Determination of cutpoints for low and high number of symptoms in patients with advanced cancer

Stephanie Gilbertson-White, Bradley E. Aouizerat, Thierry Jahan, Steven M. Paul, Claudia West, Karen Schumacher, Marylin J. Dodd, Michael Rabow, Ahmad H. Abu Raddaha, Christine Miaskowski

Research output: Contribution to journalArticle

Abstract

While patients with advanced cancer experience a wide range of symptoms, no work has been done to determine an optimal cutpoint for a low versus a high number of symptoms. Analytic approaches that established clinically meaningful cutpoints for the severity of cancer pain and fatigue provided the foundation for this study. The purpose of this study was to determine the optimal cutpoint for low and high numbers of symptoms using a range of potential cutpoints and to determine if those cutpoints distinguished between the two symptom groups on demographic and clinical characteristics and depression, anxiety, and quality of life (QOL). Patients with advanced cancer (n=110) completed a symptom assessment scale, and measures of depression, anxiety, and QOL. Combinations of cutpoints were tested to yield one-and two-cutpoint solutions. Using analysis of variance for QOL scores, the F-ratio that indicated the highest between-group difference was determined to be the optimal cutpoint between low and high number of symptoms. A cutpoint of ≤12 symptoms (i.e., 0-12 is low, 13-32 is high) was the optimal cutpoint for total number of symptoms. Significant differences in depression, anxiety, and QOL scores validated this cutpoint. Psychological symptoms had higher occurrence rates in the high symptom group. Findings suggest that a threshold exists between a low and a high number of symptoms in patients with advanced cancer. Psychological symptoms were significantly different between patients in the low versus high symptom groups and may play an important role in QOL outcomes in patients with advanced cancer.

Original languageEnglish (US)
Pages (from-to)1027-1036
Number of pages10
JournalJournal of Palliative Medicine
Volume15
Issue number9
DOIs
StatePublished - Sep 1 2012

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Quality of Life
Anxiety
Neoplasms
Depression
Psychology
Symptom Assessment
Fatigue
Analysis of Variance
Demography

ASJC Scopus subject areas

  • Medicine(all)
  • Anesthesiology and Pain Medicine
  • Nursing(all)

Cite this

Gilbertson-White, S., Aouizerat, B. E., Jahan, T., Paul, S. M., West, C., Schumacher, K., ... Miaskowski, C. (2012). Determination of cutpoints for low and high number of symptoms in patients with advanced cancer. Journal of Palliative Medicine, 15(9), 1027-1036. https://doi.org/10.1089/jpm.2012.0045

Determination of cutpoints for low and high number of symptoms in patients with advanced cancer. / Gilbertson-White, Stephanie; Aouizerat, Bradley E.; Jahan, Thierry; Paul, Steven M.; West, Claudia; Schumacher, Karen; Dodd, Marylin J.; Rabow, Michael; Abu Raddaha, Ahmad H.; Miaskowski, Christine.

In: Journal of Palliative Medicine, Vol. 15, No. 9, 01.09.2012, p. 1027-1036.

Research output: Contribution to journalArticle

Gilbertson-White, S, Aouizerat, BE, Jahan, T, Paul, SM, West, C, Schumacher, K, Dodd, MJ, Rabow, M, Abu Raddaha, AH & Miaskowski, C 2012, 'Determination of cutpoints for low and high number of symptoms in patients with advanced cancer', Journal of Palliative Medicine, vol. 15, no. 9, pp. 1027-1036. https://doi.org/10.1089/jpm.2012.0045
Gilbertson-White, Stephanie ; Aouizerat, Bradley E. ; Jahan, Thierry ; Paul, Steven M. ; West, Claudia ; Schumacher, Karen ; Dodd, Marylin J. ; Rabow, Michael ; Abu Raddaha, Ahmad H. ; Miaskowski, Christine. / Determination of cutpoints for low and high number of symptoms in patients with advanced cancer. In: Journal of Palliative Medicine. 2012 ; Vol. 15, No. 9. pp. 1027-1036.
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