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Psychooncology. 2017 May;26(5):693-697. doi: 10.1002/pon.4208. Epub 2016 Jul 28.

The Distress Thermometer for screening for severe fatigue in newly diagnosed breast and colorectal cancer patients.

Author information

1
Expert Center for Chronic Fatigue (ECCF), Radboud University Medical Center, Nijmegen, The Netherlands.
2
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
3
Department of Medical Psychology, Hospital Gelderse Vallei, Ede, The Netherlands.
4
Department of Education and Training, University Medical Center Utrecht, Utrecht, The Netherlands.
5
Department of Surgery, Hospital Gelderse Vallei, Ede, The Netherlands.
6
Department of Medical Oncology, Hospital Gelderse Vallei, Ede, The Netherlands.
7
Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.

Abstract

OBJECTIVE:

Internationally, the Distress Thermometer and associated Problem List are increasingly used in oncology as screening tools for psychological distress. Cancer-related fatigue is common but often overlooked in clinical practice. We examined if severe fatigue in cancer patients can be identified with the fatigue item of the Problem List.

METHODS:

Newly diagnosed breast (N = 334) and colorectal (N = 179) cancer patients were screened for severe fatigue, which was defined as having a positive score on the fatigue item of the Problem List. The Fatigue Severity subscale of the Checklist Individual Strength was used as gold standard measure for severe fatigue.

RESULTS:

In total, 78% of breast cancer patients and 81% of colorectal cancer patients were correctly identified with the fatigue item. The sensitivity was 89% in breast cancer patients and 91% in colorectal cancer patients. The specificity was 75% in breast cancer patients and 77% in colorectal cancer patients. The positive predictive value was 53% in breast cancer patients and 64% in colorectal cancer patients, whereas the negative predictive value was 95% in both tumor types.

CONCLUSIONS:

The fatigue item of the Problem List performs satisfactorily as a quick screening tool for severe fatigue. However, a positive screen should be followed up with a more thorough assessment of fatigue, ie, a questionnaire with a validated cutoff point. Given time pressure of clinicians, this already implemented and brief screening tool may prevent severe fatigue from going undetected in clinical practice.

KEYWORDS:

Distress Thermometer; cancer; fatigue; oncology; psychometric properties; screening

PMID:
27362532
DOI:
10.1002/pon.4208
[Indexed for MEDLINE]

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