Discrepancy in patient-rated and oncologist-rated performance status on depression and anxiety in cancer

A prospective study protocol

Chan Caryn Mei Hsien, Wan Azmad Wan Azman, Mastura Md Yusof, Gwo Fuang Ho, Edward Krupat

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: Psychological 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 design: This 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. Conclusion: This 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 number: MEC 896.52.

Original languageEnglish
Article numbere001799
JournalBMJ Open
Volume2
Issue number5
DOIs
Publication statusPublished - 2012
Externally publishedYes

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Anxiety
Prospective Studies
Depression
Neoplasms
Psychology
Institutional Ethics
Oncologists
Early Detection of Cancer
Ethics
Referral and Consultation
Quality of Life

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Discrepancy in patient-rated and oncologist-rated performance status on depression and anxiety in cancer : A prospective study protocol. / Caryn Mei Hsien, Chan; Wan Azman, Wan Azmad; Md Yusof, Mastura; Ho, Gwo Fuang; Krupat, Edward.

In: BMJ Open, Vol. 2, No. 5, e001799, 2012.

Research output: Contribution to journalArticle

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AB - Objective: Psychological 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 design: This 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. Conclusion: This 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 number: MEC 896.52.

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