Discrepancy in patient-rated and oncologist-rated performance status on depression and anxiety in cancer: a prospective study protocol: Table A1

Abstract

ObjectivePsychological distress is common in patients with cancer. We need a rapid means of screening for and identifying depression and anxiety in patients with cancer. The present study evaluates the potential of the Eastern Cooperative Oncology Group (ECOG) performance status (PS) scoring as a brief screening tool to assess psychological distress in routine cancer care. The ECOG PS is widely used by oncologists and the WHO, as a standardised measure to assess general well-being in patients with cancer and quality of life in cancer trials. We examine the discrepancy between patient-rated and oncologist-rated PS scores on the ECOG in a comparative assessment against the Hospital Anxiety and Depression Scale (HADS).Methods and designThis is a prospective evaluation of approximately 500 ambulatory adult cancer patients from a large academic medical centre. Participants will be asked to assess their own ECOG PS on a scale of 0–4, which will be compared to ECOG PS as rated by their oncologists. Higher ECOG PS scores indicate poorer daily functioning. Both patient-rated and oncologist-rated ECOG PS and their absolute differences will be tested for predictive and concurrent validity against the HADS. A HADS cut-off ≥15 will be used. Ethics approval for this study has been secured from the institutional ethics board. Outcomes are re-evaluated at 4-week to 6-week and 1-year follow-up.ConclusionThis study holds practical significance for rapid screening of psychological distress in the cancer clinic with the use of the ECOG PS scoring. Given the high prevalence of anxiety and depression in patients with cancer, screening is important to increase its recognition, which will, in turn, help to direct referrals and deliver appropriate intervention. This study also generates greater insight into the association between psychosomatic complaints and psychological distress.Trial registration numberMEC 896.52.

Psychological distress and cancer pain: Results from a controlled cross-sectional survey in China

“…These findings in Chinese patients with cancer are consistent with the previously reported negative correlation between the length or duration of cancer pain and psychological distress3637. The predictive role of performance status (PS) in anxiety and depression in patients with cancer has been identified333839. PS is often recognized as a functional capacity index that is not only related to patients’ age and disease stage, but also with the concurrence of symptoms.…”

Factors affecting the performance of activities of daily living in patients with advanced cancer undergoing inpatient rehabilitation: results from a retrospective observational study

“…We believe this novel finding will promote the utilization of cancer rehabilitation, regardless of the phase of patients. In this study we noticed an improvement of PS score, which includes the assessment of psychological aspects32, 45 ) . Psychological effects may partly contribute to the beneficial effects of rehabilitation for patients with advanced cancer.…”

“…The validity and reliability of PS have been shown to exhibit good results27, 28 ) . PS is ordinarily used to evaluate the severity of toxicity experienced by patients in cancer treatment trials27, 29 ) , but can also evaluate the performance of ADL30 ) , quality of life31 ) , and psychological distress32 ) in these patients. The measurement uses a scale of 0 through 4, with 0 to 1 indicating good PS and 2 to 4 indicating poor PS29, 33 ) .…”

Course and predictors of post‐traumatic stress disorder in a cohort of psychologically distressed patients with cancer: A 4‐year follow‐up study

“…Preliminary testing for the English-language HADS yielded a Cronbach a of 0.91. 20 The Malay version of the HADS has been used in previous large cohort studies in Malaysian patients with cancer 21 and has demonstrated excellent internal consistency with Cronbach a values of 0.88 for the anxiety subscale and 0.79 for the depression subscale. 22 The anxiety and depression subscales on the HADS are 7-item subscales scored on a 4-point Likert scale (from 0 to 3; with higher scores indicate more distress), yielding maximum subscale scores of 21 for anxiety and depression, respectively, and a maximum total score of 42.…”