CONTEXT: Constipation is often inadequately assessed and underdiagnosed in patients with advanced cancer. Many studies use patient-reported constipation (PRC) as an outcome. OBJECTIVES: The aim was to compare the accuracy of PRC as compared with the modified Rome III (ROME) criteria and to determine the agreement between PRC, physician assessment of constipation, and objective assessment of constipation by modified ROME criteria among outpatients with advanced cancer. METHODS: Patients with advanced cancer attending a supportive care clinic were screened. Constipation was assessed using the modified ROME criteria, patient report (yes or no and rated 0-10; 10=worst possible symptom), and physician assessments (yes or no and rated 0-10). RESULTS: One hundred patients were enrolled, and 50 of 100 patients (50%) met the modified ROME criteria for constipation. Disagreement between ROME criteria and the patient report (yes/no) was found in 33 patients (33%) and between ROME criteria and the physician assessment (yes/no) in 39 patients (39%). The best combination of sensitivity (0.84) and specificity (0.62) was found with scores ≥3/10 for PRC. CONCLUSION: We found a high frequency of constipation. The limited agreement with modified ROME criteria suggests that a patient's self-report as yes or no is not useful for clinical practice. Patient self-rating on a 0 to 10 scale (score of three or greater) seems to be the best tool for constipation screening among this population. More research is needed to identify the best way to assess constipation in patients with advanced cancer.
CONTEXT: Constipation is often inadequately assessed and underdiagnosed in patients with advanced cancer. Many studies use patient-reported constipation (PRC) as an outcome. OBJECTIVES: The aim was to compare the accuracy of PRC as compared with the modified Rome III (ROME) criteria and to determine the agreement between PRC, physician assessment of constipation, and objective assessment of constipation by modified ROME criteria among outpatients with advanced cancer. METHODS:Patients with advanced cancer attending a supportive care clinic were screened. Constipation was assessed using the modified ROME criteria, patient report (yes or no and rated 0-10; 10=worst possible symptom), and physician assessments (yes or no and rated 0-10). RESULTS: One hundred patients were enrolled, and 50 of 100 patients (50%) met the modified ROME criteria for constipation. Disagreement between ROME criteria and the patient report (yes/no) was found in 33 patients (33%) and between ROME criteria and the physician assessment (yes/no) in 39 patients (39%). The best combination of sensitivity (0.84) and specificity (0.62) was found with scores ≥3/10 for PRC. CONCLUSION: We found a high frequency of constipation. The limited agreement with modified ROME criteria suggests that a patient's self-report as yes or no is not useful for clinical practice. Patient self-rating on a 0 to 10 scale (score of three or greater) seems to be the best tool for constipation screening among this population. More research is needed to identify the best way to assess constipation in patients with advanced cancer.
Authors: R D Nipp; A El-Jawahri; M Ruddy; C Fuh; B Temel; S M D'Arpino; B J Cashavelly; V A Jackson; D P Ryan; E P Hochberg; J A Greer; J S Temel Journal: Ann Oncol Date: 2019-02-01 Impact factor: 32.976
Authors: P Connor Johnson; Yian Xiao; Risa L Wong; Sara D'Arpino; Samantha M C Moran; Daniel E Lage; Brandon Temel; Margaret Ruddy; Lara N Traeger; Joseph A Greer; Ephraim P Hochberg; Jennifer S Temel; Areej El-Jawahri; Ryan D Nipp Journal: J Oncol Pract Date: 2019-04-04 Impact factor: 3.840
Authors: Daniel E Lage; Ryan D Nipp; Sara M D'Arpino; Samantha M Moran; P Connor Johnson; Risa L Wong; William F Pirl; Ephraim P Hochberg; Lara N Traeger; Vicki A Jackson; Barbara J Cashavelly; Holly S Martinson; Joseph A Greer; David P Ryan; Jennifer S Temel; Areej El-Jawahri Journal: J Clin Oncol Date: 2017-10-25 Impact factor: 44.544
Authors: Wadih Rhondali; Sriram Yennurajalingam; Gary Chisholm; Jeanette Ferrer; Sun Hyun Kim; Jung Hun Kang; Marilene Filbet; Eduardo Bruera Journal: Support Care Cancer Date: 2013-04-16 Impact factor: 3.603
Authors: Ryan D Nipp; Areej El-Jawahri; Sara M D'Arpino; Andy Chan; Charn-Xin Fuh; P Connor Johnson; Daniel E Lage; Risa L Wong; William F Pirl; Lara Traeger; Barbara J Cashavelly; Vicki A Jackson; David P Ryan; Ephraim P Hochberg; Jennifer S Temel; Joseph A Greer Journal: Cancer Date: 2018-06-15 Impact factor: 6.860
Authors: Ryan D Nipp; Areej El-Jawahri; Samantha M Moran; Sara M D'Arpino; P Connor Johnson; Daniel E Lage; Risa L Wong; William F Pirl; Lara Traeger; Inga T Lennes; Barbara J Cashavelly; Vicki A Jackson; Joseph A Greer; David P Ryan; Ephraim P Hochberg; Jennifer S Temel Journal: Cancer Date: 2017-10-23 Impact factor: 6.860