Validation of a Dutch adaptation of the Edmonton Symptom Assessment System

FH van der Baan, Josephine Koldenhof, Daniëlle Zweers, GM Hesselmann, Sigrid Vervoort, Bernard H Vos, Everlien de Graaf, E. Witteveen, A de Graeff, Karijn Suijkerbuijk, Saskia C.C.M. Teunissen

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Background/aims: The Utrecht Symptom Diary (USD) is a Dutch adapted version of the Edmonton Symptom Assessment System (ESAS), a patient-reported outcome measurement tool (PROM) to routinely asses and monitor symptoms in cancer patients. The USD has been implemented in multiple hospitals, general practices and hospices in the Netherlands. Aim To validate the USD in patients during all stages of cancer on two measurement properties: validity and responsiveness. Methods: An observational longitudinal cohort study consisting of adult cancer patients, treated at the University Medical Center Utrecht, the Netherlands. Both in- and outpatients were included, who completed at least one USD as part of routine care in 2012-2019. Criterion validity was assessed as the degree to which the USD scores relate to a concurrent Distress Thermometer and Problem Checklist (DT&PC), presented as area under receiver operating characteristic (ROC) curve. Construct validity was assessed for USD items not on the DT&PC, defined as the extent to which the USD scores were consistent with hypotheses derived from literature, using a Chi-squared test. Responsiveness was assessed in patients with >1 concurrent DT&PC, distinguishing between patients who improved and deteriorated over time, using a Mann-Whitney U test. Results: 3913 patients were included, representing all types and stages of cancer. ROC for criterion validity was >0.7 demonstrating good criterion validation for all USD items also present on DT&PC. Construct validity was confirmed for the remaining USD items (p< 0.1*10-15). Different USD scores for patients when improving and when deteriorating on each of the USD items (p< .05) confirmed responsiveness of the USD. Conclusions: The USD is 1) a valid PROM for all symptoms that are most prevalent in cancer patients, 2) able to detect clinically important changes over time, and 3) suitable for patients with curable disease as well as patients through the whole continuum of palliative care.
Original languageEnglish
Article numberP01-355
JournalPalliative Medicine
Volume34
Issue numberSuppl_1
Publication statusPublished - 21 Sept 2020
EventEAPC World Research Congress 2020 - online
Duration: 7 Oct 20209 Oct 2020

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