Clinic of Medical Oncology, UMHAT "St. Marina", 1 "Hristo Smirnenski" Blvd., 9000, Varna, Bulgaria.
Department of Propedeutics of Internal Diseases, Medical University of Varna, Varna, Bulgaria.
Support Care Cancer. 2019 Jun;27(6):2031-2037. doi: 10.1007/s00520-018-4461-1. Epub 2018 Sep 15.
Our study explores the potential relationship between time estimation and level of distress in cancer patients prior to starting chemotherapy.
Time estimation was assessed in 262 chemonaïve patients with solid tumors by evaluating each subject's prospective estimation of how fast 1 min passed compared to the actual time. The median value (40 s) of time estimation was used to stratify the patients into two categories of fast and slow time estimation. The National Comprehensive Cancer Network Distress Thermometer was used at the beginning of treatment to evaluate levels of distress. Patients scoring 4 or above (51.9%) were regarded as having high levels of distress.
The pattern of the time estimation distributions significantly changed according to the level of distress. Patients with a fast time estimation had significantly higher levels of distress (4.55 ± 3.1) than patients with a slow time estimation (3.3 ± 2.9) (p = 0.001). ROC analysis revealed that at the optimal cutoff value of time estimation, patients with low and high distress levels can be discriminated with an AUC = 0.60 (95% CI: 0.53-0.67, p = 0.005) and with a sensitivity of 62.5% and specificity of 53.2%. Moreover, in a multivariate logistic regression model, fast time estimation was an independent predictor of high levels of distress.
Time estimation is a novel potent indicator of high levels of distress in cancer patients. This test is an easily performed, time-saving, and nonintrusive ultrashort screening tool that is even suitable for patients who are not willing to reveal their level of distress via direct questionnaires.
本研究旨在探讨癌症患者在开始化疗前的时间估计与痛苦程度之间的潜在关系。
通过评估每个患者对 1 分钟过去的速度的预期与实际时间之间的差异，来评估 262 名接受初次化疗的实体瘤患者的时间估计。时间估计的中位数（40 秒）用于将患者分为快速和慢速时间估计两个类别。在治疗开始时使用国家综合癌症网络痛苦温度计来评估痛苦程度。评分在 4 或以上（51.9%）的患者被认为存在高度痛苦。
时间估计分布的模式根据痛苦程度显著改变。快速时间估计的患者明显比慢速时间估计的患者具有更高的痛苦水平（4.55±3.1）（p=0.001）。ROC 分析显示，在时间估计的最佳截断值时，低和高痛苦水平的患者可以通过 AUC=0.60（95%CI：0.53-0.67，p=0.005）来区分，灵敏度为 62.5%，特异性为 53.2%。此外，在多变量逻辑回归模型中，快速时间估计是高痛苦水平的独立预测因子。
时间估计是癌症患者高度痛苦的一个新的有力指标。该测试是一种简单易行、节省时间、非侵入性的超短筛查工具，甚至适用于不愿通过直接问卷透露其痛苦程度的患者。
