Bagha, S.M., Macedo, A., Jacks, L.M., Lo, C., Zimmermann, C., Rodin, G.M., and Li, M. (2013) The utility of the Edmonton Symptom Assessment System in screening for anxiety and depression. European Journal of Cancer Care, 22. pp. 60-69.

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Abstract

The Edmonton Symptom Assessment System (ESAS) is a common screening tool in cancer, although its validity for distress screening is unproven. Here, screening performance of the ESAS anxiety (ESAS-A) and depression (ESAS-D) items were validated against the anxiety [Generalised Anxiety Disorder-7 (GAD-7)] and depression [Patient Health Questionnaire-9 (PHQ-9)] subscales of the PHQ. A total of 1215 cancer patients completed the Distress Assessment and Response Tool (DART), a computerised distress screening instrument. Spearman's rank correlation coefficients and receiver operating characteristic curve analyses were used to evaluate the ability of ESAS-A and ESAS-D to identify moderate distress (GAD-7/PHQ-9 ≥ 10). Spearman's rank correlation coefficients comparing ESAS-A and ESAS-D with GAD-7 and PHQ-9 were 0.74 and 0.72 respectively. Areas under the receiver operating characteristic curves were 0.89 and 0.88 for anxiety and depression respectively. A cut-off of ≥3 on ESAS-A demonstrated a sensitivity of 0.91, specificity of 0.68, positive predictive value of 0.34 and negative predictive value of 0.97. A cut-off of ≥2 on the ESAS-D demonstrated a sensitivity of 0.86, specificity of 0.72, positive predictive value of 0.46 and negative predictive value of 0.95. High sensitivities of ESAS-A and ESAS-D at certain cut-offs suggest they have use in ruling-out distress. However, their low specificities indicate secondary screening is needed to rule-in anxiety or depression for case-finding.

Item ID:	86483
Item Type:	Article (Research - C1)
ISSN:	1365-2354
Copyright Information:	© 2012 Blackwell Publishing Ltd.
Date Deposited:	12 Aug 2025 00:07
FoR Codes:	42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 50% 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520399 Clinical and health psychology not elsewhere classified @ 50%
SEO Codes:	28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280121 Expanding knowledge in psychology @ 30% 20 HEALTH > 2004 Public health (excl. specific population health) > 200499 Public health (excl. specific population health) not elsewhere classified @ 30% 20 HEALTH > 2002 Evaluation of health and support services > 200202 Evaluation of health outcomes @ 40%
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