Establishing Mild, Moderate, and Severe Scores for Cancer-Related Symptoms

How Consistent and Clinically Meaningful Are Interference-Based Severity Cut-Points?

Barbara Given, Charles W. Given, Alla Sikorskii, Sangchoon Jeon, Ruth McCorkle, Victoria Champion, David Decker

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Methods are presented to separate 16 frequently occurring cancer symptoms measured on 10-point symptom severity rating scales into mild, moderate, and severe categories that are clinically interpretable and significant for use in oncology practice settings. At their initial intervention contact, 588 solid tumor cancer patients undergoing chemotherapy reported severity on a standard 11-point rating scale for 16 symptoms. All reporting a one or higher were asked to rate on an 11-point scale how much the symptom interfered with enjoyment of life, relationship with others, general daily activities, and emotions. Factor analysis revealed that these items tapped into the same dimension, and the items were summed to form an interference scale. Cut-points for mild, moderate, and severe categories of symptom severity were defined by comparing the differences in interference scores corresponding to each successive increases in severity for each symptom. The cut-points differed among symptoms. Pain, fatigue, weakness, cough, difficulty remembering, and depression had lower cut-points for each category compared to other symptoms. Cut-points for each symptom were not related to site or stage of cancer, age, or gender but were associated with a global depression measure. Cut-points were related to limitations in physical function, suggesting differences in the quality of patients' lives. The resulting cut-points summarize severity ratings into clinically significant and useful categories that clinicians can use to assess symptoms in their practices.

Original languageEnglish (US)
Pages (from-to)126-135
Number of pages10
JournalJournal of Pain and Symptom Management
Volume35
Issue number2
DOIs
StatePublished - Feb 2008

Fingerprint

Neoplasms
Depression
Cough
Statistical Factor Analysis
Fatigue
Emotions
Drug Therapy
Pain

Keywords

  • symptom measures
  • Symptom severity cut-points
  • symptoms and quality of life

ASJC Scopus subject areas

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

Cite this

Establishing Mild, Moderate, and Severe Scores for Cancer-Related Symptoms : How Consistent and Clinically Meaningful Are Interference-Based Severity Cut-Points? / Given, Barbara; Given, Charles W.; Sikorskii, Alla; Jeon, Sangchoon; McCorkle, Ruth; Champion, Victoria; Decker, David.

In: Journal of Pain and Symptom Management, Vol. 35, No. 2, 02.2008, p. 126-135.

Research output: Contribution to journalArticle

Given, Barbara ; Given, Charles W. ; Sikorskii, Alla ; Jeon, Sangchoon ; McCorkle, Ruth ; Champion, Victoria ; Decker, David. / Establishing Mild, Moderate, and Severe Scores for Cancer-Related Symptoms : How Consistent and Clinically Meaningful Are Interference-Based Severity Cut-Points?. In: Journal of Pain and Symptom Management. 2008 ; Vol. 35, No. 2. pp. 126-135.
@article{b6a89ffe2ea243928afeb72c7907fb6c,
title = "Establishing Mild, Moderate, and Severe Scores for Cancer-Related Symptoms: How Consistent and Clinically Meaningful Are Interference-Based Severity Cut-Points?",
abstract = "Methods are presented to separate 16 frequently occurring cancer symptoms measured on 10-point symptom severity rating scales into mild, moderate, and severe categories that are clinically interpretable and significant for use in oncology practice settings. At their initial intervention contact, 588 solid tumor cancer patients undergoing chemotherapy reported severity on a standard 11-point rating scale for 16 symptoms. All reporting a one or higher were asked to rate on an 11-point scale how much the symptom interfered with enjoyment of life, relationship with others, general daily activities, and emotions. Factor analysis revealed that these items tapped into the same dimension, and the items were summed to form an interference scale. Cut-points for mild, moderate, and severe categories of symptom severity were defined by comparing the differences in interference scores corresponding to each successive increases in severity for each symptom. The cut-points differed among symptoms. Pain, fatigue, weakness, cough, difficulty remembering, and depression had lower cut-points for each category compared to other symptoms. Cut-points for each symptom were not related to site or stage of cancer, age, or gender but were associated with a global depression measure. Cut-points were related to limitations in physical function, suggesting differences in the quality of patients' lives. The resulting cut-points summarize severity ratings into clinically significant and useful categories that clinicians can use to assess symptoms in their practices.",
keywords = "symptom measures, Symptom severity cut-points, symptoms and quality of life",
author = "Barbara Given and Given, {Charles W.} and Alla Sikorskii and Sangchoon Jeon and Ruth McCorkle and Victoria Champion and David Decker",
year = "2008",
month = "2",
doi = "10.1016/j.jpainsymman.2007.03.012",
language = "English (US)",
volume = "35",
pages = "126--135",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Establishing Mild, Moderate, and Severe Scores for Cancer-Related Symptoms

T2 - How Consistent and Clinically Meaningful Are Interference-Based Severity Cut-Points?

AU - Given, Barbara

AU - Given, Charles W.

AU - Sikorskii, Alla

AU - Jeon, Sangchoon

AU - McCorkle, Ruth

AU - Champion, Victoria

AU - Decker, David

PY - 2008/2

Y1 - 2008/2

N2 - Methods are presented to separate 16 frequently occurring cancer symptoms measured on 10-point symptom severity rating scales into mild, moderate, and severe categories that are clinically interpretable and significant for use in oncology practice settings. At their initial intervention contact, 588 solid tumor cancer patients undergoing chemotherapy reported severity on a standard 11-point rating scale for 16 symptoms. All reporting a one or higher were asked to rate on an 11-point scale how much the symptom interfered with enjoyment of life, relationship with others, general daily activities, and emotions. Factor analysis revealed that these items tapped into the same dimension, and the items were summed to form an interference scale. Cut-points for mild, moderate, and severe categories of symptom severity were defined by comparing the differences in interference scores corresponding to each successive increases in severity for each symptom. The cut-points differed among symptoms. Pain, fatigue, weakness, cough, difficulty remembering, and depression had lower cut-points for each category compared to other symptoms. Cut-points for each symptom were not related to site or stage of cancer, age, or gender but were associated with a global depression measure. Cut-points were related to limitations in physical function, suggesting differences in the quality of patients' lives. The resulting cut-points summarize severity ratings into clinically significant and useful categories that clinicians can use to assess symptoms in their practices.

AB - Methods are presented to separate 16 frequently occurring cancer symptoms measured on 10-point symptom severity rating scales into mild, moderate, and severe categories that are clinically interpretable and significant for use in oncology practice settings. At their initial intervention contact, 588 solid tumor cancer patients undergoing chemotherapy reported severity on a standard 11-point rating scale for 16 symptoms. All reporting a one or higher were asked to rate on an 11-point scale how much the symptom interfered with enjoyment of life, relationship with others, general daily activities, and emotions. Factor analysis revealed that these items tapped into the same dimension, and the items were summed to form an interference scale. Cut-points for mild, moderate, and severe categories of symptom severity were defined by comparing the differences in interference scores corresponding to each successive increases in severity for each symptom. The cut-points differed among symptoms. Pain, fatigue, weakness, cough, difficulty remembering, and depression had lower cut-points for each category compared to other symptoms. Cut-points for each symptom were not related to site or stage of cancer, age, or gender but were associated with a global depression measure. Cut-points were related to limitations in physical function, suggesting differences in the quality of patients' lives. The resulting cut-points summarize severity ratings into clinically significant and useful categories that clinicians can use to assess symptoms in their practices.

KW - symptom measures

KW - Symptom severity cut-points

KW - symptoms and quality of life

UR - http://www.scopus.com/inward/record.url?scp=38349093035&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38349093035&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2007.03.012

DO - 10.1016/j.jpainsymman.2007.03.012

M3 - Article

VL - 35

SP - 126

EP - 135

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

IS - 2

ER -