Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T07:05:45.457Z Has data issue: false hasContentIssue false
  • English
  • Français

A chart review, pilot study of two single-item screens to detect cancer patients at risk for cachexia

Published online by Cambridge University Press:  01 December 2003

KENNETH L. KIRSH, ,
CHRISTINE DUGAN ,
DALE E. THEOBALD  and
STEVEN D. PASSIK
KENNETH L. KIRSH,
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
CHRISTINE DUGAN
Affiliation:
Quality of Life Program, Community Cancer Care, Indianapolis, Indiana
DALE E. THEOBALD
Affiliation:
Quality of Life Program, Community Cancer Care, Indianapolis, Indiana
STEVEN D. PASSIK
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: Cachexia is a problematic wasting syndrome experienced by some cancer patients that can lead to early death in these patients. The purpose of the present study was to examine the criterion validity and sensitivity and specificity of two single items from a depression scale to rapidly screen patients in ambulatory oncology clinics for cancer-related nutritional risk and cachexia.

Methods: A chart review was conducted of 50 randomly selected patient profiles. Patients' responses to item 5 (“I eat as much as I used to”) and item 7 (“I notice I am losing weight”) of the Zung Self Rating Depression Scale (ZSDS) were compared against the Scored Patient-Generated Subjective Global Assessment (PG-SGA) as well as to Body Mass Index (BMI) scores and weight at two time periods.

Results: Item 5 of the ZSDS was significantly related to initial weight (F3,45 = 6.06, p < 0.001), weight at 6-month follow-up (F3,27 = 4.16, p < 0.05), BMI score (F3,46 = 2.89, p < 0.05), and nutritional risk on the PG-SGA (F3,45 = 5.80, p < 0.01). Item 7 of the ZSDS was only a significant predictor of nutritional risk as measured by the PG-SGA (F3,46 = 6.01, p < 0.01). When the two items were combined to form a two-item scale, it maintained the individual items' significant relationship to the PG-SGA (F1,48 = 13.99, p < 0.001). Using this as the criterion for identifying nutritionally at-risk patients, the two-item screen yields a sensitivity of 50% and specificity of 88%.

Significance of the research: It is concluded that a single item or a combination of two items can yield a reliable initial screen for identifying patients who might be at nutritional risk for the development of cachexia. Further study is needed in prospective trials to further explore the utility of these items.

Keywords

CancerCachexiaNutritionAssessment
Type
Research Article
Information
Palliative & Supportive Care , Volume 1 , Issue 4 , December 2003 , pp. 331 - 335
Copyright
© 2003 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bray, G.A. & Gray, D.S. (1988). Obesity, part i: Pathogenesis. Western Journal of Medicine, 149, 429–441.Google Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.Google Scholar
Dugan, W., McDonald, M., Passik, & S., et al. (1998). Use of the Zung Self-Rating Depression Scale in cancer patients: Feasibility as a screening tool. Psycho-Oncology, 7, 483–493.Google Scholar
Fearon, K.C. & Moses, A.G. (2002). Cancer cachexia. International Journal of Cardiology, 85, 73–81.Google Scholar
Gabrys, J. & Peters, K. (1985). Reliability, discriminant and predictive validity of the zung self-rating depression scale. Psychological Reports, 57, 1091–1096.Google Scholar
Inui, A. (1999). Cancer anorexia-cachexia syndrome: Are neuropeptides the key? Cancer Research, 59, 4493–4501.Google Scholar
Kern, K.A. & Norton, J.A. (1988). Cancer cachexia. JPEN: Journal of Parenteral and Enteral Nutrition, 12, 286–298.Google Scholar
Kibiger, G., Kirsh, K.L., Wall, & J., et al. (2003). My mind is as clear as it used to be: A pilot study illustrating the difficulties of employing a single item subjective screen to detect cognitive impairment in outpatients with cancer. Journal of Pain and Symptom Management, 26, 705–715.Google Scholar
Kirsh, K.L., Passik, S.D., Holtsclaw, & E., et al. (2001). I get tired for no reason: A single item screening for cancer related fatigue. Journal of Pain and Symptom Management, 22, 931–937.Google Scholar
Ottery, F.D. (1994). Cancer cachexia: Prevention, early diagnosis, and management. Cancer Practice, 2, 123–131.Google Scholar
Passik, S.D., Whitcomb, L.A., Kirsh, & K.L., et al. (2003). An unsuccessful attempt to develop a single item screen for insomnia in cancer patients. Journal of Pain and Symptom Management, 25, 284–287.Google Scholar
Tate, D., Forchheimer, M., Maynard, & F., et al. (1993). Comparing two measures of depression in spinal cord injury. Rehabilitation Psychology, 38, 53–61.Google Scholar
Weisman, A. & Worden, J. (1976). The essential plight in cancer: Significance of the first 100 days. International Journal of Psychiatry in Medicine, 7, 1–15.Google Scholar
Zabora, J. (1998). Screening procedures for psychosocial distress. In Psycho-oncology, Holland, J. (ed.). New York: Oxford University Press.
Zung, W. (1967a). Depression in the normal aged. Psychosomatics, 7, 287–292.Google Scholar
Zung, W. (1967b). Factors influencing the self-rating depression scale. Archives of General Psychiatry, 16, 543–547.Google Scholar