Validation of the Edmonton Symptom Assessment System in Korean Patients With Cancer

• Published in: Journal of pain and symptom management 2013-12, Vol.46 (6), p.947-956
• Main Authors: Kwon, Jung Hye, MD, PhD, Nam, Seung-Hyun, MD, Koh, Sujin, MD, PhD, Hong, Young Seon, MD, PhD, Lee, Kyung Hee, MD, PhD, Shin, Sang-Won, MD, PhD, Hui, David, MD, MSc, FRCPC, Park, Kyun Woo, MD, Yoon, So Young, MD, PhD, Won, Ji Yun, RN, Chisholm, Gary, MS, Bruera, Eduardo, MD
• Format: Article
• Language: English
• Subjects: Advanced cancer; Aged; Anesthesia & Perioperative Care; Anxiety-Depression; Biological and medical sciences; Cancer; Correlation coefficients; Edmonton Symptom Assessment System; ESAS; Female; Humans; Korea; Male; Medical sciences; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasms - diagnosis; Neoplasms - epidemiology; Neoplasms - psychology; Pain Medicine; Pharmacology. Drug treatments; Prevalence; Psychometrics - methods; Psychometrics - statistics & numerical data; Quality of Life; Reproducibility of Results; Republic of Korea - epidemiology; Responsiveness; Sensitivity and Specificity; Surveys and Questionnaires; Symptom Assessment - methods; Symptom Assessment - statistics & numerical data; Symptoms; Test-Retest reliability; Tumors
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2013.01.012

Abstract Context The Edmonton Symptom Assessment System (ESAS) is a brief, widely adopted, multidimensional questionnaire to evaluate patient-reported symptoms. Objectives To develop a Korean version of the ESAS (K-ESAS) and to perform a psychometric analysis in Korean patients with advanced cancer. Methods We tested the K-ESAS in two pilot studies with 15 patients each. We assessed internal consistency, test-retest reliability, and concurrent validity in 163 Korean patients, who completed the K-ESAS along with the Korean versions of the M. D. Anderson Symptom Inventory (K-MDASI) and the Hospital Anxiety and Depression Scale (K-HADS) twice. A total of 38 patients completed the questionnaires again seven days later to assess responsiveness. Results The K-ESAS scores had good internal consistency, with a Cronbach's alpha coefficient of 0.88, indicating that no questions had undue influence on the score. Pearson correlation coefficients for K-ESAS symptom scores between baseline and after two to four hours ranged from 0.72 (95% CI 0.64–0.79) to 0.87 (95% CI 0.82–0.90), indicating strong test-retest reliability. For concurrent validity, Pearson correlation coefficients between K-ESAS symptom scores and corresponding K-MDASI symptom scores ranged from 0.70 (95% CI 0.62–0.77) to 0.83 (95% CI 0.77–0.87), indicating good concurrent validity. For the K-HADS, concurrent validity was good for anxiety ( r = 0.73, 95% CI 0.65–0.79) but moderate for depression ( r = 0.4, 95% CI 0.26–0.52). For responsiveness, changes in K-ESAS scores after seven days were moderately correlated with changes in K-MDASI scores but weakly correlated with changes in K-HADS scores. Conclusion The K-ESAS is a valid and reliable tool for measuring multidimensional symptoms in Korean patients with cancer.