Objective: Cachexia is a problematic wasting syndrome
experienced by some cancer patients that can lead to early death in
these patients. The purpose of the present study was to examine the
criterion validity and sensitivity and specificity of two single items
from a depression scale to rapidly screen patients in ambulatory
oncology clinics for cancer-related nutritional risk and cachexia.
Methods: A chart review was conducted of 50 randomly
selected patient profiles. Patients' responses to item 5 (“I
eat as much as I used to”) and item 7 (“I notice I am
losing weight”) of the Zung Self Rating Depression Scale (ZSDS)
were compared against the Scored Patient-Generated Subjective Global
Assessment (PG-SGA) as well as to Body Mass Index (BMI) scores and
weight at two time periods.
Results: Item 5 of the ZSDS was significantly related to
initial weight (F3,45 = 6.06, p <
0.001), weight at 6-month follow-up (F3,27 = 4.16,
p < 0.05), BMI score (F3,46 = 2.89,
p < 0.05), and nutritional risk on the PG-SGA
(F3,45 = 5.80, p < 0.01). Item 7 of the
ZSDS was only a significant predictor of nutritional risk as measured
by the PG-SGA (F3,46 = 6.01, p < 0.01).
When the two items were combined to form a two-item scale, it
maintained the individual items' significant relationship to the
PG-SGA (F1,48 = 13.99, p < 0.001).
Using this as the criterion for identifying nutritionally at-risk
patients, the two-item screen yields a sensitivity of 50% and
specificity of 88%.
Significance of the research: It is concluded that a single
item or a combination of two items can yield a reliable initial screen
for identifying patients who might be at nutritional risk for the
development of cachexia. Further study is needed in prospective trials
to further explore the utility of these items.