The value of FACT-G in screening cancer patients for depression

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19557-19557
Author(s):  
S. Jang ◽  
J. Ackler ◽  
L. Braitman ◽  
W. Tester
Keyword(s):  
Major Depression ◽  
Cancer Patients ◽  
Strong Correlation ◽  
Screening Tool ◽  
Depression Scale ◽  
Screening Tools ◽  
Clinical Interviews ◽  
Total Score Range ◽  
Patient Responses ◽  
Chemotherapy Patients

19557 Background: The prevalence of depression in cancer patients varies greatly, reported in the range of 5–50% depending upon the population studied. Several tools have been used to screen for depression, but it remains uncertain which tool is most valuable. The Zung self-rating depression scale (ZSDS) is one of the commonly used screening tools for depression. Using a cutoff value of ≥ 40, one study reported sensitivity of 100% and specificity of 55% in diagnosing depression. This study was designed (1) to investigate the prevalence of major depression in our population of outpatients receiving chemotherapy, (2) to determine the correlation between the ZSDS score and Functional Assessment of Cancer Therapy - General version (FACT-G) score and (3) to examine whether statements from the FACT-G can be used as a screening tool for major depression. Methods: Sixty-two chemotherapy patients completed both ZSDS and FACT-G. Median age was 62 years (range 22–81); 55% were female. Patients with ZSDS scores ≥ 40 were interviewed, using standard DSM-IV criteria to evaluate for major depression. Pearson’s correlation was used to examine the correlation between ZSDS and FACT-G scores. We then analyzed responses to FACT-G statements to evaluate if certain questions from the FACT-G could be used as a screening tool for major depression. Results: Thirty patients had ZSDS score < 40, and were considered to not have major depression. Among the 32 patients with ZSDS score = 40, 30 underwent clinical interviews. Seven of these 30 were diagnosed with major depression. The prevalence of major depression was 7/60, or 12% (95% CI: 5% - 23%). The ZSDS score and FACT-G score had strong correlation (R= -0.75). If the total score (range 0–24) of six statements from FACT-G were ≤12, then these six FACT-G statements had sensitivity of 100% and specificity of 81% in predicting major depression. Conclusions: The prevalence of major depression was 12% in our population of chemotherapy patients. The ZSDS and FACT-G scores showed strong correlation. Patient responses to six selected statements from the FACT-G appear to be useful as a screening tool for depression. A confirmatory study with larger numbers of patients is planned. No significant financial relationships to disclose.

scholarly journals Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community-dwelling oldest-old sample: the Pietà Study

2017 ◽  
Vol 39 (4) ◽  
pp. 276-279 ◽  
Author(s):  
Filipi Leles da Costa Dias ◽  
Antônio Lúcio Teixeira ◽  
Henrique Cerqueira Guimarães ◽  
Maira Tonidandel Barbosa ◽  
Elisa de Paula França Resende ◽  
...  
Keyword(s):  
Major Depression ◽  
Screening Tool ◽  
Oldest Old ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Screening Tools ◽  
Elderly Subjects ◽  
Geriatric Depression ◽  
Psychiatric Interview

Abstract Introduction Late-life depression (LLD) is common, but remains underdiagnosed. Validated screening tools for use with the oldest-old in clinical practice are still lacking, particularly in developing countries. Objectives To evaluate the accuracy of a screening tool for LLD in a community-dwelling oldest-old sample. Methods We evaluated 457 community-dwelling elderly subjects, aged ≥75 years and without dementia, with the Geriatric Depression Scale (GDS-15). Depression diagnosis was established according to DSM-IV criteria following a structured psychiatric interview with the Mini International Neuropsychiatric Interview (MINI). Results Fifty-two individuals (11.4%) were diagnosed with major depression. The area under the receiver operating characteristic (ROC) curve was 0.908 (p<0.001). Using a cut-off score of 5/6 (not depressed/depressed), 84 (18.4%) subjects were considered depressed by the GDS-15 (kappa coefficient = 53.8%, p<0.001). The 4/5 cut-off point achieved the best combination of sensitivity (86.5%) and specificity (82.7%) (Youden's index = 0.692), with robust negative (0.9802) and reasonable positive predictive values (0.3819). Conclusion GDS-15 showed good accuracy as a screening tool for major depression in this community-based sample of low-educated oldest-old individuals. Our findings support the use of the 4/5 cut-off score, which showed the best diagnostic capacity.

scholarly journals The development of the visual screening tool for anxiety disorders and depression: Addressing barriers to screening for depression and anxiety disorders in hypertension and/or diabetes

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Zimbini Ogle ◽  
Liezl Koen ◽  
Dana J.H. Niehaus
Keyword(s):  
Anxiety Disorders ◽  
Screening Tool ◽  
Common Mental Disorders ◽  
Maternal Mental Health ◽  
Depression Scale ◽  
Screening Tools ◽  
Depression And Anxiety ◽  
Health Care Centre ◽  
Cross Sectional ◽  
Visual Screening

Background: There is a lack of screening tools for common mental disorders that can be applied across cultures, languages and levels of education in people with diabetes and hypertension. Aim: To develop a visual screening tool for depression and anxiety disorders that is applicable across cultures and levels of education. Setting: Participants were purposively recruited from two not-for-profit organisations and two public health facilities – a maternal mental health unit and a primary health care centre. Method: This was a qualitative cross-sectional study. Thirteen drawings based on the Hospital Anxiety and Depression Scale depicting symptoms of anxiety disorders and depression were drawn. Participants described emotions and thoughts depicted in the drawings. Data were analysed through content analysis. Results: Thirty-one women (66%) and 16 men (34%) participated in the development of the visual screening tool. The mean age was 34 (standard deviation [SD] 12.46). There were 32 (68%) black participants, 11 (23%) mixed race participants and 4 (9%) white participants. Two participants (4%) had no schooling, 14 (31%) primary schooling, 8 (18%) senior schooling, 13 (29%) matric qualification and 8 (18%) had post-matric qualification. Participants correctly described 10 out of the 13 visual depiction of symptoms as associated with depression and anxiety disorders, with no differences between levels of education and cultural groups. Conclusion: Ten drawings were appropriate for inclusion in the visual screening tool for anxiety disorders and depression (VISTAD). The VISTAD will be validated against the mini international neuropsychiatric interview (MINI) in a primary care population with hypertension and/or diabetes.

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

2018 ◽  
Vol 26 (3) ◽  
pp. 281-284 ◽  
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.

A Novel, Very Short Questionnaire As a Screening Tool For Depression

2016 ◽  
Vol 33 (S1) ◽  
pp. S423-S423
Author(s):  
K. Pękala ◽  
T. Sobow
Keyword(s):  
Major Depression ◽  
Screening Tool ◽  
Assessment Tools ◽  
Screening Tools ◽  
Depression Severity ◽  
Self Assessment ◽  
Functional Impact ◽  
Symptoms Of Depression ◽  
Icd 10 ◽  
Competing Interest

IntroductionSelf-assessment tools are frequently used as screening tools for depression. However, they are usually long and time-consuming.Aim of the studyTo assess specificity, sensitivity and overall accuracy of a novel, very short, 5 questions tool.Subjects and methodsThe questionnaire consists of 3 phenomenological (based on main symptoms of depression) and 2 questions to assess functional impact of the symptoms. One hundred and ninety patients diagnosed clinically as having major depression (according to ICD-10 criteria and with the help of MINI tool) filled the questionnaire in twice, during episode and remission.ResultsAt least two (out of three possible) “yes” answers to phenomenological questions and both two “yes” functional answers yielded 100% specificity (no person in remission). At least one “yes” answer to phenomenological questions and both “yes” answers to functional question yielded 82.8% specificity, 83.7% sensitivity and 83,3% overall accuracy. These results varied insignificantly in subgroups with different depression severity.ConclusionA short, 5-question questionnaire may be used as a screening tool for depression. Specificity, sensitivity and overall accuracy are above 80% largely independently of depression severity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The incidence of anxiety and depression in adult cancer outpatients in an area of social deprivation.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20709-e20709
Author(s):  
Hannah Louise Chapman ◽  
Lucinda Melcher ◽  
Justin Shute
Keyword(s):  
Cancer Patients ◽  
Screening Tool ◽  
Social Deprivation ◽  
Clinical Sample ◽  
Demographic Data ◽  
Depression Scale ◽  
University Hospital ◽  
Clinical Population ◽  
Anxiety And Depression ◽  
Sample Mean

e20709 Background: Psychological distress is common in cancer patients and negatively impacts patient quality of life. Untreated depression predicts early death in patients with advanced cancer. Anxiety and depression may be unrecognised in cancer patients as symptoms can be mistakenly attributed to the underlying malignancy. We assessed the incidence of anxiety and depression in patients attending two hospitals located in areas of significant social deprivation and ethnic diversity. Methods: Patients attending the oncology department at North Middlesex University Hospital and Princess Alexandra Hospital during a one week period were invited to complete a questionnaire. We collected socio-demographic data. The rest of the questionnaire consisted of the Hospital Anxiety and Depression Scale (HADS). HADS is a 14 question, validated screening tool. Total scores range from 0-42, but can be divided into two subscales: HADS-D for depression and HADS-A for anxiety. Interpretation is based primarily on cut-off scores suggested by the test’s authors. In a previously reported non-clinical sample, mean total HADS was 9.82, HADS-D 3.68 and HADS-A 6.14. Results: 96 patients completed the questionnaire. 64 out of 96 patients (67%) were aged between 50 and 79 years. The majority were of white UK ethnicity. The most common types of cancer were breast and colorectal. Seventy five patients (78%) had a ‘normal’ total HADS (≤14). The mean scores for total HADS, HADS-D and HADS-A were 10.53, 4.61 and 5.93, respectively. On the HADS-A subscale, 14 patients had mild anxiety, 12 had moderate and 2 patients had severe anxiety. Depression scores were slightly lower: 12 patients had mild depression and 4 had moderate depression. No patient had severe depression. Only 6 (6%) patients reported taking anti-depressant medication. Conclusions: We demonstrate lower levels of anxiety and depression in a mixed group of cancer patients than previously reported. We explore the possible causes for this difference. Thresholds set to identify ‘cases’ in a non-clinical population may be too high for cancer patients. HADS is a useful screening tool in oncology patients but should be combined with clinical assessment to improve sensitivity and specificity.

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

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.

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

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]

scholarly journals Validation of the PHQ-9 depression scale in Ethiopian cancer patients attending the oncology clinic at Tikur Anbessa specialized hospital

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mikyas Degefa ◽  
Benyam Dubale ◽  
Fikirte Bayouh ◽  
Biniyam Ayele ◽  
Yared Zewde
Keyword(s):  
Cancer Patients ◽  
Internal Consistency ◽  
Gold Standard ◽  
Screening Tool ◽  
Depression Scale ◽  
Area Under The Curve ◽  
Diagnostic Interview ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital

Abstract Background Although depression is highly prevalent among cancer patients, it is often underdiagnosed and poorly managed particularly in developing nations. These shortcomings can have substantial adverse effects not only on the disease prognosis but also on patients’ quality of life. The Patient Health Questionnaire-9 is a widely used depression screening tool but it has not been validated among patients with chronic illnesses such as cancer in Ethiopia. We aim to validate the PHQ-9 among Ethiopian cancer patients in an outpatient setting. Methods A cross-sectional study was conducted among cancer patients attending the oncology clinic at Tikur Anbessa Specialized Hospital (TASH). We assessed criterion validity and performance of the PHQ-9 test against the gold standard Mini-International Neuropsychiatric Interview (MINI) diagnostic tool among patients with cancer. The MINI was administered by psychiatric nurses who were blind to the initial PHQ-9 screening tool. Results A total of 163 patients completed the 2 stages of a diagnostic interview in the study. The majority (64%) of the participants were women, the mean age was 46 (13.5) years. Using the gold standard MINI test the prevalence of Major Depressive Episode (MDE) was 15%. The internal consistency (Cronbach’s α) for PHQ-9 was 0.78 suggesting good (acceptable) internal consistency for the reliability of the test scores. When the total PHQ-9 score was used to identify cases of MDE, the Area under the Curve (AUC) was 0.93 (95% confidence interval [CI], 0.88–0.97) on Receiver Operating Characteristic (ROC) analysis. This shows evidence for the excellent discriminating power of the PHQ-9 between cases and non-cases of MDE. At cutoff point ≥4, the PHQ-9 had a sensitivity of 88% and specificity of 78.1% on the ROC curve to detect MDE. Conclusion PHQ-9 is a reliable and valid instrument to detect MDE among individuals with chronic conditions such as cancer patients in outpatient settings and it can be used in resource-limited settings for early diagnosis and proper therapy of such patients.

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