Peter Esser1, Tim J Hartung1, Michael Friedrich1, Christoffer Johansen1,2,3, Hans-Ulrich Wittchen4,5, Hermann Faller6, Uwe Koch7, Martin Härter8, Monika Keller9, Holger Schulz8, Karl Wegscheider10, Joachim Weis11, Anja Mehnert1. 1. Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany. 2. Oncology Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 3. Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark. 4. Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany. 5. Psychiatric University Hospital, Ludwig-Maximilians-Universität, Munich, Germany. 6. Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany. 7. Deanery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 8. Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 9. Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany. 10. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 11. University Clinic Center, Comprehensive Cancer Center Freiburg, Freiburg, Germany.
Abstract
OBJECTIVE: Anxiety in cancer patients may represent a normal psychological reaction. To detect patients with pathological levels, appropriate screeners with established cut-offs are needed. Given that previous research is sparse, we investigated the diagnostic accuracy of 2 frequently used screening tools in detecting generalized anxiety disorder (GAD). METHODS: We used data of a multicenter study including 2141 cancer patients. Diagnostic accuracy was investigated for the Generalized Anxiety Disorder Screener (GAD-7) and the anxiety module of the Hospital Anxiety and Depression Scale (HADS-A). GAD, assessed with the Composite International Diagnostic Interview for Oncology, served as a reference standard. Overall accuracy was measured with the area under the receiver operating characteristics curve (AUC). The AUC of the 2 screeners were statistically compared. We also calculated accuracy measures for selected cut-offs. RESULTS: Diagnostic accuracy could be interpreted as adequate for both screeners, with an identical AUC of .81 (95% CI: .79-.82). Consequently, the 2 screeners did not differ in their performance (P = .86). The best balance between sensitivity and specificity was found for cut-offs ≥7 (GAD-7) and ≥8 (HADS-A). The officially recommended thresholds for the GAD-7 (≥ 10) and the HADS-A (≥11) showed low sensitivities of 55% and 48%, respectively. CONCLUSIONS: The GAD-7 and HADS-A showed AUC of adequate diagnostic accuracy and hence are applicable for GAD screening in cancer patients. Nevertheless, the choice of optimal cut-offs should be carefully evaluated.
OBJECTIVE:Anxiety in cancerpatients may represent a normal psychological reaction. To detect patients with pathological levels, appropriate screeners with established cut-offs are needed. Given that previous research is sparse, we investigated the diagnostic accuracy of 2 frequently used screening tools in detecting generalized anxiety disorder (GAD). METHODS: We used data of a multicenter study including 2141 cancerpatients. Diagnostic accuracy was investigated for the Generalized Anxiety Disorder Screener (GAD-7) and the anxiety module of the Hospital Anxiety and Depression Scale (HADS-A). GAD, assessed with the Composite International Diagnostic Interview for Oncology, served as a reference standard. Overall accuracy was measured with the area under the receiver operating characteristics curve (AUC). The AUC of the 2 screeners were statistically compared. We also calculated accuracy measures for selected cut-offs. RESULTS: Diagnostic accuracy could be interpreted as adequate for both screeners, with an identical AUC of .81 (95% CI: .79-.82). Consequently, the 2 screeners did not differ in their performance (P = .86). The best balance between sensitivity and specificity was found for cut-offs ≥7 (GAD-7) and ≥8 (HADS-A). The officially recommended thresholds for the GAD-7 (≥ 10) and the HADS-A (≥11) showed low sensitivities of 55% and 48%, respectively. CONCLUSIONS: The GAD-7 and HADS-A showed AUC of adequate diagnostic accuracy and hence are applicable for GAD screening in cancerpatients. Nevertheless, the choice of optimal cut-offs should be carefully evaluated.
Authors: Daniel C McFarland; Allison J Applebaum; Erik Bengtsen; Yesne Alici; William Breitbart; Andrew H Miller; Christian Nelson Journal: Psychooncology Date: 2021-09-04 Impact factor: 3.955
Authors: Sebastian W Nielsen; Christina H Ruhlmann; Lise Eckhoff; Dorthe Brønnum; Jørn Herrstedt; Susanne O Dalton Journal: Support Care Cancer Date: 2021-08-28 Impact factor: 3.359
Authors: Hamad S Alyami; Abdallah Y Naser; Eman Zmaily Dahmash; Mohammed H Alyami; Musfer S Alyami Journal: Int J Clin Pract Date: 2021-04-27 Impact factor: 3.149
Authors: Anna M Sawka; Sangeet Ghai; George Tomlinson; Nancy N Baxter; Martin Corsten; Syed Ali Imran; Eric Bissada; Rebecca Lebouef; Nathalie Audet; Maryse Brassard; Han Zhang; Michael Gupta; Anthony C Nichols; Deric Morrison; Stephanie Johnson-Obeski; Eitan Prisman; Don Anderson; Shamir P Chandarana; Sana Ghaznavi; Jennifer Jones; Amiram Gafni; John J Matelski; Wei Xu; David P Goldstein Journal: Front Endocrinol (Lausanne) Date: 2021-06-10 Impact factor: 5.555
Authors: Johanna T W Snijkers; Wendy van den Oever; Zsa Zsa R M Weerts; Lisa Vork; Zlatan Mujagic; Carsten Leue; Martine A M Hesselink; Joanna W Kruimel; Jean W M Muris; Roel M M Bogie; Ad A M Masclee; Daisy M A E Jonkers; Daniel Keszthelyi Journal: Neurogastroenterol Motil Date: 2021-05-03 Impact factor: 3.960