Accuracy of the Distress Thermometer for home care patients with palliative care needs in Germany

Wüller, Johannes; Küttner, Stefanie; Foldenauer, Ann Christina; Rolke, Roman; Pastrana, Tania

doi:10.1017/s1478951516000699

Cited by 13 publications

(21 citation statements)

References 21 publications

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“…ROC curve analysis showed that the AUC was 0.757, which indicated a fair accuracy. This result was in agreement with some previous reports (eg, Shim et al: 0.75; Wuller et al: 0.70). Against the HADS cutoff of 15 as the standard, a cutoff score of 5 yielded optimal sensitivity of 86.1% and specificity of 53.1% among cancer pain inpatients with PPV 0.736 and NPV 0.715.…”

Section: Discussionsupporting

confidence: 94%

“…Against the HADS cutoff of 15 as the standard, a cutoff score of 5 yielded optimal sensitivity of 86.1% and specificity of 53.1% among cancer pain inpatients with PPV 0.736 and NPV 0.715. This specificity was higher than some previous studies: Ozalp et al: 49%, Wuller et al: 34.4%, but lower than most previous studies: Wang, et al: 86.9%, Deng et al: 85%, Tang et al: 69.9%, Jacobsen et al: 68%, and Shim et al: 59%. Differences in study methodology or culture may contribute to these discrepancies.…”

Section: Discussioncontrasting

confidence: 61%

“…Furthermore, HADS total score was strongly correlated with the pain degree. Some studies have found that patients with “advanced disease” were more likely to suffer DT and HADS total distress . But more notable in advanced cancer sample is that the high levels of psychological distress were related to more severe pain …”

Section: Discussionmentioning

confidence: 97%

“…The reliability and validity of the Chinese version has been proved . Validation of the DT versus HADS has been conducted several times, most studies have shown that a total score of 15 was the optimal cutoff score for screening distress …”

Section: Methodsmentioning

confidence: 99%

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The use of distress thermometer in advanced cancer inpatients with pain

et al. 2019

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Objective: This study aimed to provide support for the extensive application of Distress Thermometer (DT) in advanced cancer inpatients with pain and explored factors associated with high DT scores among this population. Methods: Advanced cancer patients with pain were recruited from Department of Pain Relief in Tianjin Cancer Hospital and Institute, China. They completed the DT with problems list and HADS within 48 h after admission. The cutoff score of DT was evaluated against Hospital Anxiety and Depression Scale (HADS) for its sensitivity and specificity by using receiver operating characteristic (ROC) curves. Multiple logistic regression model analysis was performed to investigate correlates of DT scores.Results: Four hundred forty one inpatients with mixed diagnoses were recruited.Referring to the cutoff of 15 on HADS, DT cutoff score of 5 yielded AUC of 0.757, with an optimal sensitivity of 0.861 and specificity of 0.531. Using the cutoff scores of greater than or equal to 5, 70.5% of the patients were distressed. Logistic regression analysis of DT found that the breakthrough pain, poorer KPS, higher pain degree, and emotional problems were the predictive factor for current distress.Conclusion: DT is efficacious in screening for psychological distress in advanced cancer inpatients with pain. Psychological distress is prevalent with a cutoff score of greater than or equal to five. To better identify the distressed cancer patients with pain, pain degree, performance status, and emotional problems should be considered together.

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Section: Discussionsupporting

confidence: 94%

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

The use of distress thermometer in advanced cancer inpatients with pain

et al. 2019

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“…There is acknowledged variation in Distress Thermometer clinical cut-offs according to instrument language, country, clinical population and setting, and therefore a need for revalidation in new populations. 21 A potential limitation of existing validation studies is that three 23,24,26 have derived data from either heterogeneous clinical populations of both patients with malignant and non-malignant disease 24,26 or across settings, for example, acute hospital and inpatient hospice units. 23 The other existing study 25 included a more homogenous sample of patients with advanced cancer with pain but in an acute hospital setting.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Distress Thermometer in patients with advanced cancer receiving specialist palliative care in a hospice setting

et al. 2020

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Background: Ongoing assessment of psychological reaction to illness in palliative and end of life care settings is recommended, yet validated tools are not routinely used in clinical practice. The Distress Thermometer is a short screening tool developed for use in oncology, to detect individuals who would benefit from further psychological assessment. However the optimal cut-off to detect indicative psychological morbidity in patients with advanced cancer receiving specialist palliative care is unclear. Aim: To provide the first validation of the Distress Thermometer in an advanced cancer population receiving specialist palliative care in a UK hospice setting. Design: Receiver Operating Characteristics analysis was used to compare the sensitivity and specificity of cut-offs indicative of psychological morbidity on the Distress Thermometer in comparison to the Hospital Anxiety and Depression Scale. Setting/Participants: Data were derived from 202 patients with advanced cancer who were approached on admission to inpatient or day hospice care, with 139 patients providing complete data on both measures. Results: The area under the curve was optimal using a Distress Thermometer cut-off score of ⩾6 for total distress and for anxiety, and a cut-off score of ⩾4 optimal when screening for depression. Conclusions: The Distress Thermometer is a valid, accurate screening tool to be used in advanced cancer but with caution in relation to the lack of specificity. With little variation between the area under the curve scores, arguably a Distress Thermometer cut-off score of ⩾5 is most appropriate in screening for all types of psychological morbidity if sensitivity is to be prioritised.

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A systematic review of the translation and validation methods used for the national comprehensive cancer network distress thermometer in non‐English speaking countries

et al. 2022

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Objective The National Comprehensive Cancer Network (NCCN) distress thermometer (DT) was developed as a brief screening tool for detecting distress in cancer patients. Conceptually, distress was considered a more acceptable and inclusive term than other psychological terms such as depression or anxiety. It is used extensively in the United States and other English‐speaking countries. We aim to describe the translation and validation methods of the DT and describe the recommended cutoff scores used to identify cancer patients experiencing clinically significant distress. Methods Nine bibliographic databases were searched using keywords to identify original research studies for non‐English speaking countries' cancer patients. Full articles were independently assessed for inclusion and data extraction by two authors. Results The review of 4442 articles yielded 39 articles that validated the DT. We identified 20 languages in 25 countries. In all but one country, investigators were able to agree upon a word or phrase that meant distress in their native language that was subsequently validated against standardized instruments. Asian, Middle Eastern and European counties recommended cutoff score of 4 or 5 to identify clinically significant distress; however, European Union countries had a range of 2 to 7. Conclusions Use of the translated DT with non‐English speaking cancer patients provides a simple and quick tool to identify high distress. Similar to NCCN, the cutoff score of 4 or 5 was suggested by 78% of the studies; however, more studies of different types of cancer and within and among more countries will strengthen a recommended global DT cutoff score.

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Accuracy of the Distress Thermometer for home care patients with palliative care needs in Germany

Cited by 13 publications

References 21 publications

The use of distress thermometer in advanced cancer inpatients with pain

The use of distress thermometer in advanced cancer inpatients with pain

Validation of the Distress Thermometer in patients with advanced cancer receiving specialist palliative care in a hospice setting

A systematic review of the translation and validation methods used for the national comprehensive cancer network distress thermometer in non‐English speaking countries

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