New Instrument for Comprehensive Symptom Profile Assessment In Patients with Malignant Lymphomas

Abstract 2561

Comprehensive symptom assessment before and during treatment in lymphoma patients is worthwhile. We aimed to develop a new symptom assessment tool — Comprehensive Symptom Profile in Lymphoma Patients (CSP-Lym) and test its applicability to this patient population.

The CSP-Lym is a self-reported tool which allows the assessment of the severity of 45 symptoms in lymphoma patients. It consists of numerical rating scales, scored from “0” (no symptom) to “10” (most expressed symptom). Thirteen symptom clusters have been identified, which were clinically relevant and increased the practicability of the tool. Utility of the CSP-Lym was demonstrated by means of interviewing both patients and physicians. Applicability of the tool with preliminary analysis of psychometric properties was tested in a pilot study. 75 patients with different types of malignant lymphomas (Stage – I-IV) were included in the study: Non-Hodgkin's lymphoma – 26; Hodgkin's lymphoma – 49. Mean age was 33.5 years old; male/female distribution –28/47. Patients filled out the CSP-Lym before and at different time-points of treatment.

The utility of the CSP-Lym was demonstrated. The patients acknowledged the comprehensiveness of the tool. All of the items were easy for the patients to read and understand. Completion of the CSP-Lym in paper and pencil format took 5–7 min. The data produced by the tool were clear for interpretation by physicians and were used by them in day-to-day decision making.

The construct validity of the CSP-Lym was proven by factor analysis and “known-group” comparison. A six factor structure was found for the core symptom items, which explained 65% of the total variance. The analysis of symptom severity in the groups with and without B-symptoms revealed differences between the groups: all of the symptoms were more severe in patients with B-symptoms. Statistically significant differences between the groups (p<0.05) were found for the majority of symptoms. Reliability of the CSP-Lym was satisfactory: Chronbach's alpha coefficient varied from 0.63 to 0.92. Sensitivity to changes was demonstrated by the comparison of symptom severity before and after treatment. The majority of symptoms after treatment were less severe than at base-line.

Thus, the CSP-Lym is an appropriate and practical tool to assess the symptom severity in lymphoma patients. The utility of the questionnaire was shown; preliminary psychometric properties appeared to be satisfactory. Further studies are needed before the wide-spread use of the CSP-Lym in clinical practice and clinical trials.