オランダ版エドモントン症状評価システムの検証

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Cancer Med.2020 Jul;doi: 10.1002/cam4.3253.Epub 2020-07-09.

オランダ版エドモントン症状評価システムの検証

Validation of the Dutch version of the Edmonton Symptom Assessment System.

Frederieke H van der Baan
Josephine J Koldenhof
Ellen J de Nijs
Michael A Echteld
Danielle Zweers
Ginette M Hesselmann
Sigrid C Vervoort
Jan B Vos
Everlien de Graaf
Petronella O Witteveen
Karijn P Suijkerbuijk
Alexander de Graeff
Saskia C Teunissen

PMID: 32643871 DOI: 10.1002/cam4.3253.

抄録

背景:

Utrecht Symptom Diary（USD）は、Edmonton Symptom Assessment System（エドモントン症状評価システム）のオランダ語版であり、がん患者の症状を評価およびモニタリングするための患者報告アウトカム測定（PROM）ツールである。この研究では、USDの妥当性と反応性、および症状スコアの臨床的意義を決定するためのカットオフポイントを分析している。

BACKGROUND: The Utrecht Symptom Diary (USD) is a Dutch and adapted version of the Edmonton Symptom Assessment System, a patient-reported outcome measurement (PROM) tool to asses and monitor symptoms in cancer patients. This study analyses the validity and responsiveness of the USD and the cutoff points to determine the clinical significance of a symptom score.

方法:

METHODS: Observational longitudinal cohort study including adult in- and outpatients treated in an academic hospital in the Netherlands who completed at least one USD as part of routine care (2012-2019). The distress thermometer and problem checklist (DT&PC) was used as a reference PROM. Content, construct and criterion validity, responsiveness, and cutoff points are shown with prevalences, area under receiver operating characteristic (ROC) curve, Chi-squared test, Wilcoxon signed-rank test, and positive and negative predictive values, respectively.

結果:

RESULTS: A total of 3913 patients completed 22 400 USDs. Content validity was confirmed for all added USD items with prevalences of ≥22%. All USD items also present on the DT&PC demonstrated a good criterion validity (ROC >0.8). Construct validity was confirmed for the USD as a whole and for the items dry mouth, dysphagia and well-being (P < .0001). USD scores differed significantly for patients when improving or deteriorating on the DT&PC which confirmed responsiveness. Optimal cutoff points (3 or 4) differed per symptom.

結論:

USDは、がん患者に最も一般的な症状に対する有効な12項目のPROMであり、内容的妥当性、基準的妥当性および構成的妥当性を有し、治癒期および緩和期の両方において、時間の経過とともに臨床的に重要な変化を検出する。

CONCLUSION: The USD is a valid 12-item PROM for the most prevalent symptoms in cancer patients, which has content, criterion, and construct validity, and detects clinically important changes over time, in both curative and palliative phase.