Optimal frequency of psychosocial distress screening in radiation oncology

Clayton B. Hess, Maria Singer, Aliasgher Khaku, Justin Malinou, Justin J. Juliano, John M. Varlotto, Henry Wagner Jr., Jiangang (Jason) Liao, Kimberly Myers, Martha Levine, Heath Mackley

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To accurately hypothesize the optimal frequency of psychosocial distress screening in patients undergoing radiation therapy using exploratory modeling of prospective data. Materials and Methods: Between October 2010 and May 2011, 71 RT patients underwent daily screening with the Distress Thermometer. Prevalences of Distress Thermometer scores ≥ 4 were recorded. Optimal screening frequency was evaluated by planned post hoc comparison of prevalence rates and required screening events estimated by numerical modeling, consisting of data point omission to mimic weekly, every-other-week, monthly, and one-time screening intervals. Dependence on clinical variables and chronologic trends were assessed as secondary end points. Results: A total of 2,028 daily screening events identified that 37% of patients reported distress at least once during the course of treatment. Weekly, every-other-week, monthly, and one-time screening models estimated distress prevalences of 32%, 31%, 23%, and 17%, respectively, but required only 21%, 12%, 7%, and 4% of the assessments required for daily screening. No clinical parameter significantly predicted distress in univariable analysis, but "alone" living situation trended toward significance (P = .06). Physician-reported grade 3 toxicity predicted distress with 98% specificity, but only 19% sensitivity. Conclusion: Thirty-seven percent of radiation oncology patients reported distress at least once during treatment. Screening at every-other-week intervals optimized efficiency and frequency, identifying nearly 90% of distressed patients with 12% of the screening events compared with daily screening.

Original languageEnglish (US)
Pages (from-to)298-302
Number of pages5
JournalJournal of oncology practice
Volume11
Issue number4
DOIs
StatePublished - Jul 1 2015

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Radiation Oncology
Thermometers
Radiotherapy
Physicians
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Hess, C. B., Singer, M., Khaku, A., Malinou, J., Juliano, J. J., Varlotto, J. M., ... Mackley, H. (2015). Optimal frequency of psychosocial distress screening in radiation oncology. Journal of oncology practice, 11(4), 298-302. https://doi.org/10.1200/JOP.2014.003392
Hess, Clayton B. ; Singer, Maria ; Khaku, Aliasgher ; Malinou, Justin ; Juliano, Justin J. ; Varlotto, John M. ; Wagner Jr., Henry ; Liao, Jiangang (Jason) ; Myers, Kimberly ; Levine, Martha ; Mackley, Heath. / Optimal frequency of psychosocial distress screening in radiation oncology. In: Journal of oncology practice. 2015 ; Vol. 11, No. 4. pp. 298-302.
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Optimal frequency of psychosocial distress screening in radiation oncology. / Hess, Clayton B.; Singer, Maria; Khaku, Aliasgher; Malinou, Justin; Juliano, Justin J.; Varlotto, John M.; Wagner Jr., Henry; Liao, Jiangang (Jason); Myers, Kimberly; Levine, Martha; Mackley, Heath.

In: Journal of oncology practice, Vol. 11, No. 4, 01.07.2015, p. 298-302.

Research output: Contribution to journalArticle

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AU - Hess, Clayton B.

AU - Singer, Maria

AU - Khaku, Aliasgher

AU - Malinou, Justin

AU - Juliano, Justin J.

AU - Varlotto, John M.

AU - Wagner Jr., Henry

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AU - Mackley, Heath

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N2 - Purpose: To accurately hypothesize the optimal frequency of psychosocial distress screening in patients undergoing radiation therapy using exploratory modeling of prospective data. Materials and Methods: Between October 2010 and May 2011, 71 RT patients underwent daily screening with the Distress Thermometer. Prevalences of Distress Thermometer scores ≥ 4 were recorded. Optimal screening frequency was evaluated by planned post hoc comparison of prevalence rates and required screening events estimated by numerical modeling, consisting of data point omission to mimic weekly, every-other-week, monthly, and one-time screening intervals. Dependence on clinical variables and chronologic trends were assessed as secondary end points. Results: A total of 2,028 daily screening events identified that 37% of patients reported distress at least once during the course of treatment. Weekly, every-other-week, monthly, and one-time screening models estimated distress prevalences of 32%, 31%, 23%, and 17%, respectively, but required only 21%, 12%, 7%, and 4% of the assessments required for daily screening. No clinical parameter significantly predicted distress in univariable analysis, but "alone" living situation trended toward significance (P = .06). Physician-reported grade 3 toxicity predicted distress with 98% specificity, but only 19% sensitivity. Conclusion: Thirty-seven percent of radiation oncology patients reported distress at least once during treatment. Screening at every-other-week intervals optimized efficiency and frequency, identifying nearly 90% of distressed patients with 12% of the screening events compared with daily screening.

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Hess CB, Singer M, Khaku A, Malinou J, Juliano JJ, Varlotto JM et al. Optimal frequency of psychosocial distress screening in radiation oncology. Journal of oncology practice. 2015 Jul 1;11(4):298-302. https://doi.org/10.1200/JOP.2014.003392