Miyoshi Yumiko, Onishi Chie, Fujie Mifumi, Senoo Naomi, Wakatsuki Ritsuko, Suzumiya Junji
Department of Nursing, Shimane University Hospital, Japan.
Intern Med. 2015;54(7):737-42. doi: 10.2169/internalmedicine.54.3318. Epub 2015 Apr 1.
Objective Chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting side effect of some anti-cancer drugs. However, medical staff frequently encounter difficulties in ascertaining the severity of CIPN. We sought to develop a questionnaire in order to accurately assess CIPN. The validity of this questionnaire was compared with that of free-style interviews. Methods We developed the CIPN self-check sheet by analyzing existing self-assessment tools for CIPN and matching the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) grades. From August to December 2011, 77 cancer patients participated in this study. In order to evaluate the validity of the CIPN self-check sheet compared with a free-style interview assessment, the cross-classification and κ coefficients between the CTCAE grades from each assessment and those from a comprehensive assessment were analyzed. The comprehensive assessment utilized information obtained from the medical examination, free-style interview and CIPN self-check sheet. Results Upon completion of the study, 248 CIPN self-check sheets were collected (median number of sheets per patient, 3; range, 1-14). The cross-classification analysis illustrated that the CIPN self-check sheet successfully identified all grade 3 cases. The coefficient of the CIPN self-check sheet was significantly higher than that of the free-style interviews [κ values: 0.988 (p<0.01) and 0.501 (p<0.01) for the self-check sheet and interviews, respectively]. Conclusion The CIPN self-check sheet can be used to assess the severity of CIPN based on the CTCAE grade more accurately than free-style interviews.
目的 化疗引起的周围神经病变（CIPN）是某些抗癌药物的主要剂量限制性副作用。然而，医务人员在确定CIPN的严重程度时经常遇到困难。我们试图开发一份问卷以准确评估CIPN。将该问卷的有效性与自由式访谈的有效性进行比较。方法 通过分析现有的CIPN自我评估工具并与美国国立癌症研究所不良事件通用术语标准（NCI-CTCAE）分级相匹配，我们开发了CIPN自我检查表。2011年8月至12月，77名癌症患者参与了本研究。为了评估CIPN自我检查表与自由式访谈评估相比的有效性，分析了每次评估的CTCAE分级与综合评估的CTCAE分级之间的交叉分类和κ系数。综合评估利用了从体格检查、自由式访谈和CIPN自我检查表中获得的信息。结果 研究结束时，共收集到248份CIPN自我检查表（每位患者的检查表中位数为3份；范围为1 - 14份）。交叉分类分析表明，CIPN自我检查表成功识别了所有3级病例。CIPN自我检查表的系数显著高于自由式访谈的系数[自我检查表和访谈的κ值分别为0.988（p<0.01）和0.501（p<0.01）]。结论 与自由式访谈相比，CIPN自我检查表可更准确地根据CTCAE分级评估CIPN的严重程度。
