Top

Journal of Clinical Psychology in Medical Settings

Published in:

01-06-2021 | Affective Disorder

A Systematic Review and Meta-analysis of the Distress Thermometer for Screening Distress in Asian Patients with Cancer

Authors: Huihui Sun, Sudip Thapa, Bangyan Wang, Xiaofen Fu, Shiying Yu

Published in: Journal of Clinical Psychology in Medical Settings | Issue 2/2021

Abstract

The distress thermometer (DT) is a commonly used tool for screening distress in Asian patients with cancer. However, the optimal cut-off score and discriminative accuracy remain unclear. Hence, this meta-analysis aimed to examine its diagnostic value and optimal cut-off score in Asia. A systematic search was conducted in the PubMed, EMBASE and Cochrane Library databases. The pooled sensitivity, specificity, positive and negative predictive values, and diagnostic odds ratio were calculated. The area under the curve (AUC) was computed from the summary receiver-operating characteristic (SROC) curve. All analyses were performed using STATA 12.0 software. Finally, 10 studies describing 2851 patients were included. After pooling all the results from the 10 studies, the optimal DT cut-off score was 4 with a pooled sensitivity of 0.78 (95% confidence intervals (CI) 0.68–0.86), specificity of 0.73 (95% CI 0.65–0.80) and AUC of 0.82 (95% CI 0.78–0.85). When the DT was compared to the hospital anxiety and depression scale-total (HADS-T), the cut-off score of 4 showed the best balance between the pooled sensitivity (0.81, 95% CI 0.69–0.89) and specificity (0.74, 95% CI 0.59–0.84), and the AUC was 0.84 (95% CI 0.81–0.87). In conclusion, the DT with a cut-off score of 4 was an effective screening tool in Asian patients with cancer.

Aelbrecht, K., Pype, P., Vos, J., & Deveugele, M. (2016). Having cancer in a foreign country. Patient Education and Counseling, 99, 1708–1716. https://doi.org/10.1016/j.pec.2016.05.010.CrossRefPubMed

Akizuki, N., Akechi, T., Nakanishi, T., Yoshikawa, E., Okamura, M., Nakano, T., … Uchitomi, Y. (2003). Development of a brief screening interview for adjustment disorders and major depression in patients with cancer. Cancer, 97, 2605–2613. https://doi.org/10.1002/cncr.11358.

Alosaimi, F. D., Abdel-Aziz, N., Alsaleh, K., AlSheikh, R., AlSheikh, R., & Abdel-Warith, A. (2018). Validity and feasibility of the Arabic version of distress thermometer for Saudi cancer patients. PLoS ONE, 13, e0207364. https://doi.org/10.1371/journal.pone.0207364.CrossRefPubMedPubMedCentral

Bidstrup, P. E., Mertz, B. G., Dalton, S. O., Deltour, I., Kroman, N., Kehlet, H., … Johansen, C. (2012). Accuracy of the Danish version of the ‘distress thermometer’. Psychooncology, 21, 436–443. https://doi.org/10.1002/pon.1917.

Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 68, 394–424. https://doi.org/10.3322/caac.21492.CrossRef

Bultz, B. D., & Carlson, L. E. (2005). Emotional distress: The sixth vital sign in cancer care. Journal of Clinical Oncology, 23, 6440–6441. https://doi.org/10.1200/jco.2005.02.3259.CrossRefPubMed

Caci, H., Baylé, F. J., Mattei, V., Dossios, C., Robert, P., & Boyer, P. (2003). How does the Hospital and Anxiety and Depression Scale measure anxiety and depression in healthy subjects? Psychiatry Research, 118, 89–99. https://doi.org/10.1016/S0165-1781(03)00044-1.CrossRefPubMed

Chiou, Y. J., Chiu, N. M., Wang, L. J., Li, S. H., Lee, C. Y., Wu, M. K., … Lee, Y. (2016). Prevalence and related factors of psychological distress among cancer inpatients using routine Distress Thermometer and Chinese Health Questionnaire screening. Neuropsychiatric Disease and Treatment, 12, 2765–2773. https://doi.org/10.2147/NDT.S118667.

Cleophas, T. J., & Zwinderman, A. H. (2009). Meta-analyses of diagnostic studies. Clinical Chemistry and Laboratory Medicine, 47, 1351–1354. https://doi.org/10.1515/CCLM.2009.317.CrossRefPubMed

Cutillo, A., O’Hea, E., Person, S., Lessard, D., Harralson, T., & Boudreaux, E. (2017). The distress thermometer: Cutoff points and clinical use. Oncology Nursing Forum, 44, 329–336. https://doi.org/10.1188/17.Onf.329-336.CrossRefPubMedPubMedCentral

Deng, Y. T., Zhong, W. N., & Jiang, Y. (2014). Measurement of distress and its alteration during treatment in patients with nasopharyngeal carcinoma. Head and Neck, 36, 1077–1086. https://doi.org/10.1002/hed.23412.CrossRefPubMed

Dolbeault, S., Bredart, A., Mignot, V., Hardy, P., Gauvain-Piquard, A., Mandereau, L., … Medioni, J. (2008). Screening for psychological distress in two French cancer centers: Feasibility and performance of the adapted distress thermometer. Palliat Support Care, 6, 107–117. https://doi.org/10.1017/s1478951508000187.

Donovan, K. A., Grassi, L., McGinty, H. L., & Jacobsen, P. B. (2014). Validation of the distress thermometer worldwide: State of the science. Psychooncology, 23, 241–250. https://doi.org/10.1002/pon.3430.CrossRefPubMed

Glas, A. S., Lijmer, J. G., Prins, M. H., Bonsel, G. J., & Bossuyt, P. M. (2003). The diagnostic odds ratio: A single indicator of test performance. Journal of Clinical Epidemiology, 56, 1129–1135. https://doi.org/10.1016/s0895-4356(03)00177-x.CrossRefPubMed

Hegel, M. T., Collins, E. D., Kearing, S., Gillock, K. L., Moore, C. P., & Ahles, T. A. (2008). Sensitivity and specificity of the Distress Thermometer for depression in newly diagnosed breast cancer patients. Psychooncology, 17, 556–560. https://doi.org/10.1002/pon.1289.CrossRefPubMedPubMedCentral

Hegel, M. T., Moore, C. P., Collins, E. D., Kearing, S., Gillock, K. L., Riggs, R. L., … Ahles, T. A. (2006). Distress, psychiatric syndromes, and impairment of function in women with newly diagnosed breast cancer. Cancer, 107, 2924–2931. https://doi.org/10.1002/cncr.22335.

Hoffman, B. M., Zevon, M. A., D’Arrigo, M. C., & Cecchini, T. B. (2004). Screening for distress in cancer patients: The NCCN rapid-screening measure. Psychooncology, 13, 792–799. https://doi.org/10.1002/pon.796.CrossRefPubMed

Holland, J. C., Andersen, B., Breitbart, W. S., Buchmann, L. O., Compas, B., Deshields, T. L., … Freedman-Cass, D. A. (2013). Distress management. Journal of the National Comprehensive Cancer Network, 11, 190–209.

Holland, J., Watson, M., & Dunn, J. (2011). The IPOS new International Standard of Quality Cancer Care: Integrating the psychosocial domain into routine care. Psychooncology, 20, 677–680. https://doi.org/10.1002/pon.1978.CrossRefPubMed

Hong, J. S., & Tian, J. (2013). Sensitivity and specificity of the Distress Thermometer in screening for distress in long-term nasopharyngeal cancer survivors. Current Oncology, 20, e570–e576. https://doi.org/10.3747/co.20.1617.CrossRefPubMedPubMedCentral

Iskandarsyah, A., de Klerk, C., Suardi, D. R., Soemitro, M. P., Sadarjoen, S. S., & Passchier, J. (2013). The Distress Thermometer and its validity: A first psychometric study in Indonesian women with breast cancer. PLoS ONE, 8, e56353. https://doi.org/10.1371/journal.pone.0056353.CrossRefPubMedPubMedCentral

Kim, S. J., Rha, S. Y., Song, S. K., Namkoong, K., Chung, H. C., Yoon, S. H., … Kim, K. R. (2011). Prevalence and associated factors of psychological distress among Korean cancer patients. Gen Hosp Psychiatry, 33, 246–252. https://doi.org/10.1016/j.genhosppsych.2011.02.008.

Kvale, E. A., Murthy, R., Taylor, R., Lee, J. Y., & Nabors, L. B. (2009). Distress and quality of life in primary high-grade brain tumor patients. Supportive Care in Cancer, 17, 793–799. https://doi.org/10.1007/s00520-008-0551-9.CrossRefPubMed

Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P., … Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ, 339, b2700. https://doi.org/10.1136/bmj.b2700.

Ma, X., Zhang, J., Zhong, W., Shu, C., Wang, F., Wen, J., … Liu, L. (2014). The diagnostic role of a short screening tool–the distress thermometer: A meta-analysis. Support Care Cancer, 22, 1741–1755. https://doi.org/10.1007/s00520-014-2143-1.

Melsen, W. G., Bootsma, M. C., Rovers, M. M., & Bonten, M. J. (2014). The effects of clinical and statistical heterogeneity on the predictive values of results from meta-analyses. Clinical Microbiology & Infection, 20, 123–129. https://doi.org/10.1111/1469-0691.12494.CrossRef

Metz, C. E. (1978). Basic principles of ROC analysis. Seminars in Nuclear Medicine, 8, 283–298. https://doi.org/10.1016/s0001-2998(78)80014-2.CrossRefPubMed

Mitchell, A. J. (2007). Pooled results from 38 analyses of the accuracy of distress thermometer and other ultra-short methods of detecting cancer-related mood disorders. Journal of Clinical Oncology, 25, 4670–4681. https://doi.org/10.1200/JCO.2006.10.0438.CrossRefPubMed

Pilleron, S., Sarfati, D., Janssen-Heijnen, M., Vignat, J., Ferlay, J., Bray, F., & Soerjomataram, I. (2019). Global cancer incidence in older adults, 2012 and 2035: A population-based study. International Journal of Cancer, 144, 49–58. https://doi.org/10.1002/ijc.31664.CrossRefPubMed

Ploos van Amstel, F. K., Tol, J., Sessink, K. H., van der Graaf, W. T. A., Prins, J. B., & Ottevanger, P. B. (2017). A specific distress cutoff score shortly after breast cancer diagnosis. Cancer Nursing, 40, E35–e40. https://doi.org/10.1097/ncc.0000000000000380.CrossRefPubMed

Roth, A. J., Kornblith, A. B., Batel-Copel, L., Peabody, E., Scher, H. I., & Holland, J. C. (1998). Rapid screening for psychologic distress in men with prostate carcinoma: A pilot study. Cancer, 82, 1904–1908. https://doi.org/10.1002/(sici)1097-0142(19980515)82:10%3c1904:aid-cncr13%3e3.0.co;2-x.CrossRefPubMed

Rüsch, N., Angermeyer, M. C., & Corrigan, P. W. (2005). Mental illness stigma: Concepts, consequences, and initiatives to reduce stigma. European Psychiatry, 20, 529–539. https://doi.org/10.1016/j.eurpsy.2005.04.004.CrossRefPubMed

Russ, T. C., Stamatakis, E., Hamer, M., Starr, J. M., Kivimaki, M., & Batty, G. D. (2012). Association between psychological distress and mortality: Individual participant pooled analysis of 10 prospective cohort studies. BMJ, 345, e4933. https://doi.org/10.1136/bmj.e4933.CrossRefPubMedPubMedCentral

Saeedi-Saedi, H., Shahidsales, S., Koochak-Pour, M., Sabahi, E., & Moridi, I. (2015). Evaluation of emotional distress in breast cancer patients. Iranian Journal of Cancer Prevention, 8, 36–41.PubMedPubMedCentral

Shim, E. J., Shin, Y. W., Jeon, H. J., & Hahm, B. J. (2008). Distress and its correlates in Korean cancer patients: Pilot use of the distress thermometer and the problem list. Psychooncology, 17, 548–555. https://doi.org/10.1002/pon.1275.CrossRefPubMed

Sterne, J. A., Egger, M., & Smith, G. D. (2001). Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis. BMJ, 323, 101–105. https://doi.org/10.1136/bmj.323.7304.101.CrossRefPubMedPubMedCentral

Tang, L. L., Zhang, Y. N., Pang, Y., Zhang, H. W., & Song, L. L. (2011). Validation and reliability of distress thermometer in Chinese cancer patients. Chinese Journal of Cancer Research, 23, 54–58. https://doi.org/10.1007/s11670-011-0054-y.CrossRefPubMedPubMedCentral

Thompson, R., & Van Der Molen, B. (2009). Access to cancer services–do culture and ethnicity make a difference? European Journal of Cancer Care (England), 18, 3. https://doi.org/10.1111/j.1365-2354.2008.01078.x.CrossRef

Tsai, W., & Lu, Q. (2018). Ambivalence over emotional expression and intrusive thoughts as moderators of the link between self-stigma and depressive symptoms among Chinese American breast cancer survivors. Journal of Behavioral Medicine. https://doi.org/10.1007/s10865-018-9996-6.CrossRefPubMedPubMedCentral

Wang, G. L., Cheng, C. T., Feng, A. C., Hsu, S. H., Hou, Y. C., & Chiu, C. Y. (2017). Prevalence, risk factors, and the desire for help of distressed newly diagnosed cancer patients: A large-sample study. Palliat Support Care, 15, 295–304. https://doi.org/10.1017/S1478951516000717.CrossRefPubMed

Wang, G.-L., Hsu, S.-H., Feng, A.-C., Chiu, C.-Y., Shen, J.-F., Lin, Y.-J., & Cheng, C.-C. (2011). The HADS and the DT for screening psychosocial distress of cancer patients in Taiwan. Psycho-Oncology, 20, 639–646. https://doi.org/10.1002/pon.1952.CrossRefPubMed

Wang, Y., Zou, L., Jiang, M., Wei, Y., & Jiang, Y. (2013). Measurement of distress in Chinese inpatients with lymphoma. Psychooncology, 22, 1581–1586. https://doi.org/10.1002/pon.3170.CrossRefPubMed

Whiting, P., Rutjes, A. W., Reitsma, J. B., Bossuyt, P. M., & Kleijnen, J. (2003). The development of QUADAS: A tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Medical Research Methodology, 3, 25. https://doi.org/10.1186/1471-2288-3-25.CrossRefPubMedPubMedCentral

Xie, J., Ding, S., He, S., Duan, Y., Yi, K., & Zhou, J. (2017). A prevalence study of psychosocial distress in adolescents and young adults with cancer. Cancer Nursing, 40, 217–223. https://doi.org/10.1097/NCC.0000000000000396.CrossRefPubMed

Yasri, S., & Wiwanitkit, V. (2014). Distress screening using distress thermometer. Indian Journal of Palliative Care, 20, 65. https://doi.org/10.4103/0973-1075.125574.CrossRefPubMedPubMedCentral

Zheng, B., Du, P., Yi, T., Liu, J., Zeng, Z., Luo, D., & Jiang, Y. (2018). Effects of two translated phrases of distress thermometer on screening distress in Chinese cancer patients: A comparative study. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.14678.CrossRefPubMed

Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scand., 67, 361–370.CrossRef

Title: A Systematic Review and Meta-analysis of the Distress Thermometer for Screening Distress in Asian Patients with Cancer
Authors: Huihui Sun
Sudip Thapa
Bangyan Wang
Xiaofen Fu
Shiying Yu
Publication date: 01-06-2021
Publisher: Springer US
Keywords: Affective Disorder
Affective Disorder
Anxiety
Published in: Journal of Clinical Psychology in Medical Settings / Issue 2/2021
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI: https://doi.org/10.1007/s10880-020-09705-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A Systematic Review and Meta-analysis of the Distress Thermometer for Screening Distress in Asian Patients with Cancer

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2021

Bridging the Gap: Can Group Interventions Assist Addiction Consult Services in Providing Integrated, Comprehensive Healthcare for Patients Hospitalized for Opioid-Related Infections?

Predicting Intense Levels of Child Anxiety During Anesthesia Induction at Hospital Arrival

A Secondary Analysis of Integrated Pediatric Chronic Pain Services Related to Cost Savings

Exploring Post-traumatic Growth in Parkinson's Disease: A Mixed Method Study

Comparisons Between Patients Diagnosed with PTSD in Primary Care Versus Mental Health Care in Five Large Civilian Health Care Systems

Does Posttraumatic Growth Buffer the Association Between Death Anxiety and Quality of Life Among People living with HIV/AIDS?