Establishing Cutoff Points for Defining Symptom Severity Using the Edmonton Symptom Assessment System-Revised Japanese Version

Takashi Yamaguchi, Tatsuya Morita, Akihiro Nitto, Naoko Takahashi, Shingo Miyamoto, Hiroyuki Nishie, Junji Matsuoka, Hiroki Sakurai, Tatsuhiko Ishihara, Yoko Tarumi, Asao Ogawa

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Context Symptom screening is important for appropriate symptom management. It remains uncertain as to which scores on the Edmonton Symptom Assessment System-Revised (ESAS-r) comprise the optimal cutoff points to determine symptom severity for Japanese cancer patients. Objectives To investigate optimal cutoff points for individual ESAS-r items for detecting symptom severity and to evaluate the screening performance of the ESAS-r depression item in Japanese cancer patients. Methods We recruited cancer patients receiving palliative care from five tertiary acute hospitals in Japan. We asked participants to complete the ESAS-r Japanese version, Verbal Rating Symptom Severity Scale, and Quick Inventory of Depressive Symptomatology-Self-Report Japanese version. We calculated sensitivity and specificity for detecting severe and moderate/severe symptoms evaluated by the Verbal Rating Symptom Severity Scale at different cutoff points of the ESAS-r. We also calculated sensitivity and specificity for detecting both the presence of depression and moderate/severe depression evaluated by the Quick Inventory of Depressive Symptomatology-Self-Report at various cutoff points for the depression item of the ESAS-r Japanese version. Results A total of 292 participants completed the questionnaire. For most of the ESAS-r symptoms, cutoff points to achieve the best balance between sensitivity and specificity were 5-7 for determining severe intensity and 3-4 for determining moderate/severe intensity. For the ESAS-r depression item, a cutoff point of 2 achieved the best balance between sensitivity and specificity for detecting both the presence of depression and moderate/severe depression. Conclusion The ESAS-r Japanese version can accurately represent the severity of many symptoms. The cutoff points established for determining the level of symptom severity using ESAS-r provides a guide for symptom management in Japanese cancer patients.

Original languageEnglish
Pages (from-to)292-297
Number of pages6
JournalJournal of Pain and Symptom Management
Volume51
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

Keywords

  • Edmonton Symptom Assessment System
  • cancer
  • cutoff point
  • depression
  • symptom severity

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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    Yamaguchi, T., Morita, T., Nitto, A., Takahashi, N., Miyamoto, S., Nishie, H., Matsuoka, J., Sakurai, H., Ishihara, T., Tarumi, Y., & Ogawa, A. (2016). Establishing Cutoff Points for Defining Symptom Severity Using the Edmonton Symptom Assessment System-Revised Japanese Version. Journal of Pain and Symptom Management, 51(2), 292-297. https://doi.org/10.1016/j.jpainsymman.2015.09.011