform intervention. The brevity the Memorial Sloan-Kettering Distress Thermometer (DT), a one item self-report measure, warrants NCCN's endorsement, however, operating characteristics DT, companion Problem List (PL) are not well established. Methods: All presenting clinic over 36 weeks for IPV (n = 1272; 15–97 YO, mean 54.7; 31% male) completed recommended DT PL, well-validated Hospital Anxiety Depression Scale (HADS), health history. Receiver (ROC) analysis established sensitivity specificity detect caseness optimal cutoffs use as screen AOP. Results: significantly correlated (p 0.00) with HADS total (HADS-T, r 0.70), (HADS-A, 0.68) (HADS-D, 0.54) scales. Area under ROC Curve greater HADS-T (87.6%) HADS-A (84.9%) than HADS-D (80.2%). Sensitivity, specificity, positive predictive value (PPV) negative (NPV) cutoff s (>4 >5) table below. Conclusions: better predicts global (GD) anxiety (ANX), depression (DEP), which less prevalent no important (DEP 14.3%; ANX 36.1%; GD 23.3%). As GD, DEP adequate both cutoffs, proportion identified cases differs 40%; >5 27%), point routine screening may based on available resources evaluate cases. No significant financial relationships disclose.