Patient-reported outcomes: using ESAS to screen for anemia.

Area of Science:

• Oncology
• Hematology
• Patient-Reported Outcomes (PROs)

Background:

• Patient symptom burden is crucial data for clinicians.
• The Edmonton Symptom Assessment Scale (ESAS) is widely used in radiation oncology and supportive care.
• Correlation between ESAS data and anemia requires investigation.

Purpose of the Study:

• To investigate the correlation between ESAS data and anemia in cancer patients.
• To determine if ESAS can serve as a screening tool for anemia.

Main Methods:

• Utilized a modified ESAS with direct patient electronic data input via tablet.
• Retrieved hemoglobin (Hb) data for 8304 patients from 9813 ESAS reports.
• Defined anemia as Hb < 13.0 g/L (men) or < 12 g/L (women), with 1351 patients having same-day data.

Main Results:

• A 2-item ESAS model (tiredness and shortness of breath ≥7) showed 80% positive predictive value for anemia and 97.6% specificity.
• This 2-item model achieved 8.2% sensitivity and 48.9% accuracy.
• A 5-item model (adding appetite, pain, primary site) improved sensitivity/accuracy but reduced specificity/PPV, deemed less clinically useful.

Conclusions:

• This study is among the first to report PRO data screening for a clinical sign (anemia).
• Predicting the absence of anemia is feasible using two ESAS questions: tiredness and shortness of breath.
• The 2-item ESAS model is a potential valuable screening tool for anemia in outpatient cancer settings.