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The following is a summary of “Diagnostic Accuracy of Single-Item Scales in Detecting Fatigue in Patients with Cancer: A Systematic Review and Meta-Analysis,” published in the September 2024 issue of Oncology by Lu et al.
Early detection of fatigue in patients with cancer is essential for improving clinical outcomes and enhancing quality of life. While single-item scales offer a practical, efficient means of assessing fatigue, their diagnostic accuracy remains to be determined, and study variability may limit their generalizability. This systematic review and meta-analysis aim to evaluate the diagnostic performance of single-item fatigue detection scales compared to more complex, multidimensional assessments, providing a clearer understanding of their clinical utility.
A comprehensive search of CINAHL, Cochrane Library, Embase, and PubMed databases was conducted to identify relevant studies. Meta-analyses were performed to calculate pooled sensitivity, specificity, diagnostic odds ratios (DOR), likelihood ratios, predictive values, and the area under the hierarchical summary receiver operating characteristic (HSROC) curve. Subgroup analyses were used to explore heterogeneity across studies, which was influenced by factors such as cancer type, study design, and gold-standard reference methods. All statistical analyses were performed using R software (version 4.3.1), and the study protocol was registered with PROSPERO (CRDXXX).
A total of 11 studies involving 3,509 patients with cancer met the inclusion criteria. The pooled sensitivity was 0.89 (95% CI: 0.82-0.93), indicating that single-item scales effectively correctly identified patients with fatigue. The pooled specificity was 0.72 (95% CI: 0.63-0.80), suggesting moderate accuracy in ruling out patients without fatigue. The diagnostic odds ratio was 19.95 (95% CI: 10.47-38.04), reflecting strong overall diagnostic performance. Additionally, the area under the curve (AUC) for the HSROC was 0.90 (95% CI: 0.89-0.91), confirming high diagnostic accuracy. Despite moderate to high heterogeneity across studies, likely due to differences in cancer types, study methodologies, and fatigue measurement standards, single-item scales showed a comparable diagnostic value to more complex fatigue assessment tools.
In conclusion, single-item fatigue detection scales provide a reliable and efficient method for assessing fatigue in patients with cancer, making them a valuable tool for routine clinical practice. However, standardizing assessment criteria and refining these tools to balance simplicity and diagnostic precision further will be essential for enhancing their accuracy and applicability across diverse patient populations. Future research should aim to address these gaps and improve consistency in fatigue assessment in oncology.
Source: sciencedirect.com/science/article/abs/pii/S1040842824002397
