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Erschienen in: Quality of Life Research 2/2022

17.06.2021

Screening for symptoms of anxiety and depression in patients treated with renal replacement therapy: utility of the Edmonton Symptom Assessment System-Revised

verfasst von: Evan Tang, Sumaya Dano, Nathaniel Edwards, Sara Macanovic, Heather Ford, Susan Bartlett, Doris Howell, Madeline Li, Marta Novak, Istvan Mucsi

Erschienen in: Quality of Life Research | Ausgabe 2/2022

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Abstract

Purpose

The Edmonton Symptom Assessment System-revised (ESASr) is widely used in clinical oncology to screen for physical and emotional symptoms. The performance of the anxiety and depression items (ESASr-A and ESASr-D, respectively) as screening tools have not been evaluated in patients treated with renal replacement therapy.

Methods

Kidney transplant recipients and patients on dialysis were recruited in Toronto. Patients were classified as having moderate/severe depression and anxiety symptoms using the established cut-off score of ≥ 10 on the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7) questionnaires.

Results

This study included 931 participants; 62% male, mean age (SD) 55(16), and 52% White. All participants completed ESASr, however only 748 participants completed PHQ-9 and 769 participants completed GAD-7. Correlation between ESASr item scores and legacy scores were moderately strong (ESASr-D/PHQ-9: 0.61; ESASr-A/GAD-7: 0.64). We found good discrimination for moderate/severe depression and anxiety [area under the receiver operating characteristics curve (95% CI) ESASr-D 0.82(0.78–0.86); ESASr-A 0.87 (0.82, 0.92)]. The cut-off ≥ 2 for ESASr-D [Sensitivity = 0.76; Specificity = 0.77; Likelihood Ratio (LR) + = 3.29; LR − = 0.31] and ≥ 4 for ESASr-A (Sensitivity = 0.75; Specificity = 0.87; LR + = 5.76; LR − = 0.29) had the best combination of measurement characteristics.

Conclusion

The identified ESASr-D and ESASr-A cut-off scores may be used to rule out patients without emotional distress with few false negatives. However, the low sensitivity identified in our analysis suggests that neither ESASr-D or ESASr-A are acceptable as standalone screening tools.
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Metadaten
Titel
Screening for symptoms of anxiety and depression in patients treated with renal replacement therapy: utility of the Edmonton Symptom Assessment System-Revised
verfasst von
Evan Tang
Sumaya Dano
Nathaniel Edwards
Sara Macanovic
Heather Ford
Susan Bartlett
Doris Howell
Madeline Li
Marta Novak
Istvan Mucsi
Publikationsdatum
17.06.2021
Verlag
Springer International Publishing
Erschienen in
Quality of Life Research / Ausgabe 2/2022
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-021-02910-5

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