title: The validity of the distress thermometer in prostate cancer populations.
abstract: BACKGROUND
  The Distress Thermometer (DT) is widely recommended for screening for distress after cancer. However, the validity of the DT in men with prostate cancer and over differing time points from diagnosis has not been well examined.
  
  
  METHODS
  Receiver operating characteristics analyses were used to evaluate the diagnostic accuracy of the DT compared with three commonly used standardised scales in two prospective and one cross-sectional survey of men with prostate cancer (n = 740, 189 and 463, respectively). Comparison scales included the Impact of Event Scale - Revised (IES-R, Study 1), the Hospital Anxiety and Depression Scale (HADS, Study 2) and the Brief Symptom Inventory-18 (BSI-18, Study 3).
  
  
  RESULTS
  Study 1: the DT showed good accuracy against the IES-R at all time points (area under curves (AUCs) ranging from 0.84 to 0.88) and sensitivity was high (>85%). Study 2: the DT performed well against both the anxiety and depression subscales for HADS at baseline (AUC = 0.84 and 0.82, respectively), but sensitivity decreased substantially after 12 months. Study 3: validity was high for the anxiety (AUC = 0.90, sensitivity = 90%) and depression (AUC = 0.85, sensitivity = 74%) subscales of the BSI-18 but was poorer for somatization (AUC = 0.67, sensitivity = 52%). A DT cut-off between ≥3 and ≥6 maximised sensitivity and specificity across analyses.
  
  
  CONCLUSIONS
  The DT is a valid tool to detect cancer-specific distress, anxiety and depression among prostate cancer patients, particularly close to diagnosis. A cut-off of ≥4 may be optimal soon after diagnosis, and for longer-term assessments, ≥3 was supported. © 2013 The Authors. Psycho-Oncology published by John Wiley & Sons, Ltd.
authors.affiliation: Griffith Health Institute, Griffith University, Brisbane, Australia; Cancer Council Queensland, Brisbane, Australia; Prostate Cancer Foundation of Australia, Sydney, Australia; Edith Cowan University, Joondalup, Australia.
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Chambers
authors.forename: Leah
authors.initials: L
authors.lastname: Zajdlewicz
authors.forename: Danny R
authors.initials: DR
authors.lastname: Youlden
authors.forename: Jimmie C
authors.initials: JC
authors.lastname: Holland
authors.forename: Jeff
authors.initials: J
authors.lastname: Dunn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D019540:Area Under Curve; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000523:psychology*; D011594:Psychometrics / Q000295:instrumentation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: distress screening; distress thermometer; prostate cancer; psychosocial care
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