title: Self-reported constipation in patients with advanced cancer: a preliminary report.
abstract: BACKGROUND
  Constipation is often inadequately assessed and underdiagnosed in patients with advanced cancer. Many studies use patient-reported constipation (PRC) as an outcome.
  
  
  OBJECTIVE
  The aim was to compare the accuracy of PRC as compared with the modified Rome III (ROME) criteria and to determine the agreement between PRC, physician assessment of constipation, and objective assessment of constipation by modified ROME criteria among outpatients with advanced cancer.
  
  
  METHODS
  Patients with advanced cancer attending a supportive care clinic were screened. Constipation was assessed using the modified ROME criteria, patient report (yes or no and rated 0-10; 10=worst possible symptom), and physician assessments (yes or no and rated 0-10).
  
  
  RESULTS
  One hundred patients were enrolled, and 50 of 100 patients (50%) met the modified ROME criteria for constipation. Disagreement between ROME criteria and the patient report (yes/no) was found in 33 patients (33%) and between ROME criteria and the physician assessment (yes/no) in 39 patients (39%). The best combination of sensitivity (0.84) and specificity (0.62) was found with scores ≥3/10 for PRC.
  
  
  CONCLUSIONS
  We found a high frequency of constipation. The limited agreement with modified ROME criteria suggests that a patient's self-report as yes or no is not useful for clinical practice. Patient self-rating on a 0 to 10 scale (score of three or greater) seems to be the best tool for constipation screening among this population. More research is needed to identify the best way to assess constipation in patients with advanced cancer.
authors: Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors: Wadih
authors: W
authors: Rhondali
authors: Linh
authors: L
authors: Nguyen
authors: Lynn
authors: L
authors: Palmer
authors: Duck-Hee
authors: DH
authors: Kang
authors: David
authors: D
authors: Hui
authors: Eduardo
authors: E
authors: Bruera
mesh_terms: D000368:Aged; D003248:Constipation / Q000150:complications / Q000175:diagnosis*; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D057566:Self Report; D011795:Surveys and Questionnaires