Journal of Pain and Symptom Management
Volume 39, Issue 2 , Pages 241-249 , February 2010

A Single Set of Numerical Cutpoints to Define Moderate and Severe Symptoms for the Edmonton Symptom Assessment System

  • Debbie Selby, MD, FRCPC

      Affiliations

    • Palliative Care Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    • Corresponding Author InformationAddress correspondence to: Debbie Selby, MD, FRCPC, Palliative Care Department, Sunnybrook Health Sciences Center, University of Toronto, 2075 Bayview Avenue, H336, Toronto, Ontario M4N 3M5, Canada.
    • ,
  • Alisa Cascella, BSc (C)

      Affiliations

    • Palliative Care Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Kate Gardiner, BSc

      Affiliations

    • Palliative Care Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Randy Do, BSc (C)

      Affiliations

    • Palliative Care Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Veronika Moravan, MSc

      Affiliations

    • Private Practice, Toronto, Ontario, Canada
    • ,
  • Jeff Myers, MD, CCFP

      Affiliations

    • Palliative Care Department, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    • ,
  • Edward Chow, MBBS, PhD, FRCPC

      Affiliations

    • Rapid Response Radiotherapy Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

,Accepted 13 July 2009.

References 

  1. Kirkova J, Davis MP, Walsh D, et al. Cancer symptom assessment instruments: a systemic review. J Clin Oncol. 2006;24:1459–1473
  2. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991;7:6–9
  3. Nekolaichuk C, Watanabe S, Beaumont C. The Edmonton Symptom Assessment System: a 15-year retrospective review of validation studies (1991–2006). Palliat Med. 2008;22:111–122
  4. Chang VT, Hwang SS, Feuerman M. Validation of the Edmonton Symptom Assessment Scale. Cancer. 2000;88:2164–2171
  5. Rees E, Hardy J, Ling J, Bradley K, A'Hern R. The use of the Edmonton Symptom Assessment Scale (ESAS) within a palliative care unit in the UK. Palliat Med. 1998;12:75–82
  6. Nelson JE, Meier DE, Oei EJ, et al. Self-reported symptom experience of critically ill cancer patients receiving intensive care. Crit Care Med. 2001;29:277–282
  7. Davison SN, Jhangri GS, Johnson JA. Cross sectional validity of a modified Edmonton Symptom Assessment System (ESAS) in dialysis patients: a simple assessment of symptom burden. Kidney Int. 2006;69:1621–1625
  8. Anderson KO. Role of cutpoints: why grade pain intensity?. Pain. 2005;113:5–6
  9. Butt Z, Wagner LI, Beaumont JL, et al. Use of a single-item screening tool to detect clinically significant fatigue, pain, distress, and anorexia in ambulatory cancer practice. J Pain Symptom Manage. 2008;35:20–30
  10. Lloyd-Williams M, Dennis M, Taylor F. A prospective study to compare three depression screening tools in patients who are terminally ill. Gen Hosp Psychiatry. 2004;26:384–389
  11. Vignaroli E, Pace E, Willey J, et al. The Edmonton Symptom Assessment System as a screening tool for depression and anxiety. J Palliat Med. 2006;9:296–303
  12. Serlin RC, Mendoza TR, Nakamura Y, Edwards KR, Cleeland CS. When is cancer pain mild, moderate, or severe? Grading pain severity by its interference with function. Pain. 1995;61:277–284
  13. Chow E, Doyle M, Li K, et al. Mild, moderate, or severe pain categorized by patients with cancer with bony metastases. J Palliat Med. 2006;9:850–853
  14. Chang YJ, Lee JS, Lee CG, et al. Assessment of clinical relevant fatigue level in cancer. Support Care Cancer. 2007;15:891–896
  15. Paul SM, Zelman DC, Smith M, Miaskowski C. Categorizing the severity of cancer pain: further exploration of the establishment of cutpoints. Pain. 2005;113:37–44
  16. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (v.1.2008), cancer-related fatigue. Available from http://www.nccn.org/professionals/physician_gls/PDF/fatigue.pdf. Accessed November 15, 2008.
  17. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (v.1.2008), adult cancer pain. Available from http://www.nccn.org/professionals/physician_gls/PDF/pain.pdf. Accessed November 15, 2008.
  18. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (v.1.2008), Distress Management. Available from http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf. Accessed November 15, 2008.
  19. Mid Trent Cancer Network-Palliative Care Group. Palliative care cancer pain standards, guidelines and patient information for hospitals July, 2005. Available from http://www.information4u.org.uk/files/Hospital%20Guidelines%20For%20Nottingham%20July%202005.pdf. Accessed November 30, 2008.
  20. World Health Organization. Cancer pain relief. Geneva, IL: World Health Organization; 1986;
  21. Jensen MP, Smith DG, Ehde DM, Robinsin LR. Pain site and the effects of amputation pain: further clarification of the meaning of mild, moderate and severe pain. Pain. 2001;109:317–322
  22. Kapstad H, Hanestad BR, Langeland N, Rustøen T, Stavem K. Cutpoints for mild, moderate and severe pain in patients with osteoarthritis of the hip or knee ready for joint replacement surgery. BMC Musculoskelet Disord. 2008;9:55–63
  23. Turner JA, Franklin G, Heagerty PJ, et al. The association between pain and disability. Pain. 2004;112:307–314
  24. Mendoza TR, Chen C, Brugger A, et al. Lessons learned from a multiple-dose post-operative analgesic trial. Pain. 2004;109:103–109
  25. Zelman DC, Dukes E, Brandenburg N, Bostrom A, Gore M. Identification of cut-points for mild, moderate and severe pain due to diabetic peripheral neuropathy. Pain. 2005;115:29–36
  26. Zelman DC, Hoffman DL, Seifeldin R, Dukes EM. Development of a metric for a day of manageable pain control: derivation of pain severity cut-points for low back pain and osteoarthritis. Pain. 2003;106:35–42

PII: S0885-3924(09)00843-4

doi: 10.1016/j.jpainsymman.2009.06.010

Journal of Pain and Symptom Management
Volume 39, Issue 2 , Pages 241-249 , February 2010

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