PMID- 23177724
OWN - NLM
STAT- MEDLINE
DCOM- 20140224
LR  - 20151119
IS  - 1873-6513 (Electronic)
IS  - 0885-3924 (Linking)
VI  - 46
IP  - 2
DP  - 2013 Aug
TI  - Minimal clinically important differences in the Edmonton symptom assessment 
      system in patients with advanced cancer.
PG  - 192-200
LID - S0885-3924(12)00494-0 [pii]
LID - 10.1016/j.jpainsymman.2012.07.022 [doi]
AB  - CONTEXT: Longitudinal symptom monitoring is important in the setting of patients 
      with advanced cancer. Scores over time may naturally fluctuate, although a 
      patient may feel the same. OBJECTIVES: The purpose of this study was to determine 
      the minimal levels of change required to be clinically relevant (minimal 
      clinically important difference [MCID]) using the Edmonton Symptom Assessment 
      System (ESAS). METHODS: Between 1999 and 2009, patients completed the ESAS before 
      palliative radiotherapy and at follow-up. MCIDs were calculated using both the 
      anchor- and distribution-based methods for improvement and deterioration; 95% 
      confidence intervals for the differences in mean change scores between adjacent 
      categories also were calculated. RESULTS: A total of 276 patients completed the 
      ESAS at baseline and during at least one follow-up visit. At the four-week 
      follow-up, decrease of 1.2 and 1.1 units in pain and depression scales, 
      respectively, constituted clinically relevant improvement, whereas increase of at 
      least 1.4, 1.8, 1.1, 1.1, and 1.4 units, respectively, in pain, tiredness, 
      depression, anxiety, and appetite loss items were required for deterioration. At 
      the subsequent follow-ups, these values were similar. Overall, the MCID for 
      improvement tended to be smaller than that for deterioration. The 
      distribution-based method estimates tended to be larger than the 0.3 SD 
      estimates, but closer to the 0.5 SD estimates. CONCLUSION: MCIDs allow health 
      care professionals to determine the success of treatment in improving the 
      patient's quality of life. MCIDs may prompt health care professionals to 
      intervene with new treatment. Future studies should confirm our findings with a 
      variety of anchors.
CI  - Copyright (c) 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. 
      All rights reserved.
FAU - Bedard, Gillian
AU  - Bedard G
AD  - Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette 
      Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, 
      Ontario, Canada.
FAU - Zeng, Liang
AU  - Zeng L
FAU - Zhang, Liying
AU  - Zhang L
FAU - Lauzon, Natalie
AU  - Lauzon N
FAU - Holden, Lori
AU  - Holden L
FAU - Tsao, May
AU  - Tsao M
FAU - Danjoux, Cyril
AU  - Danjoux C
FAU - Barnes, Elizabeth
AU  - Barnes E
FAU - Sahgal, Arjun
AU  - Sahgal A
FAU - Poon, Michael
AU  - Poon M
FAU - Chow, Edward
AU  - Chow E
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20121122
PL  - United States
TA  - J Pain Symptom Manage
JT  - Journal of pain and symptom management
JID - 8605836
SB  - IM
CIN - J Pain Symptom Manage. 2013 Mar;45(3):e4-5. PMID: 23465763
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anxiety/diagnosis/epidemiology
MH  - Causality
MH  - Comorbidity
MH  - Fatigue/diagnosis/epidemiology
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*diagnosis/*epidemiology/*radiotherapy
MH  - Ontario/epidemiology
MH  - Pain/diagnosis/epidemiology
MH  - *Patient Outcome Assessment
MH  - Prevalence
MH  - *Quality of Life
MH  - Reproducibility of Results
MH  - Risk Factors
MH  - Sensitivity and Specificity
MH  - *Severity of Illness Index
MH  - *Surveys and Questionnaires
OTO - NOTNLM
OT  - Edmonton Symptom Assessment System
OT  - Minimal clinically important difference
OT  - advanced cancer
OT  - palliative care
EDAT- 2012/11/28 06:00
MHDA- 2014/02/25 06:00
CRDT- 2012/11/27 06:00
PHST- 2012/04/10 00:00 [received]
PHST- 2012/07/31 00:00 [revised]
PHST- 2012/08/01 00:00 [accepted]
PHST- 2012/11/27 06:00 [entrez]
PHST- 2012/11/28 06:00 [pubmed]
PHST- 2014/02/25 06:00 [medline]
AID - S0885-3924(12)00494-0 [pii]
AID - 10.1016/j.jpainsymman.2012.07.022 [doi]
PST - ppublish
SO  - J Pain Symptom Manage. 2013 Aug;46(2):192-200. doi: 
      10.1016/j.jpainsymman.2012.07.022. Epub 2012 Nov 22.