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The distress thermometer predicts subjective, but not objective, cognitive complaints six months after treatment initiation in cancer patients

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Abstract
Objectives: Research has indicated that cancer-related cognitive impairments (CRCI) may be influenced by psychosocial factors such as distress, worry and fatigue. Therefore, we aimed to validate the distress thermometer (DT) as a screening tool to detect CRCI six months post-treatment-initiation in a group of general cancer patients. Methods: Patients (>= 18 years, n = 125) with a histologically confirmed diagnosis of a solid cancer or hematological malignancy, scheduled for a curative treatment, were evaluated at baseline (T0) and six months post-treatment-initiation (T1) for CRCI by a neuropsychological assessment, including patient-reported outcome measures (PROMs). Assessed cognitive domains included premorbid intelligence, attention, processing speed, flexibility, verbal and visual episodic memory and verbal fluency. PROMs entailed distress (DT, cut-off >= 4, range 0-10), anxiety and depression, fatigue (FACIT-fatigue scale) and subjective cognitive complaints. Results: At T0, 60.4% of patients showed a DT score of >= 4, whereas 50% met this criterion at T1. According to the definition of the International Cognition and Cancer Task Force, 25.5% and 28.3% of patients presented with a CRCI at T0 and T1, respectively. When evaluating the DT as a screening tool for CRCI at T1, data showed an inverse relationship between the DT and CRCI. ROC-curve analysis revealed an AUC <0.5. ROC-curve analyses evaluating the DT and FACIT-fatigue scale as screening tools for subjective cognitive complaints showed an AUC +/- SE of, respectively, 0.642 +/- 0.067 and 0.794 +/- 0.057. Conclusions: The DT at T0 cannot be used to screen for objective CRCI at T1, but both the DT and FACIT-fatigue scale at T0 showed potential as screening tools for subjective cognitive complaints at T1.
Keywords
anxiety/depression, behavioral health, breast, quantitative, survivorship, CLOCK DRAWING TEST, BREAST-CANCER, PSYCHOLOGICAL DISTRESS, ADJUVANT CHEMOTHERAPY, DEPRESSION SCALE, HOSPITAL ANXIETY, SCREENING TOOL, IMPAIRMENT, VALIDATION, SURVIVORS

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Chicago
Lycke, Michelle, Tessa Lefebvre, Lies Pottel, Hans Pottel, Lore Ketelaars, Karin Stellamans, Koen Van Eygen, et al. 2017. “The Distress Thermometer Predicts Subjective, but Not Objective, Cognitive Complaints Six Months After Treatment Initiation in Cancer Patients.” Journal of Psychosocial Oncology 35 (6): 741–757.
APA
Lycke, M., Lefebvre, T., Pottel, L., Pottel, H., Ketelaars, L., Stellamans, K., Van Eygen, K., et al. (2017). The distress thermometer predicts subjective, but not objective, cognitive complaints six months after treatment initiation in cancer patients. JOURNAL OF PSYCHOSOCIAL ONCOLOGY, 35(6), 741–757.
Vancouver
1.
Lycke M, Lefebvre T, Pottel L, Pottel H, Ketelaars L, Stellamans K, et al. The distress thermometer predicts subjective, but not objective, cognitive complaints six months after treatment initiation in cancer patients. JOURNAL OF PSYCHOSOCIAL ONCOLOGY. 2017;35(6):741–57.
MLA
Lycke, Michelle, Tessa Lefebvre, Lies Pottel, et al. “The Distress Thermometer Predicts Subjective, but Not Objective, Cognitive Complaints Six Months After Treatment Initiation in Cancer Patients.” JOURNAL OF PSYCHOSOCIAL ONCOLOGY 35.6 (2017): 741–757. Print.
@article{8534628,
  abstract     = {Objectives: Research has indicated that cancer-related cognitive impairments (CRCI) may be influenced by psychosocial factors such as distress, worry and fatigue. Therefore, we aimed to validate the distress thermometer (DT) as a screening tool to detect CRCI six months post-treatment-initiation in a group of general cancer patients.
Methods: Patients ({\textrangle}= 18 years, n = 125) with a histologically confirmed diagnosis of a solid cancer or hematological malignancy, scheduled for a curative treatment, were evaluated at baseline (T0) and six months post-treatment-initiation (T1) for CRCI by a neuropsychological assessment, including patient-reported outcome measures (PROMs). Assessed cognitive domains included premorbid intelligence, attention, processing speed, flexibility, verbal and visual episodic memory and verbal fluency. PROMs entailed distress (DT, cut-off {\textrangle}= 4, range 0-10), anxiety and depression, fatigue (FACIT-fatigue scale) and subjective cognitive complaints.
Results: At T0, 60.4\% of patients showed a DT score of {\textrangle}= 4, whereas 50\% met this criterion at T1. According to the definition of the International Cognition and Cancer Task Force, 25.5\% and 28.3\% of patients presented with a CRCI at T0 and T1, respectively. When evaluating the DT as a screening tool for CRCI at T1, data showed an inverse relationship between the DT and CRCI. ROC-curve analysis revealed an AUC {\textlangle}0.5. ROC-curve analyses evaluating the DT and FACIT-fatigue scale as screening tools for subjective cognitive complaints showed an AUC +/- SE of, respectively, 0.642 +/- 0.067 and 0.794 +/- 0.057.
Conclusions: The DT at T0 cannot be used to screen for objective CRCI at T1, but both the DT and FACIT-fatigue scale at T0 showed potential as screening tools for subjective cognitive complaints at T1.},
  author       = {Lycke, Michelle and Lefebvre, Tessa and Pottel, Lies and Pottel, Hans and Ketelaars, Lore and Stellamans, Karin and Van Eygen, Koen and Vergauwe, Philippe and Werbrouck, Patrick and Goethals, Laurence and Schofield, Patricia and Boterberg, Tom and Debruyne, Philip R},
  issn         = {0734-7332},
  journal      = {JOURNAL OF PSYCHOSOCIAL ONCOLOGY},
  keyword      = {anxiety/depression,behavioral health,breast,quantitative,survivorship,CLOCK DRAWING TEST,BREAST-CANCER,PSYCHOLOGICAL DISTRESS,ADJUVANT CHEMOTHERAPY,DEPRESSION SCALE,HOSPITAL ANXIETY,SCREENING TOOL,IMPAIRMENT,VALIDATION,SURVIVORS},
  language     = {eng},
  number       = {6},
  pages        = {741--757},
  title        = {The distress thermometer predicts subjective, but not objective, cognitive complaints six months after treatment initiation in cancer patients},
  url          = {http://dx.doi.org/10.1080/07347332.2017.1365798},
  volume       = {35},
  year         = {2017},
}

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