Hui David, Bruera Eduardo
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
J Pain Symptom Manage. 2017 Mar;53(3):630-643. doi: 10.1016/j.jpainsymman.2016.10.370. Epub 2016 Dec 29.
Routine symptom assessment represents the cornerstone of symptom management. Edmonton Symptom Assessment System (ESAS) is one of the first quantitative symptom assessment batteries that allows for simple and rapid documentation of multiple patient-reported symptoms at the same time.
To discuss the historical development of ESAS, its current uses in different settings, and future developments.
Narrative review.
Since its development in 1991, ESAS has been psychometrically validated and translated into over 20 languages. We will discuss the variations, advantages, and limitations with ESAS. From the clinical perspective, ESAS is now commonly used for symptom screening and longitudinal monitoring in patients seen by palliative care, oncology, nephrology, and other disciplines in both inpatient and outpatient settings. From the research perspective, ESAS has offered important insights into the nature of symptom trajectory, symptom clusters, and symptom modulators. Furthermore, multiple clinical studies have incorporated ESAS as a study outcome and documented the impact of various interventions on symptom burden. On the horizon, multiple groups are actively investigating further refinements to ESAS, such as incorporating it in electronic health records, using ESAS as a trigger for palliative care referral, and coupling ESAS with personalized symptom goals to optimize symptom response assessment.
ESAS has evolved over the past 25 years to become an important symptom assessment instrument in both clinical practice and research. Future efforts are needed to standardize this tool and explore its full potential to support symptom management.
常规症状评估是症状管理的基石。埃德蒙顿症状评估系统（ESAS）是首批定量症状评估量表之一，可同时简单快速地记录多种患者报告的症状。
探讨ESAS的历史发展、其在不同环境中的当前用途以及未来发展。
叙述性综述。
自1991年开发以来，ESAS已通过心理测量学验证，并被翻译成20多种语言。我们将讨论ESAS的变体、优点和局限性。从临床角度来看，ESAS现在常用于姑息治疗、肿瘤学、肾脏病学以及其他学科的住院和门诊患者的症状筛查和纵向监测。从研究角度来看，ESAS为症状轨迹、症状群和症状调节因素的本质提供了重要见解。此外，多项临床研究将ESAS纳入研究结果，并记录了各种干预措施对症状负担的影响。展望未来，多个团队正在积极研究对ESAS的进一步改进，例如将其纳入电子健康记录、将ESAS用作姑息治疗转诊的触发因素，以及将ESAS与个性化症状目标相结合以优化症状反应评估。
在过去25年中，ESAS已发展成为临床实践和研究中重要的症状评估工具。需要未来的努力来规范这一工具，并探索其支持症状管理的全部潜力。
