Goedendorp Martine M, Jacobsen Paul B, Andrykowski Michael A
Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
Psychooncology. 2016 Mar;25(3):275-81. doi: 10.1002/pon.3907. Epub 2015 Jul 22.
For clinical and research purposes, efficient identification of cases of cancer-related fatigue (CRF) is important, as CRF can be persistent and interfere with usual functioning. While various fatigue-screening instruments are available, no brief screening indices have been developed using formally diagnosed CRF cases as the criterion.
Breast cancer patients (n = 385) completed a fatigue diagnostic interview and self-report fatigue measures (Profile of Mood States-fatigue subscale, Fatigue Symptom Inventory, and SF-36 vitality subscale), after initial adjuvant therapy (post-treatment (post-Tx) 1 assessment), after completion of radiotherapy for women receiving chemotherapy + radiotherapy (post-Tx 2 assessment), and 6 months after completion of all adjuvant therapy (6-month post-Tx assessment). CRF cases were identified using specific diagnostic criteria. ROC analyses identified screening indices, which could accurately identify CRF cases after initial adjuvant therapy. Screening indices were cross-validated using post-Tx 2 and 6-month follow-up assessment data.
A total of 104 women (27%) met CRF criteria after initial adjuvant therapy. Six two-item screening indices were identified. For all indices, area under the curve exceeded 0.80, sensitivity exceeded 0.80, and specificity exceeded 0.57. Cross-validation suggested that, except for the index based on SF-36, all the indices continued to accurately identify CRF cases at the post-Tx 2 and 6-month post-Tx assessments. Overall, a two-item composite index based on Fatigue Symptom Inventory 'most severity' and 'work interference' items performed best.
Breast cancer patients and survivors meeting CRF diagnostic criteria can be accurately identified using brief screening indices derived from common self-report fatigue measures.
出于临床和研究目的，有效识别癌症相关疲劳（CRF）病例很重要，因为CRF可能持续存在并干扰日常功能。虽然有各种疲劳筛查工具可用，但尚未使用正式诊断的CRF病例作为标准来开发简短的筛查指标。
乳腺癌患者（n = 385）在初始辅助治疗后（治疗后（Tx后）1评估）、接受化疗 + 放疗的女性完成放疗后（Tx后2评估）以及所有辅助治疗完成后6个月（Tx后6个月评估），完成了疲劳诊断访谈和自我报告疲劳测量（情绪状态量表 - 疲劳分量表、疲劳症状量表和SF - 36活力分量表）。使用特定诊断标准识别CRF病例。ROC分析确定了筛查指标，这些指标可以在初始辅助治疗后准确识别CRF病例。使用Tx后2和6个月随访评估数据对筛查指标进行交叉验证。
共有104名女性（27%）在初始辅助治疗后符合CRF标准。确定了六个两项筛查指标。对于所有指标，曲线下面积超过0.80，敏感性超过0.80，特异性超过0.57。交叉验证表明，除基于SF - 36的指标外，所有指标在Tx后2和Tx后6个月评估时仍能准确识别CRF病例。总体而言，基于疲劳症状量表“最严重程度”和“工作干扰”项目的两项综合指标表现最佳。
使用从常见自我报告疲劳测量中得出的简短筛查指标，可以准确识别符合CRF诊断标准的乳腺癌患者和幸存者。
