Diagnostic Accuracy of the NCCN Distress Thermometer for the Assessment of Psychosocial Distress among Filipino Patients with Cancer

  • Dean Marvin P. Pizarro St. Luke's Medical Center
  • Marie Belle I. Francia
  • Mel Valerie C. Ordinario
Keywords: anxiety, depression, Distress thermometer, fear, sadness, Patient Health Questionnaire


Objective. The study aimed to assess the validity of the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT) for determining psychosocial distress, as applied to Filipino patients with cancer.

Methods. We conducted a cross-sectional descriptive study that included adult patients with cancer undergoing treatment at a tertiary private hospital. The NCCN-DT was administered to the patients together with the Patient Health Questionnaire-8 (PHQ-8) as the gold standard diagnostic test for psychosocial distress. Receiver Operating Characteristic (ROC) analysis was done to determine the accuracy of the NCCN-DT as a screening tool.

Results. We included 114 Filipino adults with cancer. The ROC analysis showed an Area Under the ROC Curve (AUC) score of 0.98 for the NCCN-DT against the PHQ-8. The cut-off score of ≥7 showed a sensitivity of 100% and specificity of 89.3% for detecting distress. The positive predictors for distress were identified: sadness (P<0.001), fear (P=0.001), depression (P=0.002), worry (P=0.02), childcare (P=0.03), fatigue (P=0.03), treatment decisions (P=0.04), loss of interest in usual activities (P=0.04), and memory/concentration (P=0.04).

Conclusion. The NCCN-DT had satisfactory diagnostic accuracy in agreement with PHQ-8 for screening of psychosocial distress among Filipino cancer patients. A cut-off score of ≥7 using the NCCN-DT gave the highest sensitivity and specificity for detecting distress in this population. The findings of this study can be used as validation of the NCCN-DT screening tool for a prospective application.