Comparison of Simple-Summated Scoring and Toxicity Index Scoring of Symptom Bother in the NSABP B-30 Clinical Trial

Abstract

BackgroundLevel of symptom burden for cancer patients can be summarized using simple-summated scoring of multiple patient-reported symptoms. The Toxicity Index (TI) is an alternative that has been used primarily to summarize clinician-reported toxicities.ObjectiveTo compare the TI with simple-summated scoring of 28 patient-reported symptoms.MethodsThis is a secondary analysis of longitudinal data from a clinical trial of women with stage 2 or 3 breast cancer: baseline (n = 2156) and 6 months later (n = 1764). Study participants completed the 28-item Breast Cancer Prevention Trial symptom checklist assessing level of symptom bother in the past 7 days and four criterion items assessing general health and overall quality of life.ResultsAssociations of simple-summated scoring of the 28 cancer-related symptoms with the general health and overall quality of life items tended to be larger than correlations of the TI summary scoring of the symptoms. For example, the Spearman correlation of change in quality of life was − 0.38 with change in the simple-summated score and − 0.23 with change in the TI.ConclusionThe findings suggest that simple-summated scoring and differential weighting of the level of symptom bother yield similar results.Implications for PracticeClinicians can use simple-summated scoring rather than more complicated scoring algorithms to obtain an indication of overall level of symptom burden among cancer patients.