School of Nursing (C.M., S.M.P., C.S.H., J.S., K.O., K.M.K.), University of California, San Francisco, California, USA; School of Medicine (C.M., J.D.L.), University of California, San Francisco, California, USA.
School of Nursing (C.M., S.M.P., C.S.H., J.S., K.O., K.M.K.), University of California, San Francisco, California, USA.
J Pain Symptom Manage. 2022 Jan;63(1):42-51. doi: 10.1016/j.jpainsymman.2021.07.018. Epub 2021 Jul 29.
Cutpoints can be used as a threshold for screening symptom(s) that warrant intervention(s) and for monitoring patients' responses to these interventions.
In a sample of oncology patients undergoing chemotherapy, study purposes were to determine the optimal cutpoints for low, moderate, and high symptom burden and determine if these cutpoints distinguished among the symptom groups in any demographic, clinical, and stress characteristics, as well as QOL outcomes.
Total of 1329 patients completed a modified version of the Memorial Symptom Assessment Scale (38 symptoms). Using the methodology of Serlin and colleagues, cutpoints were created using symptom occurrence rates and cancer-specific quality of life (QOL) scores. Cutpoints were validated using measures of stress and resilience and a generic measure of QOL (i.e., Medical Outcomes Study Short Form 12 (SF-12)).
Of the 25 possible cutpoints evaluated, the optimal cutpoint, with the largest between category F statistic, was CP8,15 (Low = 0-8, Moderate = 9-15, High = 16-38 symptoms). Percentage of patients in the Low, Moderate, and High cutpoint groups were 25.3%, 36.3%, and 38.4%, respectively. Significant differences were found among the symptom burden groups in global, cancer-specific, and cumulative life stress (i.e., Low < Moderate < High) and resilience and SF-12 (i.e., Low > Moderate > High) scores.
Our findings provide evidence for clinically meaningful cutpoints that can be used to guide symptom assessment and management. These cutpoints may be used to establish alert thresholds for electronic monitoring of symptoms in oncology patients.
切点可用作筛选需要干预的症状的阈值，并用于监测患者对这些干预措施的反应。
在接受化疗的肿瘤患者样本中，本研究旨在确定低、中、高症状负担的最佳切点，并确定这些切点是否在任何人口统计学、临床和应激特征以及生活质量（QOL）结果方面区分了症状组。
共有 1329 名患者完成了改良版的 Memorial 症状评估量表（38 个症状）。使用 Serlin 等人的方法，使用症状发生率和癌症特异性 QOL（即医疗结果研究短式 12 项量表（SF-12））评分创建切点。使用应激和韧性以及通用 QOL 量表（即 Medical Outcomes Study Short Form 12（SF-12））对切点进行验证。
在所评估的 25 个可能切点中，最优切点（具有最大的类别间 F 统计量）为 CP8,15（低=0-8，中=9-15，高=16-38 个症状）。低、中、高切点组的患者比例分别为 25.3%、36.3%和 38.4%。在全球、癌症特异性和累积生活应激（即低<中<高）以及韧性和 SF-12（即低>中>高）评分方面，症状负担组之间存在显著差异。
我们的研究结果为可用于指导症状评估和管理的有临床意义的切点提供了证据。这些切点可用于为肿瘤患者的症状电子监测建立警戒阈值。
