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