Screening for distress in cancer patients: the NCCN rapid-screening measure.

The present investigation evaluated the NCCN distress management screening measure (DMSM) in a sample of 68 mixed site cancer patients. The DMSM was administered with the Brief Symptom Inventory (BSI) and the Brief Symptom Inventory-18 (BSI-18). Convergent validity was established by the moderate positive correlation between the DMSM and the BSI and BSI-18 global severity indices (r=0.59, p<0.001 and r=0.61, p<0.001, respectively). Divergent validity was demonstrated by the lower correlations between the DMSM and the BSI subscales suggestive of psychopathology (e.g. paranoid ideation, obsessive-compulsive). Receiver operative characteristic (ROC) analyses demonstrated that the DMSM has moderate ability to detect distress identified by the BSI and the BSI-18 (area under curve=0.74, p<0.001 and 0.80, respectively, p<0.01, respectively). While the ROC curves suggested that the DMSM lacks a single cutoff that maximizes sensitivity and specificity, the use of multiple cutoffs renders the DMSM an effective and very rapid screen for distress among cancer patients. Copyright (c) 2004 John Wiley & Sons, Ltd.