TY - JOUR
T1 - Screening for depressed mood in patients with cancer using the MD Anderson Symptom inventory
T2 - Investigation of a practical approach for the oncologist
AU - Jones, Desiree
AU - Vichaya, Elisabeth G.
AU - Cleeland, Charles S.
AU - Cohen, Lorenzo
AU - Thekdi, Seema M.
AU - Wang, Xin Shelley
AU - Fisch, Michael J.
PY - 2014/3
Y1 - 2014/3
N2 - 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 assessed 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.
AB - 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 assessed 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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U2 - 10.1200/JOP.2013.001112
DO - 10.1200/JOP.2013.001112
M3 - Article
C2 - 24281151
AN - SCOPUS:84904504250
SN - 1554-7477
VL - 10
SP - e95-e102
JO - Journal of oncology practice
JF - Journal of oncology practice
IS - 2
ER -