Cancer symptom assessment instruments: a systematic review.
OBJECTIVE
A variety of assessment instruments have been created to identify cancer symptoms. We reviewed systematically cancer symptom assessment instruments published in English.


METHODS
A systematic search of the MEDLINE database, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and EMBASE was performed. Non-peer-reviewed articles were identified through BIOSIS. Articles were accessed through the related article links in PubMed and references were searched by hand. Studies were included if the instrument had symptom assessment as the primary outcome. Quality-of-life instruments were excluded.


RESULTS
We identified 21 instruments; some had undergone modification or validation. An additional 28 studies examined symptom prevalence and interrelations; many involved symptom checklists. Studies varied in design, patient characteristics, symptoms, and outcome. Meta-analysis was not possible due to heterogeneity in design, study outcomes, and validation. Seventy-six articles and two conference abstracts (derived from MEDLINE, Cochrane, CINAHL, EMBASE, BIOSIS, related articles link in PubMed, and search by hand) met inclusion/exclusion criteria. The electronic search (without related links) yielded only 26% of those articles and conference abstracts that met inclusion criteria. Searches by hand of related articles identified 59% of studies.


CONCLUSIONS
Twenty-one instruments were identified as appropriate for clinical use. The instruments vary in symptom content and extent of psychometric validation. Both comprehensive and shorter instruments have been developed, and some instruments are intended for specific symptom assessment or symptoms related to treatment. There is no ideal instrument, and the wide variety of instruments reflects the different settings for symptom assessment. Additional research is necessary.
Harry R. Horvitz Center for Palliative Medicine, the Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Jordanka
J
Kirkova
Mellar P
MP
Davis
Declan
D
Walsh
Eoin
E
Tiernan
Norma
N
O'Leary
Susan B
SB
LeGrand
Ruth L
RL
Lagman
K Mitchell
KM
Russell
D006304:Health Status; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome