The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Setting standards for severity of common symptoms in oncology using the PROMIS item banks and expert judgment
Open accessAbstract
Background Although the use of patient-reported outcome measures (PROs) has increased markedly, clinical interpretation of scores remains lacking. We developed a method to identify clinical severity thresholds for pain, fatigue, depression, and anxiety in people with cancer.Methods Using available Patient-Reported Outcomes Measurement Information System (PROMIS) item bank response data collected on 840 cancer patients, symptom vignettes across a range of symptom severity were developed and placed on index cards. Cards represented symptom severity at five-point intervals differences on the T score metric [mean = 50; standard deviation (SD) = 10]. Symptom vignettes for each symptom were anchored on these standardized scores at 0.5 SD increments across the full range of severity. Clinical experts, blind to the PROMIS score associated with each vignette, rank-ordered the vignettes by severity, then arrived at consensus regarding which two vignettes were at the upper and lower boundaries of normal and mildly symptomatic for each symptom. The procedure was repeated to identify cut scores separating mildly from moderately symptomatic, and moderately from severely symptomatic scores. Clinician severity rankings were then compared to the T scores upon which the vignettes were based.Results For each of the targeted PROs, the severity rankings reached by clinician consensus perfectly matched the numerical rankings of their associated T scores. Across all symptoms, the thresholds (cut scores) identified to differentiate normal from mildly symptomatic were near a T score of 50. Cut scores differentiating mildly from moderately symptomatic were at or near 60, and those separating moderately from severely symptomatic were at or near 70.Conclusions The study results provide empirically generated PROMIS T score thresholds that differentiate levels of symptom severity for pain interference, fatigue, anxiety, and depression. The convergence of clinical judgment with self-reported patient severity scores supports the validity of this methodology to derive clinically relevant symptom severity levels for PROMIS symptom measures in other settings.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“T-scores <50 for fatigue measures and T-scores <55 for sleep disturbance, pain, anxiety, and depression measures are considered normal based on published threshold scores [25, 26].”
From Symptom experiences in post-treatment cancer survivors: associations with acceptance and commitment therapy constructs. (2021) · cites this paper as [25]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Class 1 (n=65, 32%) was the least symptomatic with normal levels of all symptoms.22,23”
From Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs (2021) · cites this paper as [23]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Archives of Physical Medicine and Rehabilitation
Karin, A., & Kristina, A. (1976) · Journal of Sound and Vibration · doi:10.1016/0022-460x(76)90695-7 · Cited by 5,508
Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., Amtmann, D., Bode, R., Buysse, D., Choi, S., et al. (2010) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.04.011 · Cited by 5,128
Self-citationCella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., Ader, D., Fries, J. F., Bruce, B., & Rose, M. (2007) · Medical Care · doi:10.1097/01.mlr.0000258615.42478.55 · Cited by 3,118
Self-citationEducational measurement, 3rd ed.
Linn, R. L. (1989) · Cited by 2,858
Pilkonis, P. A., Choi, S. W., Reise, S. P., Stover, A. M., Riley, W. T., Cella, D., & PROMIS Cooperative Group (2011) · Assessment · doi:10.1177/1073191111411667 · Cited by 2,132
Self-citationSerlin, R. C., Mendoza, T. R., Nakamura, Y., Edwards, K. R., & Cleeland, C. S. (1995) · Pain · doi:10.1016/0304-3959(94)00178-h · Cited by 1,493
Psychometric Evaluation and Calibration of Health-Related Quality of Life Item Banks
Reeve, B. B., Hays, R. D., Bjørner, J. B., Cook, K. F., Crane, P. K., Teresi, J. A., Thissen, D., Revicki, D. A., Weiss, D. J., Hambleton, R. K., et al. (2007) · Medical Care · doi:10.1097/01.mlr.0000250483.85507.04 · Cited by 1,491
Self-citationDevelopment of a PROMIS item bank to measure pain interference
Amtmann, D., Cook, K. F., Jensen, M. P., Chen, W.-H., Choi, S., Revicki, D., Cella, D., Rothrock, N., Keefe, F., Callahan, L., et al. (2010) · Pain · doi:10.1016/j.pain.2010.04.025 · Cited by 1,199
Self-citationCA A Cancer Journal for Clinicians
(2008) · CA A Cancer Journal for Clinicians · doi:10.1002/(issn)1542-4863 · Cited by 648
Cella, D. F., Gershon, R. C., Lai, J., & Choi, S. W. (2007) · Quality of Life Research · doi:10.1007/s11136-007-9204-6 · Cited by 622
Self-citation
Research works printed but not linked: 2
- Zelman, D., Hoffman, D., Reed, P., Edwards, L., & Dukes, E. (2003). Quantifying a “day of manageable pain control:” The relationship between pain severity and patient daily functional expectations. Journal of Pain, 4(Suppl 1), 1.
- Baghaei, P. (2007). Applying The Rasch Rating-Scale model to set multiple cut-offs. Rasch Measurement Transactions, 20(4), 1075–1076.
Cited by
Sorted by citations
Jensen, R. E., Rothrock, N. E., DeWitt, E. M., Spiegel, B. M. R., Tucker, C. A., Crane, H. M., Forrest, C. B., Patrick, D. L., Fredericksen, R. J., Shulman, L. M., et al. (2015) · Medical Care · doi:10.1097/mlr.0000000000000289 · Cited by 222
Self-citationJensen, R. E., Potosky, A. L., Moinpour, C. M., Lobo, T., Cella, D., Hahn, E. A., Thissen, D., Smith, A. W., Ahn, J., Luta, G., et al. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2016.71.4410 · Cited by 189
Self-citationDevelopment and validation of an interpretive guide for PROMIS scores
Rothrock, N. E., Amtmann, D., & Cook, K. F. (2020) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-020-0181-7 · Cited by 194
Self-citationThissen, D., Liu, Y., Magnus, B. E., Quinn, H., Gipson, D. S., Dampier, C., Huang, I., Hinds, P. S., Selewski, D. T., Reeve, B. B., et al. (2015) · Quality of Life Research · doi:10.1007/s11136-015-1058-8 · Cited by 197
Ruark, J., Mullane, E., Cleary, N., Cordeiro, A., Bezerra, E. D., Wu, V., Voutsinas, J. M., Shaw, B. E., Flynn, K. E., Lee, S. J., et al. (2019) · Transplantation and Cellular Therapy · doi:10.1016/j.bbmt.2019.09.037 · Cited by 183
Metadata
- Authors
- Cella, D., Choi, S., Garcia, S., Cook, K. F., Rosenbloom, S., Lai, J.-S., Tatum, D. S., & Gershon, R.
- Affiliations
- Northwestern University (US)
- Corresponding author
- Cella, David
- ORCID
- Venue
- Quality of Life Research
- Published
- 2014-06-18
- Volume
- 23
- Issue
- 10
- Pages
- 2651-2661
- ISSN
- 0962-9343 (ISSN-L)
- 1573-2649
- PMC
- PMC4710358
- OpenAlex
- W2086090717
- Cited by
- 190
- References
- 29
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 19 · 2023: 25 · 2022: 26 · 2021: 17 · 2020: 17 · 2019: 20 · 2018: 14 · 2017: 8 · 2016: 7 · 2015: 7 · 2014: 1
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Quality of Life Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Comprehensive Cancer Network
- National Cancer Institute (R01CA060068, U2CCA186878, R01CA60068)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- patient-reported outcomes, cancer symptoms, pain interference, fatigue, depression, anxiety, cut-off values, expert opinion, T-score
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anxiety, Depression, Fatigue, Female, Humans, Male, Middle Aged, Neoplasms, Pain, Severity of Illness Index, Self Report, Patient Outcome Assessment
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
