Journal
JOURNAL OF ONCOLOGY PRACTICE
Volume 10, Issue 2, Pages E95-E102Publisher
AMER SOC CLINICAL ONCOLOGY
DOI: 10.1200/JOP.2013.001112
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Funding
- National Cancer Institute [CA026582, CA090966]
- MD Anderson Cancer Center Support [CA016672]
- Hawn Foundation
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Purpose: Depression is a significant concern in outpatient oncology care, yet clinicians face practical challenges in accurately and efficiently screening patients for it. This study investigated whether a single item or multiple items from an existing multisymptom scale, the MD Anderson Symptom Inventory (MDASI), might serve as effective initial screens for depressed mood. Methods: Data were collected from two cohorts of patients. Cohort 1 comprised 187 patients with non-small-cell lung cancer who completed the Beck Depression Inventory II; cohort 2 comprised 281 patients with renal cell carcinoma who completed the Center for Epidemiologic Studies Depression Scale. All patients completed the MDASI. Single-item and multiple-item MDASI solutions were identified using cohort 1 and validated in cohort 2. Sensitivity and specificity of the solutions were as-sessed through binary linear regression; cut points were identified using receiver operating characteristic analysis. Results: The MDASI single item sadness was the best solution identified in cohort 1 for screening for depressed mood relative to other affective items (distress, enjoyment of life, mood). At a cut point >= 4 (0 to 10 scale), the sadness item exhibited a clinically acceptable specificity of 81.5%, sensitivity of 72.0%, a negative predictive value of 95.0%, and a positive predictive value of 37.5%. This solution was successfully validated in cohort 2. Conclusion: The MDASI sadness item has modest sensitivity and high negative predictive value and can serve as a useful initial screen for depressed mood. This approach may improve the efficiency and acceptability of depression screening for both clinicians and patients.
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