Cella David, Yount Susan, Brucker Penny S, Du Hongyan, Bukowski Ronald, Vogelzang Nicholas, Bro William P
Evanston Northwestern Healthcare, Evanston, IL 60201, USA.
Value Health. 2007 Jul-Aug;10(4):285-93. doi: 10.1111/j.1524-4733.2007.00183.x.
Using patient and expert provider input, we previously developed a 15-item index of the most important symptoms and concerns of people being treated for advanced kidney cancer, the Functional Assessment of Cancer Therapy - Kidney Symptom Index (FKSI). These 15 concerns are a mixture of disease-related symptoms and treatment-related side effects. As a result, it may be difficult to assign an informative label to the score defined as the summation of these 15 most important concerns. Because one of the primary goals of treating advanced kidney cancer is the relief of disease-related symptoms, we set out to differentiate from the list of 15 symptoms those that are predominantly attributable to kidney cancer itself rather than its treatment, and to evaluate this abbreviated FKSI - Disease-Related Symptoms (FKSI-DRS).
Survey results from 18 experienced clinical experts were summarized to separate DRS from other concerns more arguably attributable to treatment side effects. This nine-item FKSI-DRS was then validated on a sample of 141 people with kidney cancer.
The FKSI-DRS is reliable (internal consistency range = 0.75-0.78; test-retest reliability intraclass correlation = 0.85), and valid, separating groups by performance status and the patient's own global rating of change. The likely minimally important difference in the FKSI-DRS is in the range of 2-3 points.
The FKSI-DRS is a reliable, valid, and responsive brief index of the most important symptoms associated with advanced kidney cancer.
我们之前利用患者和专业医疗人员的意见，制定了一个包含15项内容的指标，用于评估晚期肾癌患者最重要的症状和担忧，即癌症治疗功能评估-肾脏症状指数（FKSI）。这15项担忧包括与疾病相关的症状和与治疗相关的副作用。因此，可能难以给由这15项最重要担忧的总和所定义的分数赋予一个有意义的标签。由于治疗晚期肾癌的主要目标之一是缓解与疾病相关的症状，我们着手从这15种症状中区分出主要归因于肾癌本身而非其治疗的症状，并对这个简化版的FKSI-疾病相关症状（FKSI-DRS）进行评估。
汇总了18位经验丰富的临床专家的调查结果，以将疾病相关症状与其他更可归因于治疗副作用的担忧区分开来。然后，在141名肾癌患者样本中对这个包含9项内容的FKSI-DRS进行了验证。
FKSI-DRS是可靠的（内部一致性范围=0.75-0.78；重测信度组内相关系数=0.85），并且有效，能够根据患者的体能状态和患者自身对变化的总体评价将不同组区分开来。FKSI-DRS中可能的最小重要差异在2-3分的范围内。
FKSI-DRS是一种可靠、有效且具有反应性的简短指标，用于评估与晚期肾癌相关的最重要症状。
