Aynur Aktas1, Declan Walsh, Jordanka Kirkova. 1. Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA.
Abstract
PURPOSE: Various instruments are used to assess both individual and multiple cancer symptoms. We evaluated the psychometric properties of cancer multisymptom assessment instruments. METHODS: An Ovid MEDLINE search was done. All searches were limited to adults and in English. All instruments published from 2005 to 2014 (and with at least one validity test) were included. We excluded those who only reported content validity. Instruments were categorized by the three major types of symptom measurement scales employed as follows: visual analogue (VAS), verbal rating (VRS), and numerical rating (NRS) scales. They were then examined in two areas: (1) psychometric thoroughness (number of tests) and (2) psychometric strength of evidence (validity, reliability, generalizability). We also assigned an empirical global psychometric quality score (which combined the concepts of thoroughness and strength of evidence) to rank the instruments. RESULTS: We analyzed 57 instruments (17 original, 40 modifications). They varied in types of scales used, symptom dimensions measured, and time frames evaluated. Of the 57, 10 used VAS, 28 VRS, and 19 NRS. The Edmonton Symptom Assessment System (ESAS), ESAS-Spanish, Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Symptom Distress Scale (SDS), M.D. Anderson Symptom Inventory (MDASI)-Russian, and MDASI-Taiwanese were the most comprehensively tested for validity and reliability. The ESAS, ESAS-Spanish, ASDS-2, Memorial Symptom Assessment Scale (MSAS)-SF, POMS, SDS, MDASI (and some translations), and MDASI-Heart Failure all showed good validity and reliability. CONCLUSIONS: The MDASI appeared to be the best overall from a psychometric perspective. This was followed by the ESAS, ESAS-Spanish, POMS, SDS, and some MDASI translations. VRS-based instruments were most common. There was a wide range of psychometric rigor in validation. Consequently, meta-analysis was not possible. Most cancer multisymptom assessment instruments need further extensive validation to establish the excellent reliability and validity required for clinical utility and meaningful research.
PURPOSE: Various instruments are used to assess both individual and multiple cancer symptoms. We evaluated the psychometric properties of cancer multisymptom assessment instruments. METHODS: An Ovid MEDLINE search was done. All searches were limited to adults and in English. All instruments published from 2005 to 2014 (and with at least one validity test) were included. We excluded those who only reported content validity. Instruments were categorized by the three major types of symptom measurement scales employed as follows: visual analogue (VAS), verbal rating (VRS), and numerical rating (NRS) scales. They were then examined in two areas: (1) psychometric thoroughness (number of tests) and (2) psychometric strength of evidence (validity, reliability, generalizability). We also assigned an empirical global psychometric quality score (which combined the concepts of thoroughness and strength of evidence) to rank the instruments. RESULTS: We analyzed 57 instruments (17 original, 40 modifications). They varied in types of scales used, symptom dimensions measured, and time frames evaluated. Of the 57, 10 used VAS, 28 VRS, and 19 NRS. The Edmonton Symptom Assessment System (ESAS), ESAS-Spanish, Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Symptom Distress Scale (SDS), M.D. Anderson Symptom Inventory (MDASI)-Russian, and MDASI-Taiwanese were the most comprehensively tested for validity and reliability. The ESAS, ESAS-Spanish, ASDS-2, Memorial Symptom Assessment Scale (MSAS)-SF, POMS, SDS, MDASI (and some translations), and MDASI-Heart Failure all showed good validity and reliability. CONCLUSIONS: The MDASI appeared to be the best overall from a psychometric perspective. This was followed by the ESAS, ESAS-Spanish, POMS, SDS, and some MDASI translations. VRS-based instruments were most common. There was a wide range of psychometric rigor in validation. Consequently, meta-analysis was not possible. Most cancer multisymptom assessment instruments need further extensive validation to establish the excellent reliability and validity required for clinical utility and meaningful research.
Authors: Xin Shelley Wang; Adriano V Laudico; Hong Guo; Tito R Mendoza; Maria Lourdes Matsuda; Victor D Yosuico; Edilberto P Fragante; Charles S Cleeland Journal: J Pain Symptom Manage Date: 2006-06 Impact factor: 3.612
Authors: R K Portenoy; H T Thaler; A B Kornblith; J M Lepore; H Friedlander-Klar; E Kiyasu; K Sobel; N Coyle; N Kemeny; L Norton Journal: Eur J Cancer Date: 1994 Impact factor: 9.162
Authors: Teresa L Hagan; Stephanie Gilbertson-White; Susan M Cohen; Jennifer S Temel; Joseph A Greer; Heidi S Donovan Journal: Clin J Oncol Nurs Date: 2018-02-01 Impact factor: 1.027
Authors: Loretta A Williams; Meagan S Whisenant; Tito R Mendoza; Shireen Haq; Karen N Keating; Brian Cuffel; Charles S Cleeland Journal: Qual Life Res Date: 2018-09-05 Impact factor: 4.147
Authors: Jasmijn F M Holla; Lonneke V van de Poll-Franse; Peter C Huijgens; Floortje Mols; Joost Dekker Journal: Support Care Cancer Date: 2016-02-03 Impact factor: 3.603
Authors: Patrick D Hoek; Henk J Schers; Ewald M Bronkhorst; Kris C P Vissers; Jeroen G J Hasselaar Journal: BMC Med Date: 2017-06-19 Impact factor: 8.775
Authors: Fliss Em Murtagh; Christina Ramsenthaler; Alice Firth; Esther I Groeneveld; Natasha Lovell; Steffen T Simon; Johannes Denzel; Ping Guo; Florian Bernhardt; Eva Schildmann; Birgitt van Oorschot; Farina Hodiamont; Sabine Streitwieser; Irene J Higginson; Claudia Bausewein Journal: Palliat Med Date: 2019-06-12 Impact factor: 4.762
Authors: Cinzia Brunelli; Claudia Borreani; Augusto Caraceni; Anna Roli; Marco Bellazzi; Linda Lombi; Emanuela Zito; Chiara Pellegrini; Pierangelo Spada; Stein Kaasa; Anna Maria Foschi; Giovanni Apolone Journal: Health Qual Life Outcomes Date: 2020-07-28 Impact factor: 3.186
Authors: Lila J Finney Rutten; Kathryn J Ruddy; Linda L Chlan; Joan M Griffin; Jeph Herrin; Aaron L Leppin; Deirdre R Pachman; Jennifer L Ridgeway; Parvez A Rahman; Curtis B Storlie; Patrick M Wilson; Andrea L Cheville Journal: Trials Date: 2020-06-05 Impact factor: 2.279