Recklitis Christopher J, Rodriguez Paola
The Dana-Farber Cancer Institute/Harvard Medical School, Suffolk University, Boston, MA 02115, USA.
Psychooncology. 2007 May;16(5):429-36. doi: 10.1002/pon.1069.
The Brief Symptom Inventory-18 (BSI-18) is an 18-item symptom checklist used as a brief distress screening in cancer and other medical patients. This study evaluated the validity of the BSI-18 in a sample of 221 adult survivors of childhood cancers ages 18-55 (median = 26). Validity of the BSI-18 was compared to the Symptom Checklist-90-Revised (SCL-90-R). Results indicated the BSI-18 scales had acceptable internal consistency (alpha >0.80) and were highly correlated with the corresponding SCL-90-R subscales (correlations from 0.88 to 0.94). When subjects were classified as case positive (significantly distressed) using the BSI-18 manual case-rule, classification agreement with the SCL-90-R was poor as evidenced by low sensitivity (41.78%). An alternative BSI-18 case-rule previously developed for cancer patients using the General Severity Index (GSI; GSI t-score >or=57) demonstrated better sensitivity (83.54%). ROC analysis indicated the BSI-18 had strong diagnostic utility relative to the SCL-90-R (AUC = 0.98) and several possible GSI cut-off scores were evaluated. The optimal cut-of score was a t-score >or=50 which had a sensitivity of 97.47% and a specificity of 85.21%. Results support use of the BSI-18 with adult survivors of childhood cancer but indicate an alternative case-rule must be used.
简明症状量表-18（BSI-18）是一个包含18个条目的症状清单，用于对癌症患者和其他内科患者进行简短的痛苦筛查。本研究在221名年龄在18至55岁（中位数=26岁）的儿童癌症成年幸存者样本中评估了BSI-18的有效性。将BSI-18的有效性与症状自评量表-90修订版（SCL-90-R）进行了比较。结果表明，BSI-18各分量表具有可接受的内部一致性（α>0.80），并且与相应的SCL-90-R分量表高度相关（相关性从0.88至0.94）。当使用BSI-18手册病例规则将受试者分类为病例阳性（明显痛苦）时，与SCL-90-R的分类一致性较差，低敏感性（41.78%）证明了这一点。先前为癌症患者开发的一种替代BSI-18病例规则，使用总体严重程度指数（GSI；GSI t分数≥57）显示出更好的敏感性（83.54%）。ROC分析表明，相对于SCL-90-R，BSI-18具有很强的诊断效用（AUC = 0.98），并评估了几个可能的GSI临界值分数。最佳临界值分数是t分数≥50，其敏感性为97.47%，特异性为85.21%。结果支持在儿童癌症成年幸存者中使用BSI-18，但表明必须使用替代病例规则。
