Department of Cancer and Molecular Medicine, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
Psychooncology. 2010 Feb;19(2):125-33. doi: 10.1002/pon.1523.
To examine the value of a new screening instrument in a visual-analogue format.
We report the design and validation of a new five-dimensional tool called the Emotion Thermometers (ET). This is a combination of five visual-analogue scales in the form of four predictor domains (distress, anxiety, depression, anger) and one outcome domain (need for help). Between March and August 2007, 130 patients attending the chemotherapy suite for their first chemotherapy treatment were asked to complete several questionnaires with validation for distress, anxiety and depression.
Of 81 with low distress on the Distress Thermometer (DT), 51% recorded emotional difficulties on the new ET tool, suggesting added value beyond the DT alone. Of those with a broadly defined emotional complication, 93.3% could be identified using the Anxiety Thermometer (AnxT) alone, compared with 54.4% who would be recognized using the DT alone. Using a cut-off of 3v4 on all thermometers against the total Hospital Anxiety and Depression Scale (HADS) score (cut-off 14v15), the optimal thermometer was the Anger Thermometer (sensitivity 61%, specificity 92%). Against HADS anxiety scale, the optimal thermometer was AnxT (sensitivity 92%, specificity 61%) and against the HADS depression scale, the optimal thermometer was the Depression Thermometer (DepT; sensitivity 60%, specificity 78%). Finally, against DSM-IV major depression, the optimal thermometer was the DepT (sensitivity 80%, specificity 79%). Further improvements may be possible by using a combination of thermometers or by repeating the screen.
The diagnostic accuracy of the DT can be improved by the inclusion of simple addition linear domains without substantially increasing the time needed to apply the test.
探讨一种新的视觉模拟量表式筛查工具的价值。
我们报告了一种新的五维度工具的设计和验证，称为情绪温度计（ET）。这是由五个视觉模拟量表组成的组合，形式为四个预测域（痛苦、焦虑、抑郁、愤怒）和一个结果域（需要帮助）。在 2007 年 3 月至 8 月期间，130 名在化疗室接受首次化疗的患者被要求完成几项用于评估痛苦、焦虑和抑郁的验证问卷。
在痛苦温度计（DT）上得分低的 81 名患者中，51%的患者在新的 ET 工具上记录到情绪困难，这表明除了 DT 之外还有附加价值。在具有广泛定义的情绪并发症的患者中，93.3%可以仅使用焦虑温度计（AnxT）识别，而仅使用 DT 识别的比例为 54.4%。使用所有温度计相对于医院焦虑和抑郁量表（HADS）总分的 3v4 作为截断值（截断值 14v15），最佳温度计是愤怒温度计（灵敏度 61%，特异性 92%）。针对 HADS 焦虑量表，最佳温度计是 AnxT（灵敏度 92%，特异性 61%），针对 HADS 抑郁量表，最佳温度计是抑郁温度计（DepT；灵敏度 60%，特异性 78%）。最后，针对 DSM-IV 重性抑郁，最佳温度计是 DepT（灵敏度 80%，特异性 79%）。通过使用温度计组合或重复进行筛查，可能会进一步提高诊断准确性。
通过包含简单的附加线性域，可以提高 DT 的诊断准确性，而不会显著增加应用测试所需的时间。
