Validating automated screening for psychological distress by means of computer touchscreens for use in routine oncology practice

Abstract

SummaryThe aim of the study was to confirm the validity of using touchscreen computers for screening for clinically significant levels of distress among cancer patients in routine oncology practice. The Hospital Anxiety and Depression Scale (HADS), EORTC Quality of Life questionnaire (QLQ-C30), Mental Health Inventory-MHI5 and a Concerns Checklist were administered via touchscreen computer to 172 chemotherapy out-patients, twice, 2-4 weeks apart. A standard psychiatric interview (Present State Examination -PSE) was conducted within a week of the second assessment. On interview, 23% of patients were identified as 'cases'. Using the available data (questionnaires, sociodemographic details, self-reported past psychiatric history), the best screening strategy combined scores from MHI-5 and HADS from a single time-point with the following rules: if MHI-5 < 11 = non-case; if MHI-5 ≥ 11 then use HADS; then, if HADS ≥ 9 = 'case' (sensitivity 85%; specificity 71%; misclassification rate 26%; positive predictive value 47%). The computerized screening system enabled data to be collected, scored, collated and reported in real time to identify patients who warrant further clinical assessment. It offers the potential for improving 'case' detection in routine oncology practice while reducing the burden of questions put to 'non-cases'. Further work is needed to develop optimal choice of screening questions for this purpose.

Psychological problems of cancer patients: a cancer distress screening with a cancer-specific questionnaire

“…The use of electronic questionnaire versions (e.g. tablet PCs or touch screen computers) has proved to be feasible and useful in practice (Detmar and Aaronson, 1998;Velikova et al, 1999;Cull et al, 2001). We would suggest that unspecific psychopathology questionnaires should not be used for this purpose, but rather questionnaires that are relevant to the specific experiences of cancer patients and, therefore, are of greater clinical relevancy.…”

Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs

“…This study (reported fully elsewhere) found that this cutoff performed adequately (sensitivity 87% and specificity 85%) and missed few interview positive cases. We administered the HADS by either a touch-screen computer (Cull et al, 2001) or when a computer was unavailable, by pen and paper. Good reliability between these two methods of administration has been previously reported (Velikova et al, 1999).…”

“…Screening can effectively detect cases of depression among oncology outpatients (Cull et al, 2001), many of whom would otherwise have been missed (Fallowfield et al, 2001). There is, however, little information on the performance of such screening systems 'in the real world.'…”

Extending Computer Technology to Hospice Research: Interactive Pentablet Measurement of Symptoms by Hospice Cancer Patients in Their Homes

“…Researchers demonstrated that cancer outpatients are able to use computers to report and document their psychosocial distress, [1][2][3] quality of life, [4][5][6] and pain. [7][8][9] Computer documentation is a part of practice in some hospice settings, but the clinician serves as the primary recorder.…”