Validation of the Edmonton Symptom Assessment System: Ascites Modification

Masanori Mori; Tatsuya Morita; Naosuke Yokomichi; Akihiro Nitto; Naoko Takahashi; Shingo Miyamoto; Hiroyuki Nishie; Junji Matsuoka; Hiroki Sakurai; Tatsuhiko Ishihara; Yoko Tarumi; Asao Ogawa

doi:10.1016/j.jpainsymman.2018.03.016

Validation of the Edmonton Symptom Assessment System: Ascites Modification

J Pain Symptom Manage. 2018 Jun;55(6):1557-1563. doi: 10.1016/j.jpainsymman.2018.03.016. Epub 2018 Mar 23.

Authors

Affiliations

¹ Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
² Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
³ Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
⁴ Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa, Japan.
⁵ Department of Palliative Care, Japan Red Cross Medical Center, Tokyo, Japan.
⁶ Department of Oncology, Japan Red Cross Medical Center, Tokyo, Japan.
⁷ Department of Anesthesiology and Intensive Care Medicine 2, Kawasaki Medical School, Kurashiki, Japan.
⁸ Department of Palliative Care, Okayama University Hospital, Okayama, Japan.
⁹ Department of Palliative Care, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
¹⁰ Department of Palliative Care, Okayama Saiseikai General Hospital, Okayama, Japan.
¹¹ Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
¹² Division of Psycho-Oncology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan. Electronic address: asogawa@east.ncc.go.jp.

PMID: 29581035
DOI: 10.1016/j.jpainsymman.2018.03.016

Abstract

Context: Few patient-reported outcomes are available to measure the symptoms associated with malignant-related ascites in patient care and clinical research. Although the Edmonton Symptom Assessment System: Ascites Modification (ESAS:AM) is a brief tool to measure symptoms associated with malignant-related ascites, it remains to be fully validated.

Objectives: The objective of the study was to validate the ESAS:AM in Japanese cancer patients.

Methods: We assessed the internal consistency, test-retest reliability, concurrent validity, and construct validity in 292 Japanese adult patients with cancer. They completed Japanese versions of the ESAS:AM, M.D. Anderson Symptom Inventory, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, and abdominal pain/ascites subscales of the EORTC Core Quality of Life Questionnaire, 26-item pancreatic cancer module.

Results: Cronbach's alpha coefficient of the ESAS:AM was 0.89. The intraclass correlation coefficient on test-retest examination of its total score was 0.93 (P < 0.001). Pearson correlation coefficients of the total score of the ESAS:AM with the total score of the M.D. Anderson Symptom Inventory and abdominal pain/ascites subscales of the EORTC Core Quality of Life Questionnaire, 26-item pancreatic cancer module ranged from 0.44 to 0.81 (P < 0.001) and those with global health status/quality of life and functional subscales of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 ranged from -0.40 to -0.61 (P < 0.001). The total scores of the ESAS:AM were significantly higher in 20 patients with symptomatic ascites (34 [SD, 26]) than 267 patients without symptomatic ascites (23 [SD, 19]) (P = 0.018).

Conclusion: The ESAS:AM is a reliable and valid tool for measuring symptoms associated with malignant-related ascites and can be used in daily patient care and future epidemiological studies and clinical trials.

Keywords: Edmonton Symptom Assessment System: Ascites Modification; cancer; malignant-related ascites; reliability; validation; validity.

Publication types

Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Ascites / diagnosis*
Ascites / etiology*
Female
Humans
Male
Middle Aged
Neoplasms / complications*
Neoplasms / diagnosis
Palliative Care
Patient Reported Outcome Measures*
Quality of Life
Reproducibility of Results
Symptom Assessment*