title: Improving the Diagnostic Accuracy of the Distress Thermometer: A Potential Role for the Impact Thermometer.
abstract: BACKGROUND
  Screening for and management of distress in clinical practice is an important issue in the field of psycho-oncology. The Distress Thermometer (DT) is a common screening tool, but other methods recently have been proposed, with the aim of improving its diagnostic accuracy.
  
  
  OBJECTIVE
  To investigate the diagnostic accuracy of the DT alone and combined with the Impact Thermometer (IT), via the use of two possible combination methods.
  
  
  METHODS
  A heterogeneous sample of 385 adult patients with cancer completed the DT, the IT, and the Brief Symptom Inventory-18.
  
  
  RESULTS
  The results of the DT were comparable with those found in previous studies, indicating that the DT was adequate for "screening" but had limited value for "case finding." The DT and the IT combined (summed or paired scores) showed minor differences in accuracy indexes compared with the DT alone.
  
  
  CONCLUSIONS
  The results of this study suggest that the addition of the IT to the DT failed to improve its accuracy for identifying distress.
authors.affiliation: University of Valencia, Valencia, Spain. Electronic address: paula.martinez@uv.es.
authors.forename: Paula
authors.initials: P
authors.lastname: Martínez
authors.affiliation: University of Valencia, Valencia, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Andreu
authors.affiliation: University of Valencia, Valencia, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Galdón
authors.affiliation: University of Valencia, Valencia, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Ibáñez
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology; D011581:Psychological Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000175:diagnosis*
keywords: BSI-18; Distress Thermometer; Impact Thermometer; Psychosocial distress; cancer; diagnostic accuracy; screening