Evaluation of the Distress Thermometer in older patients with cancer

Abstract

Introduction

The Geriatric Depression Scale is a useful tool in screening for depression in older adults, a particularly vulnerable population in oncology. The National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) has been validated as a fast and effective screening tool for psychological distress in general oncology populations, and it could possibly be used as a surrogate for the longer Geriatric Depression Scale (GDS) test in older adults with cancer.

Materials and Methods

In this retrospective cross-sectional study in older adults prior to starting cancer treatment, we evaluated the relationship between the DT and GDS by comparing 242 older adults with cancers' DT scores to their GDS scores, used receiver operating characteristic analysis to determine a DT cutoff score, and used logistic regression to identify variables associated with higher distress.

Results

The Spearman correlation coefficient between GDS and DT was 0.41, p < 0.001. A cutoff score of 4 was found to be most sensitive and specific (0.66,0.68) for predicting a positive GDS (c-index = 0.70).

Discussion

These results indicate the potential utility of the DT as a mildly to moderately effective screening tool for depression in older adults with cancer starting treatment and support the current NCCN cutoff guidelines to indicate the need for additional distress interventions.