The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index; none of the 37 sources its claims cite is checked for support yet.
Promoting resilience in adolescents and young adults with cancer: Results from the PRISM randomized controlled trial
Open accessAbstract
Background: Adolescents and young adults (AYAs) with cancer are at risk for poor psychosocial outcomes. This study aimed to determine whether a novel intervention targeting resilience resources would improve patient‐reported resilience, quality of life, and psychological distress. Methods: In this parallel, phase 2 randomized controlled trial, English‐speaking AYAs (12‐25 years old) with cancer were randomized to the Promoting Resilience in Stress Management (PRISM) intervention or usual care (UC). PRISM is a brief, skills‐based intervention targeting stress management, goal setting, cognitive reframing, and meaning making. Participants completed surveys at enrollment and 6 months. Mixed effects regression models evaluated associations between PRISM and the primary outcome (10‐item Connor‐Davidson Resilience Scale scores) and secondary outcomes (generic and cancer‐related quality of life [Pediatric Quality of Life modules], psychological distress [Kessler‐6], and anxiety/depression [Hospital Anxiety and Depression]) at 6 months. Results: Ninety‐two AYAs were enrolled, were randomized, and completed baseline surveys (48 in the PRISM group and 44 in the UC group); 73% were 12 to 17 years old, and 62% had leukemia or lymphoma. Attrition was primarily due to medical complications and/or death; 36 PRISM participants and 38 UC participants completed 6‐month surveys. PRISM was associated with improved resilience (+3.0 points; 95% confidence interval [CI], 0.5‐5.4; P = .02) and cancer‐specific quality of life (+9.6; 95% CI, 2.6‐16.7; P = .01) and reduced psychological distress (–2.1; 95% CI, –4.1 to –0.2; P = .03) but not generic quality of life (+7.2; 95% CI, –0.8 to 15.2; P = .08). Although anxiety was similar between the groups, 2 PRISM participants (6%) and 8 UC participants (21%) met the criteria for depression at 6 months (odds ratio, 0.09; 95% CI, 0.01‐1.09; P = .06). Conclusions: PRISM was associated with improved psychosocial outcomes in comparison with UC, suggesting that brief, skills‐based interventions for AYAs may provide a benefit.
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TL;DR
In the PRISM randomized controlled trial, a brief skills-based intervention for adolescents and young adults with cancer was associated with improved patient-reported resilience, cancer-specific quality of life, and psychological distress compared with usual care at 6 months. Depression rates were lower among PRISM participants but the difference was not statistically significant.
Key findings
Among 92 enrolled AYAs (48 PRISM, 44 usual care), PRISM was associated with improved resilience (+3.0 points; 95% CI, 0.5-5.4; P = .02), improved cancer-specific quality of life (+9.6; 95% CI, 2.6-16.7; P = .01), and reduced psychological distress (−2.1; 95% CI, −4.1 to −0.2; P = .03).
- Generic quality of life did not significantly improve (+7.2; 95% CI, −0.8 to 15.2; P = .08).
- Anxiety was similar between groups: 6 PRISM participants (17%) and 10 usual care participants (26%) met criteria (OR, 0.36; 95% CI, 0.07-1.96), whereas depression was 2 PRISM participants (6%) and 8 usual care participants (21%) (OR, 0.09; 95% CI, 0.01-1.09; P = .06).
- At enrollment, 73% were 12 to 17 years old and 62% had leukemia or lymphoma; 43 of 48 PRISM participants (90%) received all 4 main sessions, and attrition was primarily due to medical complications and/or death.
Methods
Phase 2, parallel, 1:1 randomized controlled trial at Seattle Children's Hospital between January 2015 and October 2016; eligible participants were English-speaking AYAs aged 12 to 25 years with new cancer diagnosed 1 to 10 weeks before enrollment and receiving systemic chemotherapy, or with progressive/recurrent/refractory cancer at any time before enrollment; patients with preexisting or cancer-associated cognitive disabilities were excluded.
- One hundred AYAs were randomized (50 usual care, 50 PRISM); 92 completed baseline surveys (44 usual care, 48 PRISM), and 6-month surveys were completed by 38 usual care and 36 PRISM participants.
- Primary outcome was patient-reported resilience at 6 months (CDRISC-10); secondary outcomes included generic and cancer-specific quality of life (PedsQL), psychological distress (Kessler-6), and anxiety/depression (HADS).
- Primary intention-to-treat analysis used unadjusted linear mixed effects regression with patient-level random intercepts and slopes for continuous outcomes and mixed effects logistic regression for binary anxiety/depression outcomes; sensitivity analyses adjusted for sex, race/ethnicity, first language, and history of advanced cancer were unchanged; testing was 2-sided at α = .05 without correction for multiple comparisons.
Limitations
Stated: the trial was conducted at a single large academic pediatric-based AYA oncology center with a multidisciplinary psychosocial usual care team, so results may not generalize to smaller, community-based, or adult oncology centers; staff may have been aware of PRISM content; more usual care participants declined continued participation before baseline; only English-speaking patients were included; chance imbalance occurred in sex and first language; the CDRISC-10 may not exclusively reflect ability to harness resilience resources; the study could not delineate PRISM's active ingredients or dose effect, track real-life skill uptake, or assess durability; and the lack of an active control means social contact may have contributed to effects.
- Stated: the sample size may have been too small to detect subtle biases, and cultural differences in perceptions of resilience warrant further investigation.
- Evident from the text: the 6-month binary outcome analyses were based on only 74 participants, and no correction for multiple comparisons was applied, so the anxiety and depression findings are non-significant trends that should be interpreted cautiously.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among the 74 with 6-month survey data, 6 PRISM participants (17%) and 10 UC participants (26%) met criteria for anxiety (odds ratio, 0.36; 95% CI, 0.07-1.96)”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Cancer October 1, 2018
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In the paper
“but not generic quality of life (+7.2;95% CI, -0.8 to 15.2; P = .08)”
- Also stated in: § RESULTS · plain
“but not higher generic quality of life (+7.2;95% CI, -0.8 to 15.2; P = .08;Table 3)”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Abstract
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“whereas 2 PRISM participants (6%) and 8 UC participants (21%) met criteria for depression (odds ratio, 0.09; 95% CI, 0.01-1.09).”
- Also stated in: § Abstract · plain
“2 PRISM participants (6%) and 8 UC participants (21%) met the criteria for depression at 6 months (odds ratio, 0.09; 95% CI, 0.01-1.09;P = .06)”
- Also stated in: § DISCUSSION · hedged
“Patients who received PRISM showed a trend toward lower rates of depression.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Cancer October 1, 2018
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Effect sizes were small to moderate.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among the remaining 92 participants (44 UC participants and 48 PRISM participants), there were no differences between the groups with respect to clinical or demographic characteristics except for sex and first language (Table 2).”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
Strength:plain· not yet calibratedn = 92Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Reasons for attrition between the baseline and 6-month follow-up surveys were predominantly medical complications or death (4 UC participants [9%] and 10 PRISM participants [21%]; Fisher's exact P = .25).”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
Strength:plain· not yet calibratedn = 10Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“reduced psychological distress (-2.1; 95% CI, -4.1 to -0.2; P = .03)”
- Also stated in: § RESULTS · plain
“and lower psychological distress (-2.1; 95% CI, -4.1 to -0.2)”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Abstract
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no demographic differences between eligible patients who did and did not enroll.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
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In the paper
“Furthermore, there were no adverse events related to study participation.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“cancer-specific quality of life (+9.6;95% CI, 2.6-16.7;P = .01)”
- Also stated in: § RESULTS · plain
“and cancer-specific quality of life (+9.6;95% CI, 2.6-16.7)”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Abstract
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- It may state two separate claims as one. 26
- Probably not a substantial claim. 25
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Exploratory analyses suggested divergent trajectories of instrument scores (Fig. 2).For example, resilience and quality-of-life scores among UC participants went down or remained unchanged, whereas PRISM participants' scores went up.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Cancer October 1, 2018
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirty-eight UC participants and 36 PRISM participants completed 6-month surveys (median completion time, 8 days after the 6-month due date; interquartile range, 8-17 days).”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
Strength:plain· not yet calibratedn = 36Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Six UC participants (12%) did not complete the baseline surveys (5 electively and 1 on account of medical complications severely impairing her cognition).One PRISM participant (2%) elected not to complete the baseline survey.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
Strength:plain· not yet calibratedn = 6Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No PRISM participants reported high distress.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the 22-month enrollment period, we assessed 483 patients for eligibility (Fig. 1).Of 130 eligible AYAs, 100 (77%) were enrolled, and they were randomized (50 to UC and 50 to PRISM).”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
Strength:plain· not yet calibratedn = 483Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Changes in resilience and cancer-specific quality of life met or exceeded the MCID.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
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In the paper
“All 48 PRISM participants received at least 1 session, 43 (90%) received all 4 main sessions, and 40 (83%) opted in for coming together (Fig. 1).”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > RESULTS
Strength:plain· not yet calibratedn = 48Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“resilience (defined as the process of harnessing resources to sustain physical and emotional well-being in the face of significant stress) represents a promising approach.14”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [14] source
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In the paper
“goal seeking and problem solving improve psychosocial health, 16”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [16] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“These challenges may translate into underemployment, excessive medical expenditures, and significant corresponding productivity losses.9”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [9] source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“we developed and demonstrated the feasibility and acceptability of a novel, developmentally appropriate, brief, skills-based psychosocial intervention targeting resilience resources: Promoting Resilience in Stress Management (PRISM).24,25”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
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In the paper
“Inadequate psychosocial support and underdeveloped skills for navigating adversity may exacerbate these challenges.7,[10][11][12]”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites 7,[10][11][12]
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Impaired physical, social, and emotional health during and after cancer therapy are common.7,8”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
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In the paper
“and mindfulness improves quality of life.17”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [17] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Reductions in stress and distress improve immune function and reduce morbidity and mortality.[18][19][20]”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [18][19][20]
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“AYA cancer survivors report greater psychological distress and fewer positive health beliefs than younger pediatric or older adult counterparts.6”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [6] source
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In the paper
“AYAs learn and communicate differently than younger and older patients, and this necessitates age-targeted language and educational methods.22”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [22] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Promoting resilience resources (eg, skills in stress management, goal setting, cognitive reframing, and meaning making) may be valuable.15”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [15] source
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
In the paper
“among older adults with cancer, stress management reduces depression, 16”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
What the sources say
- Not checked yetcites [16] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Fewer than 50% of American AYAs with cancer enroll in clinical trials.35”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
What the sources say
- Not checked yetcites [35] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In this primary intention-to-treat analysis, data were analyzed and reported as planned.We included data from all patients who completed baseline surveys.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Statistical Analyses
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None of the sources cited for this claim have been checked yet.
In the paper
“we developed and demonstrated the feasibility and acceptability of a novel, developmentally appropriate, brief, skills-based psychosocial intervention targeting resilience resources: Promoting Resilience in Stress Management (PRISM).24,25”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > INTRODUCTION
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Sensitivity analyses were adjusted for patient sex, race/ethnicity, first language, and history of advanced cancer.Because the estimates were unchanged, we report unadjusted models.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Cancer October 1, 2018
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In the paper
“where participation in clinical research is common.40”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
What the sources say
- Not checked yetcites [40] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All testing was 2-sided and conducted at a .05significance level without correction for multiple comparisons.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Cancer October 1, 2018
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In the paper
“this is another variable associated with AYA engagement in clinical research.39”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
What the sources say
- Not checked yetcites [39] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We cannot determine whether this group had different baseline psychological characteristics, nor can we assess how attrition affected study findings.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
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In the paper
“Qualitative analyses suggest that the stress associated with a new cancer diagnosis limits enrollment, whereas directed patient engagement in consent discussions facilitates it.36”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
What the sources say
- Not checked yetcites [36] source
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All participants were invited to complete a survey consisting of AYA age-validated instruments upon enrollment (before any PRISM sessions, where relevant) and 6 months later.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Study Instruments
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In the paper
“This may be because they perceived a lack of benefit from the control arm.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“PRISM was administered by trained, bachelor's degreelevel nonclinical staff.25 All interventionists received ≥8 hours of standardized training, including mock sessions with role playing.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Delivery
What the sources say
- Not checked yetcites [25] source
Strength:plain· not yet calibratedn = 7Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our enrollment rate of 77% among eligible patients was higher than rates in published studies, perhaps because we waited to approach patients until at least 2 weeks after their diagnosis and directly engaged them in consent discussions.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The randomization algorithm was constructed with permuted blocks of various sizes; schedules were stratified by age (12-17 vs 18-25 years) because intervention materials were written at the developmental levels of these 2 age groups.Staff were blinded to the randomization scheme until after enrollment.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Recruitment and Randomization
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None of the sources cited for this claim have been checked yet.
In the paper
“All PRISM sessions were audio-recorded.For each interventionist, the first 5 sessions and 1 of any 5 randomly selected sessions were scored for fidelity with a standardized tool.25,27 Although our protocol included processes to retrain interventionists if needed, no remediation was necessary.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > Fidelity
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
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In the paper
“It is manualized (eg, it has been standardized through comprehensive protocols outlining training, delivery, and maintenance of fidelity).”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > PRISM Intervention
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“However, the construct of resilience, as assessed by the Connor Davidson Resilience Scale, has been associated with variable traits, states, processes, and outcomes such as hardiness, affect, coping, and life satisfaction.43”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
What the sources say
- Not checked yetcites [43]
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We did not track the real-life application of PRISM skills, so we cannot measure its uptake.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Linear models were based on 92 participants with baseline data; logistic models were based on 74 participants with 6-month data.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:plain· not yet calibratedn = 92Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because 90% of PRISM recipients received all 4 main sessions, we cannot delineate PRISM's active ingredients or a dose effect.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is possible that PRISM's impact is due to the social aspect of its delivery, rather than its content”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“By chance, more UC participants than PRISM participants spoke English as a second language and/or were female.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We cannot assess the durability of outcome improvements or the persistence of PRISM-developed skills.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PRISM's apparent efficacy may be because primary English speakers or young men are more responsive.”
§ Promoting Resilience in Adolescents and Young Adults With Cancer: Results From the PRISM Randomized Controlled Trial > DISCUSSION
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
Traditional cognitive behavioral therapy is designed for patients with maladaptive coping.
“Finally, CBT is designed for patients with maladaptive coping; AYAs may avoid the development of maladaptive behaviors through preventive learning.”
The paper relies on this without support.
Adolescents and young adults may avoid developing maladaptive behaviors through preventive learning.
“Finally, CBT is designed for patients with maladaptive coping; AYAs may avoid the development of maladaptive behaviors through preventive learning.”
The authors state this as an assumption.
AYAs, especially those with serious illness, may have underdeveloped resources.
“we postulate that AYAs, especially those with serious illness, may have underdeveloped resources.”
The authors state this as an assumption.
PRISM's mechanism of action is to bolster these resources and, in turn, enable AYA well-being.
“PRISM's proposed mechanism of action is to bolster these resources and, in turn, enable AYA well-being.”
The paper relies on this without support.
PRISM has been validated only in English.
“because PRISM has been validated only in English.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“A clinical trial testing the efficacy of the PRISM skills intervention compared to usual care among adolescents and young adults after cancer treatment, aged 12-25 years (N=100), showed statistically significant improvements in patient‐reported resilience and cancer‐specific quality of life, as well as reduced psychological distress [29].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Cancer-specific quality-of-life MCID does not match the stated calculation
MinorTable 2 gives a cancer-specific quality-of-life baseline SD of 16.3. Half of that is 8.15, not the MCID of 9.3 reported in Table 3.
Reported 9.3 · recomputed 8.15
“| Cancer-specific | 9.3 | 0.5 | 9.6 (2.6-16.7) | .01 |”
Overall nonwhite percentage is understated
MinorThe table lists 34 nonwhite participants among 92 overall, or approximately 37%, rather than 36%.
Reported 36 · recomputed 36.956522
“| Nonwhite race, No. (%) | 19 (43) | 15 (31) | 34 (36) |”
PRISM-group CNS percentage is overstated
MinorThree of 48 PRISM participants is 6.25%, which rounds to 6% at the table's whole-percentage precision, not 7%.
Reported 7 · recomputed 6.25
“| CNS, No. (%) | 3 (7) | 3 (7) | 6 (7) |”
Generic quality-of-life MCID does not match the stated calculation
MinorThe paper defines MCID as half the pooled baseline standard deviation. Table 2 gives a generic quality-of-life baseline SD of 18.6, making the MCID 9.3 rather than the reported 7.2.
Reported 7.2 · recomputed 9.3
“| Generic quality of life | 7.2 | 0.4 | 7.2 (-0.8 to 15.2) | .08 |”
Citations
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KESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327
The validity of the Hospital Anxiety and Depression Scale
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“The Hospital Anxiety and Depression Scale (HADS) assesses anxiety and depression in patients with serious illness.(33) Caseness is defined as a score >7 points in the relevant subdomain.”
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“3916 Cancer October 1, 2018 meta-analyses suggest that even small effect sizes of positive psychology interventions are associated with meaningful patient-centered outcomes.(46) Although future research is needed to examine the duration of PRISM’s efficacy, its active ingredients, and strategies for its dissemination…”
BackgroundThe PedsQL™ in pediatric cancer
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Flagged first, then by citations
Research works printed but not linked: 1
- Davidson J, 2010, Connor‐Davidson Resilience Scale Manual
Cited by
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Metadata
- Authors
- Rosenberg, A. R., Bradford, M. C., McCauley, E., Curtis, J. R., Wolfe, J., Baker, K. S., & Yi‐Frazier, J. P.
- Affiliations
- Seattle Children's Hospital (US)
- Seattle Children's Research Institute (US)
- University of Washington (US)
- Boston Children's Hospital (US)
- Corresponding author
- Rosenberg, Abby R.
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2018-09-19
- Volume
- 124
- Issue
- 19
- Pages
- 3909-3917
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- OpenAlex
- W2889985123
- Semantic Scholar
- 39e1761eb0018edd597bc57f0b1459e063402656
- Cited by
- 215
- References
- 45
- Citations by year
- 2026: 18 · 2025: 27 · 2024: 35 · 2023: 36 · 2022: 29 · 2021: 32 · 2020: 20 · 2019: 15 · 2018: 2
- FWCI
- 19.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- Funders
- CureSearch for Children's Cancer (KL2TR000421)
- National Institutes of Health (KL2TR000421)
- National Cancer Institute (L40 CA170049)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Keywords
- adolescent and young adult cancer, resilience, psychosocial interventions, stress management, quality of life, psychological distress, anxiety, depression, cognitive reframing, meaning-making, goal setting, leukemia, lymphoma, psychosocial outcomes, Kessler-6, Connor-Davidson Resilience Scale
- MeSH terms
- Adolescent, Adult, Child, Counseling, Female, Humans, Male, Neoplasms, Patient Education as Topic, Psychotherapy, Stress, Psychological, Treatment Outcome, Age of Onset, Resilience, Psychological, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
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