Healthcare Provider Perspectives on Bipolar I Disorder Screening and the Rapid Mood Screener (RMS), a Pragmatic, New Tool

AbstractIntroductionAlthough mania is the hallmark symptom of bipolar I disorder (BD-I), most patients initially present for treatment with depressive symptoms. Misdiagnosis of BD-I as major depressive disorder (MDD) is common, potentially resulting in poor outcomes and inappropriate antidepressant monotherapy treatment. Screening patients with depressive symptoms is a practical strategy to help healthcare providers (HCPs) identify when additional assessment for BD-I is warranted. The new 6-item Rapid Mood Screener (RMS) is a pragmatic patient-reported BD-I screening tool that relies on easily understood terminology to screen for manic symptoms and other BD-I features in <2 minutes. The RMS was validated in an observational study in patients with clinically confirmed BD-I (n=67) or MDD (n=72). When 4 or more items were endorsed (“yes”), the sensitivity of the RMS for identifying patients with BP-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. To more thoroughly understand screening tool use among HCPs, a 10-minute survey was conducted.MethodsA nationwide sample of HCPs (N=200) was selected using multiple HCP panels; HCPs were asked to describe their opinions/current use of screening tools, assess the RMS, and evaluate the RMS versus the widely recognized Mood Disorder Questionnaire (MDQ). Results were reported by grouped specialties (primary care physicians, general nurse practitioners [NPs]/physician assistants [PAs], psychiatrists, and psychiatric NPs/PAs). Included HCPs were in practice <30 years, spent at least 75% of their time in clinical practice, saw at least 10 patients with depression per month, and diagnosed MDD or BD in at least 1 patient per month. Findings were reported using descriptive statistics; statistical significance was reported at the 95% confidence interval.ResultsAmong HCPs, 82% used a tool to screen for MDD, while 32% used a tool for BD. Screening tool attributes considered to be of the greatest value included sensitivity (68%), easy to answer questions (66%), specificity (65%), confidence in results (64%), and practicality (62%). Of HCPs familiar with screening tools, 70% thought the RMS was at least somewhat better than other screening tools. Most HCPs were aware of the MDQ (85%), but only 29% reported current use. Most HCPs (81%) preferred the RMS to the MDQ, and the RMS significantly outperformed the MDQ across valued attributes; 76% reported that they were likely to use the RMS to screen new patients with depressive symptoms. A total of 84% said the RMS would have a positive impact on their practice, with 46% saying they would screen more patients for bipolar disorder.DiscussionThe RMS was viewed positively by HCPs who participated in a brief survey. A large percentage of respondents preferred the RMS over the MDQ and indicated that they would use it in their practice. Collectively, responses indicated that the RMS is likely to have a positive impact on screening behavior.FundingAbbVie Inc.

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The Rapid Mood Screener: A Novel and Pragmatic Screener Tool for Bipolar I Disorder

CNS Spectrums ◽

10.1017/s1092852920002709 ◽

2021 ◽

Vol 26 (2) ◽

pp. 167-168

Author(s):

C. Brendan Montano ◽

Mehul Patel ◽

Rakesh Jain ◽

Prakash S. Masand ◽

Amanda Harrington ◽

...

Keyword(s):

Risk Factors ◽

Primary Care ◽

Health Outcomes ◽

Screening Tool ◽

Clinical Interview ◽

Clinical Practices ◽

Predictive Values ◽

Bipolar I Disorder ◽

Manic Symptoms ◽

Depressive Episodes

AbstractIntroductionApproximately 70% of patients with bipolar disorder (BPD) are initially misdiagnosed, resulting in significantly delayed diagnosis of 7–10 years on average. Misdiagnosis and diagnostic delay adversely affect health outcomes and lead to the use of inappropriate treatments. As depressive episodes and symptoms are the predominant symptom presentation in BPD, misdiagnosis as major depressive disorder (MDD) is common. Self-rated screening instruments for BPD exist but their length and reliance on past manic symptoms are barriers to implementation, especially in primary care settings where many of these patients initially present. We developed a brief, pragmatic bipolar I disorder (BPD-I) screening tool that not only screens for manic symptoms but also includes risk factors for BPD-I (eg, age of depression onset) to help clinicians reduce the misdiagnosis of BPD-I as MDD.MethodsExisting questionnaires and risk factors were identified through a targeted literature search; a multidisciplinary panel of experts participated in 2 modified Delphi panels to select concepts thought to differentiate BPD-I from MDD. Individuals with self-reported BPD-I or MDD participated in cognitive debriefing interviews (N=12) to test and refine item wording. A multisite, cross-sectional, observational study was conducted to evaluate the screening tool’s predictive validity. Participants with clinical interview-confirmed diagnoses of BPD-I or MDD completed a draft 10-item screening tool and additional questionnaires/questions. Different combinations of item sets with various item permutations (eg, number of depressive episodes, age of onset) were simultaneously tested. The final combination of items and thresholds was selected based on multiple considerations including clinical validity, optimization of sensitivity and specificity, and pragmatism.ResultsA total of 160 clinical interviews were conducted; 139 patients had clinical interview-confirmed BPD-I (n=67) or MDD (n=72). The screening tool was reduced from 10 to 6 items based on item-level analysis. When 4 items or more were endorsed (yes) in this analysis sample, the sensitivity of this tool for identifying patients with BPD-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. These properties represent an improvement over the Mood Disorder Questionnaire, while using >50% fewer items.ConclusionThis new 6-item BPD-I screening tool serves to differentiate BPD-I from MDD in patients with depressive symptoms. Use of this tool can provide real-world guidance to primary care practitioners on whether more comprehensive assessment for BPD-I is warranted. Use of a brief and valid tool provides an opportunity to reduce misdiagnosis, improve treatment selection, and enhance health outcomes in busy clinical practices.FundingAbbVie Inc.

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Comparison of Malnutrition Screening Tools for Use in Hospitalized Older Adults (OR36-02-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz035.or36-02-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Rachel Deer ◽

Mackenzie McCall ◽

Elena Volpi

Keyword(s):

Older Adults ◽

Elderly Patients ◽

Screening Tool ◽

Screening Tools ◽

Good Sensitivity ◽

Predictive Values ◽

Hospitalized Elderly ◽

Nrs 2002 ◽

Hospitalized Elderly Patients ◽

Hospitalized Older Adults

Abstract Objectives Malnutrition is a common problem in geriatric patients that often goes unrecognized. Undernutrition is a primary health concern for older adults due to associations with increased mortality, complications, and length of hospital stay. Yet, there is no consensus on which malnutrition screening tool should be used for hospitalized older adults. Therefore, the objective of this study was to determine which screening tool is best to rapidly detect malnutrition in hospitalized older adults so that patient outcomes may be improved. Methods Older adult patients (n = 211; ≥65 yrs old) were enrolled during acute hospitalization. Testing occurring within 72 hours of admission and included the following screening tools included: Malnutrition Screening Tool (MST), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening 2002 (NRS-2002), and Geriatric Nutritional Risk Index (GNRI). These screening tools were compared to a malnutrition diagnostic tool, the Subjective Global Assessment (SGA). Results According to SGA, 49% of patients were at risk of being malnourished. The other screening tools indicated a wide range of malnutrition prevalence, from 18% (MST) to 76% (MNA-SF). MST (93%) and MUST (92%) were highest in sensitivity. NRS-2002 had moderately good sensitivity (71%). MNA-SF and GNRI had poor sensitivity, eliminating them as good screening tools for hospitalized elderly patients. Of the remaining tools, NRS-2002 had the highest specificity (77%). MST and MUST had poor specificity (31%, 39%, respectively), eliminating them as good screening tools for hospitalized elderly patients. The remaining screening tool, NRS-2002, had moderately good positive and negative predictive values (76%, 72%, respectively). It also had the highest kappa (0.479). Overall, NRS-2002 had the best agreement to SGA and showed moderately good sensitivity, specificity and predictive values. Conclusions Our data suggests NRS-2002 is the best malnutrition screening tool for rapid detection of malnutrition in elderly hospitalized patients, when compared to the diagnostic tool, SGA. Future research is needed to determine which screening tool is most effective for use in different settings. Additional research can assist in standardizing malnutrition criteria and care processes. Funding Sources National Dairy Council, National Institutes of Health-National Center for Advancing Translational Sciences, and UTMB Claude D. Pepper OAIC. Supporting Tables, Images and/or Graphs

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Perioperative Nutritional Screening Tools Are Not Associated with Poor Outcomes After Musculoskeletal Trauma

Current Developments in Nutrition ◽

10.1093/cdn/nzaa055_021 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1136-1136

Author(s):

Aspen Miller ◽

John Davison ◽

Nathan Hendrickson ◽

Erin Wilson ◽

Natalie Glass ◽

...

Keyword(s):

Screening Tool ◽

Screening Method ◽

Screening Tools ◽

Nutritional Deficiencies ◽

Screening Methods ◽

Complication Rates ◽

Nutritional Screening ◽

Patient Reported ◽

Poor Outcomes ◽

Musculoskeletal Trauma

Abstract Objectives Malnutrition is predictive of poor outcomes after trauma. Side effects of both pain and narcotics often limit postoperative dietary intake increasing nutritional deficiencies and limiting wound healing. The purpose of this study was to compare the predictive ability of a dietician nutritional evaluation and a patient reported nutritional screening tool for post-operative complications after musculoskeletal trauma. Methods Adults with operative pelvis or long bone fractures were prospectively enrolled in a single-blinded RCT and included in this analysis. Subjects were evaluated with the Patient Generated Subjective Global Assessment (PG-SGA) survey at baseline. Dietician Nutritional Assessment Screening (NAS) was performed for patients ≥65 years with low Albumin or Vitamin D, or admitted to the ICU. Complication analysis included subjects having minimum 6-month follow-up and/or ≥1 complication within six months. Spearman's Correlation was used to evaluate agreement between screening methods. Comparison using X analysis was done of complications between pre-operative assignment of malnutrition for each screening tool. Results Agreement of NAS and self-reported PG-SGA for 265 subjects demonstrated a weak correlation of rho = 0.23, P = 0.0002. Neither screening method had significant correlation for rates of non-union, mortality, medical, or surgical complications between designations of malnutrition (all P > .05). Among study subjects, incidence of those having a medical or surgical complication not screened by a dietician was 31.3% and 37.7% respectively. Conclusions Results indicate inconsistency in methods for assigning malnutrition in trauma population. Additionally, designation of malnutrition by either method was not associated with post-operative complication rates. The high incidence of those with a complication who were not evaluated by a dietician during initial hospitalization (1/3rd) support the need to develop better methods for screening malnutrition after trauma. Funding Sources American Academy of Orthopaedic Surgeons, Board of Specialty Societies Quality and Patient Safety Action Fund.

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Linking reimbursement to patient-reported quality of life: Provider perspectives.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.75 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 75-75

Author(s):

Bruce A. Feinberg ◽

Yolaine Jeune-Smith ◽

Stephanie Fortier ◽

Ting-Chun Yeh ◽

Jonathan Kish ◽

...

Keyword(s):

Quality Of Life ◽

Nurse Practitioners ◽

Physician Assistants ◽

The United States ◽

Care Organization ◽

Psychosocial Needs ◽

Incentive Payment ◽

Provider Perspectives ◽

Patient Reported

75 Background: In the value-based era, policymakers have begun incorporating quality of life (QoL) components into payment models, such as the Merit-based Incentive Payment System (MIPs), Oncology Care Model (OCM), and Accountable Care Organization (ACO), to increase accountability. This qualitative research study sought to understand how providers address their patients’ QoL issues in a value-based environment. Methods: A live meeting in September 2019 brought together community oncology healthcare providers (HCPs) from across the United States. Participants submitted their demographic information via a web-based pre-meeting survey and their responses pertaining to patient QoL via an audience response system during the live meeting. Participant responses and their practice demographics were analyzed using descriptive statistics. Results: 71 HCPs participated in this live market research program: 51 medical oncologists/hematologists (herein referred to as physicians) and 20 nurse practitioners or physician assistants (herein referred to as APPs). 50% of physicians and 25% of APPs were from privately owned community practices. Half of HCPs indicated that their practices are collecting and reporting QoL data through value-based programs: 28% of physicians and 60% of APPs were in OCM-participating practices. Regarding accountability, over 80% of HCPs strongly agreed that they have a role in improving patients’ QoL. However, 32% of physicians and 25% of APPs agreed that their payment should be tied to patients’ QoL improvement. According to HCPs, the top factor impacting patients’ QoL was symptom and symptom burden (83%). To address QoL in their patients, HCPs reported addressing patients’ psychosocial needs (78%), implementing survivorship care planning (76%), and using nurse navigators (69%). 70% of physicians and 95% of APPs were confident that their patients have reliable resources for managing their QoL issues. Conclusions: HCPs recognize their role in improving patients’ QoL, and their practices have made several transformations to improve patients’ QoL; they are confident that their patients have resources for managing QoL issues. However, many HCPs disagree with linking QoL improvements to their payment. Further studies are needed to understand QoL from patients’ perspectives in the value-based environment.

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Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening

Journal of Clinical Medicine ◽

10.3390/jcm10020287 ◽

2021 ◽

Vol 10 (2) ◽

pp. 287

Author(s):

Caroline Sekundo ◽

Tobias Bölk ◽

Olivier Kalmus ◽

Stefan Listl

Keyword(s):

Diagnostic Accuracy ◽

Area Under The Curve ◽

German Society ◽

Screening Tools ◽

University Hospital ◽

Predictive Values ◽

Periodontal Inflammation ◽

Specificity And Sensitivity ◽

Patient Reported ◽

Sensitivity Specificity

Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76–0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥ 7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82–132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.

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Beck Depression Inventory as a screening tool for depression in chronic haemodialysis patients

Australasian Psychiatry ◽

10.1177/1039856218758582 ◽

2018 ◽

Vol 26 (3) ◽

pp. 281-284 ◽

Cited By ~ 6

Author(s):

Alison Bautovich ◽

Ivor Katz ◽

Colleen Ken Loo ◽

Samuel B Harvey

Keyword(s):

Chronic Kidney Disease ◽

Major Depression ◽

Beck Depression Inventory ◽

Screening Tool ◽

Diagnostic Interview ◽

Screening Tools ◽

Chronic Haemodialysis ◽

Predictive Values ◽

Dsm Iv ◽

Sensitivity Specificity

Objectives: To evaluate the psychometric properties of the Beck Depression Inventory (BDI) and Cognitive Depression Index (CDI) as a potential screening tool for major depression in haemodialysis (HD) patients. Methods: Forty-five HD patients completed both the BDI/CDI and diagnostic interview. The interview was conducted by two experienced clinicians and was based on DSM-IV criteria. The sensitivity, specificity and positive (PPV) and negative (NPV) predictive values were then calculated. Results: A diagnosis of depression was found in 6 of the 45 participants (13.3%). Optimal cut-offs were ≥18 for the BDI (sensitivity 1.0, specificity 0.90, PPV 0.60, NPV 1.0) and ≥11 for the CDI (sensitivity 1.0, specificity 0.92, PPV 0.67, NPV 1.0). Conclusions: Both the BDI and CDI were shown to be acceptable screening tools for depression in this population of chronic HD patients. The recommended cut-off scores for both scales are higher than those suggested for the general population and slightly higher than previously found in the chronic kidney disease literature, suggesting that altered thresholds are required when using these screening tools amongst HD patients.

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Abstract 68: Bedside Dysphagia Screening Tool Validation Study

Stroke ◽

10.1161/str.48.suppl_1.68 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Melissa M Meighan ◽

Barbara A Schumacher Finnegan ◽

Noelani C Warren ◽

Jorge Lipiz ◽

Mai N Nguyen-Huynh

Keyword(s):

Screening Tool ◽

High Sensitivity ◽

Stroke Care ◽

Feeding Tube ◽

Screening Tools ◽

Point Estimate ◽

Kappa Score ◽

Rater Reliability ◽

Predictive Values ◽

Speech Language Pathologist

Background: Dysphagia or difficulty swallowing occurs in up to 50% of patients with acute stroke symptoms. Dysphagia screening is considered standard stroke care. Few dysphagia screening tools have been well validated with high sensitivity and specificity. Purpose: The purpose was to validate our system’s dysphagia screening tool. Methods: From August 17, 2015 through September 30, 2015, bedside dysphagia screening was prospectively performed by 2 blinded nurses on all patients age ≥18 years admitted through the emergency department with stroke symptoms at 22 stroke centers in an integrated healthcare system. The tool consisted of three parts: history, physical exam and progressive testing from ice chips to water. A speech language pathologist blinded to the results performed an evaluation on the same patient. Patients with a feeding tube or intubation on arrival, treated with alteplase, or were discharged with a diagnosis other than stroke were excluded from final study analyses. The study quantified the reproducibility of the dysphagia screening tool by computing the percent agreement and kappa score for inter-rater reliability. Validity of dysphagia screening tool was determined using the speech pathologist evaluation as the reference standard. We assessed the sensitivity, specificity, and negative (NPV) and positive predictive values (PPV) for the dysphagia screening tool. The point estimate and 95% confidence interval (CI) were calculated. Results: Dysphagia screening was performed in 726 patients with stroke symptoms. There were 370 patients included in the analysis. Average age was 70 ± 14 years, and 48.2% female. Inter-rater reliability of the dysphagia screen was excellent between both raters at 93.5% agreement (k’= 0.83). The screen performed well when compared to speech language pathologist evaluation, demonstrating both high sensitivity (86.4%, CI: 73.3% to 93.6%) and high NPV (93.6%, CI: 86.8% to 97.0%). Conclusion: Our bedside dysphagia screening tool is highly reliable and valid. The tool had been used in over thirty-five facilities since 2007. The hospital acquired pneumonia rate for ischemic stroke patients has averaged 2-3% a year. This dysphagia screening tool requires minimal training and is easily administered in a timely manner.

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Omitting the First Step of GLIM Framework Yielded Better Accordance With PG-SGA in Chinese Ambulatory Cancer Patients: a Prospective Cross-sectional Study

10.21203/rs.3.rs-1013336/v1 ◽

2021 ◽

Author(s):

Yanfei Wang ◽

Ziqi Liu ◽

yunyi Wang ◽

Xiaoyan Chen ◽

Zhongfen Liu ◽

...

Keyword(s):

Cancer Patients ◽

Screening Tool ◽

Cross Sectional Study ◽

Screening Tools ◽

Nutritional Risk ◽

Severe Malnutrition ◽

Sectional Study ◽

Cross Sectional ◽

Nutrition Screening ◽

Predictive Values

Abstract Background and Aims: The Global Leadership Initiative on Malnutrition (GLIM) criteria is a new framework for diagnosing malnutrition in combination of phenotypic and etiologic criteria after nutrition screening using validated screening tools. The aim of this study was to evaluate the efficacy of malnutrition screening tool (MST), malnutrition universal screening tool (MUST) and nutritional risk screening 2002 (NRS2002) as the first step of GLIM framework in comparison to Patients-Generated Subjective Global Assessment (PG-SGA) in Chinese ambulatory cancer patients.Methods: A single-center prospective cross-sectional study was conducted. Nutritional screening and assessment were performed within 4h after admission to the hospital using a structured questionnaire including MST, MUST, NRS2002, PG-SGA and GLIM, with supplement information of calf circumference (CC) measurement and body composition measurement using bioelectrical impedance analysis (BIA). Malnutrition diagnosis made by GLIM framework using MST, MUST or NRS2002 as the first step or without screening step were compared to PG-SGA separately. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and κ values were used to evaluate performance of the screening tools.Results: Of the 562 included patients, Of the participants 62.8% (355/562) were male and 37.2% (210/562) were female, with a male to female radio of 1.69:1. The median age of the patients was 59.0 years (range, 21-82y; interquels range 52.0-65.0y). From the 562 patients included in the study, 41.8% of patients were evaluated as malnutrition (PG-SGA≥4) and 11.9% were diagnosed as severe malnutrition (PG-SGA D). For GLIM criteria, omitting the screening step yielded fair accordance with PG-SGA in diagnosing malnutrition (κ=0.623) and severe malnutrition (κ=0.515). Using MUST as the first step of GLIM framework has better performance (κ=0.614; κ=0.515) than using MST (κ=0.504, κ=0.496) or NRS2002 (κ=0.363, κ=0.503) as the screening tool regardless of severity gradings.Conclusions: Using PG-SGA as the standard, GLIM framework omitting first step has better performance compared with using MST, MUST or NRS2002 as the screening tool. Among the screening tools validated to be used in the first step of GLIM framework, MUST may be the better choice for ambulatory cancer patients.

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The performance of the EQ-5D-3L in screening for anxiety and depressive symptoms in hospital and community settings

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01731-x ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Hilary Short ◽

Fatima Al Sayah ◽

Arto Ohinmaa ◽

Jeffrey A. Johnson

Keyword(s):

Depressive Symptoms ◽

Community Setting ◽

Anxiety Symptoms ◽

Self Report ◽

Screening Tools ◽

Receiver Operating Curve ◽

Community Settings ◽

Post Discharge ◽

Patient Reported ◽

Anxiety Depression

Abstract Background To examine the performance of the EQ-5D-3L in screening for anxiety and depressive symptoms in hospital and community settings compared to other patient-reported screening tools. Methods Data from a prospective cohort of patients discharged from general internal medicine wards from two hospitals in Edmonton, Alberta were used in this study. Two waves of measurements (discharge and 90-days post-discharge) were analyzed. The performance of the EQ-5D-3L was compared to other self-report screening tools: Generalized Anxiety Disorder 2-item questionnaire was used to categorize anxiety symptoms into absent (< 3) and present (≥ 3), and the Patient Health Questionnaire 9-items was used to categorize depressive symptoms by two severity cut-points: no (< 10) vs. mild (≥ 10), and no (< 15) vs. moderate-severe (≥ 15). Performance of EQ-5D-3L in screening for anxiety and depressive symptoms was evaluated using receiver operating curve (ROC) analysis. Results Average age of participants (n = 493) was 62.9 years (SD 18.6); 51% were female. At discharge, 30.0% screened positive for mild and 12.8% for moderate-severe depressive symptoms, while 27.6% screened positive for anxiety symptoms. For co-morbid symptoms, 17.1% screened positive for anxiety and any depressive symptoms, while 10.8% for anxiety and moderate-severe depressive symptoms. While the EQ-5D-3L had limited screening ability in hospital, the anxiety/depression dimension performed well in the community setting (90-days post-discharge) in screening for anxiety (area under ROC 0.79), depressive symptoms (any: 0.78, moderate-severe: 0.84), and a combination of both (any: 0.86; moderate-severe: 0.91). Conclusions The EQ-5D-3L anxiety/depression dimension could be a useful tool in screening for anxiety and depressive symptoms in community settings compared to other self-report screening tools. The usefulness of the EQ-5D-3L as a screening tool in other settings and populations is warranted.

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Correlates of distress for cancer patients: Results from multi-institution use of holistic patient-reported screening tool.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.11587 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 11587-11587

Author(s):

Christine B. Weldon ◽

James I. Gerhart ◽

Frank J. Penedo ◽

Paramjeet Khosla ◽

Betty Roggenkamp ◽

...

Keyword(s):

Supportive Care ◽

Physical Function ◽

Cancer Patients ◽

Screening Tool ◽

Screening Tools ◽

Distress Screening ◽

Age Related ◽

Distress Score ◽

Patient Reported ◽

Chi Squared

11587 Background: The Commission on Cancer (CoC) Standard 3.2 requires distress screening and indicated action for cancer patients. NCCN and ASCO supportive care and age-related guidelines include patient reported concerns beyond distress. This study compares PHQ4 scores to other patient reported concerns. Methods: The Coleman Supportive Oncology Collaborative aggregated “best of” screening tools to assess patient reported needs and concerns aligned with CoC, NCCN and ASCO guidance. This supportive care screening tool was implemented at 8 sites from July 2015 thru July 2018. Analysis used chi squared test. Results: Most patients, 86% (10,635/12,295), reported one plus concerns and/or above threshold scores on PHQ4, PROMIS Pain, Fatigue or Physical Function. A chi squared comparison of patients with at least mild distress on PHQ4 to patients with no distress resulted in p values < .0001 for every screening category. Conclusions: Patients with a PHQ4 distress score of mild, moderate or severe also reported statistically significant levels of practical, family, physical, nutrition and treatment concerns. These patients also scored threshold levels for PROMIS Pain, Fatigue, and Physical Function. Screening only for distress without screening for other patient concerns may direct patients to services that do not address or focus on the underlying cause of the distress. [Table: see text]

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