title: Toxicity grading systems. A comparison between the WHO scoring system and the Common Toxicity Criteria when used for nausea and vomiting.
abstract: BACKGROUND
  The Common Toxicity Criteria adopted by the NCI in the USA for grading toxicity in cancer clinical trials have been compared to the WHO scoring system which is still in use in Europe.
  
  
  METHODS
  Sixty-six patients undergoing emetic chemotherapy at the Netherlands Cancer Institute completed questionnaires, 32 according to the WHO criteria and 34 to the Common Toxicity Criteria, on the severity, frequency and duration of gastro-intestinal toxicity. Their answers were then compared to the scores coded by research nurses and physicians. The nurses coded acute toxicity when the patients were discharged, and the doctors coded overall toxicity when the patients returned for the subsequent course of chemotherapy. To evaluate the coding systems, an estimate was made of the percentage agreement between the patients' answers and the nurses' and doctors' ratings.
  
  
  RESULTS
  The percentage agreement of the Common Toxicity Criteria with the patients' own experiences of nausea and vomiting was considerably better than that of the WHO score. The Gamma statistic confirmed this. The Common Toxicity Criteria have now been adopted for grading toxicity in studies of the Early Clinical Trials Group of the EORTC and are recommended for use in other clinical trials.
authors.affiliation: The Netherlands Cancer Institute, Antonie van Leeuwenhoek Huis, Amsterdam.
authors.forename: H R
authors.initials: HR
authors.lastname: Franklin
authors.forename: G P
authors.initials: GP
authors.lastname: Simonetti
authors.forename: A C
authors.initials: AC
authors.lastname: Dubbelman
authors.forename: W W
authors.initials: WW
authors.lastname: ten Bokkel Huinink
authors.forename: B G
authors.initials: BG
authors.lastname: Taal
authors.forename: G
authors.initials: G
authors.lastname: Wigbout
authors.forename: I A
authors.initials: IA
authors.lastname: Mandjes
authors.forename: O B
authors.initials: OB
authors.lastname: Dalesio
authors.forename: N K
authors.initials: NK
authors.lastname: Aaronson
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced*; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000139:chemically induced*; D014944:World Health Organization
chemical_list: D000970:Antineoplastic Agents