Screening for distress in cancer patients: The NCCN rapid‐screening measure

Abstract

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.

Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

“…The Distress Thermometer (DT) is a visual-analog tool developed to efficiently screen for distress in cancer patients [7,[33][34][35]. The sensitivity, specificity, and appropriate cut-off score of the DT are established [16], with scores of 4 or above indicative of clinically-significant levels of distress.…”

“…The DT has been used to evaluate distress in patients diagnosed with prostate cancer [33], patients undergoing bone marrow transplant [34], and ambulatory cancer patients with mixed cancer diagnoses [7,16,35]. Categories of symptoms consistently associated with clinicallysignificant levels of distress on the DT were emotional, family, and physical problems.…”

“…Categories of symptoms consistently associated with clinicallysignificant levels of distress on the DT were emotional, family, and physical problems. Inconsistent results were found for the relationship between clinically-significant distress and spiritual problems [16,35]. In addition to clarifying the problem categories that contribute most to distress, researchers have called for future studies to focus on homogeneous diagnostic groups [35] and expansion of the symptom problem list frequently used with the DT to include a format for patients to identify other potential sources of distress and/or the issues for which they would most like help [16].…”

“…Inconsistent results were found for the relationship between clinically-significant distress and spiritual problems [16,35]. In addition to clarifying the problem categories that contribute most to distress, researchers have called for future studies to focus on homogeneous diagnostic groups [35] and expansion of the symptom problem list frequently used with the DT to include a format for patients to identify other potential sources of distress and/or the issues for which they would most like help [16]. The present study addresses these issues through our focus on patients evaluated and treated in a lung cancer clinic and through the adaptation of the Symptom Problem List (see section 2.3.3 under Measures).…”

“…In prior research on the DT with ambulatory cancer patients, less than 100 lung cancer patients participated across three studies [7,16,35]. Given that lung cancer is the leading cause of cancerrelated death for women and men [36], additional information on rates and predictors of distress in this population is needed.…”