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. 2013 Dec;46(6):947-56.
doi: 10.1016/j.jpainsymman.2013.01.012. Epub 2013 Apr 28.

Validation of the Edmonton Symptom Assessment System in Korean patients with cancer

Jung Hye Kwon  1 , Seung-Hyun Nam, Sujin Koh, Young Seon Hong, Kyung Hee Lee, Sang-Won Shin, David Hui, Kyun Woo Park, So Young Yoon, Ji Yun Won, Gary Chisholm, Eduardo Bruera
Affiliations

Validation of the Edmonton Symptom Assessment System in Korean patients with cancer

Jung Hye Kwon et al. J Pain Symptom Manage. 2013 Dec.

Abstract

Context: The Edmonton Symptom Assessment System (ESAS) is a brief, widely adopted, multidimensional questionnaire to evaluate patient-reported symptoms.

Objectives: To develop a Korean version of the ESAS (K-ESAS) and to perform a psychometric analysis in Korean patients with advanced cancer.

Methods: We tested the K-ESAS in two pilot studies with 15 patients each. We assessed internal consistency, test-retest reliability, and concurrent validity in 163 Korean patients, who completed the K-ESAS along with the Korean versions of the M. D. Anderson Symptom Inventory (K-MDASI) and the Hospital Anxiety and Depression Scale (K-HADS) twice. A total of 38 patients completed the questionnaires again seven days later to assess responsiveness.

Results: The K-ESAS scores had good internal consistency, with a Cronbach's alpha coefficient of 0.88, indicating that no questions had undue influence on the score. Pearson correlation coefficients for K-ESAS symptom scores between baseline and after two to four hours ranged from 0.72 (95% CI 0.64-0.79) to 0.87 (95% CI 0.82-0.90), indicating strong test-retest reliability. For concurrent validity, Pearson correlation coefficients between K-ESAS symptom scores and corresponding K-MDASI symptom scores ranged from 0.70 (95% CI 0.62-0.77) to 0.83 (95% CI 0.77-0.87), indicating good concurrent validity. For the K-HADS, concurrent validity was good for anxiety (r=0.73, 95% CI 0.65-0.79) but moderate for depression (r=0.4, 95% CI 0.26-0.52). For responsiveness, changes in K-ESAS scores after seven days were moderately correlated with changes in K-MDASI scores but weakly correlated with changes in K-HADS scores.

Conclusion: The K-ESAS is a valid and reliable tool for measuring multidimensional symptoms in Korean patients with cancer.

Keywords: Advanced cancer; ESAS; Edmonton Symptom Assessment System; Korea.

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Conflict of interest statement

Disclosures

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Validated Korean version of the Edmonton Symptom Assessment System.
Fig. 2
Fig. 2
Median changes in the K-ESAS scores after 7 (±1) days (n = 38).
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