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Screening childhood cancer survivors with the brief symptom inventory‐18: classification agreement with the symptom checklist‐90‐revised
Author(s) -
Recklitis Christopher J.,
Rodriguez Paola
Publication year - 2007
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.1069
Subject(s) - checklist , medicine , internal consistency , distress , childhood cancer , cancer , pediatrics , clinical psychology , psychometrics , psychology , cognitive psychology
The Brief Symptom Inventory‐18 (BSI‐18) is an 18‐item symptom checklist used as a brief distress screening in cancer and other medical patients. This study evaluated the validity of the BSI‐18 in a sample of 221 adult survivors of childhood cancers ages 18–55 (median = 26). Validity of the BSI‐18 was compared to the Symptom Checklist‐90‐Revised (SCL‐90‐R). Results indicated the BSI‐18 scales had acceptable internal consistency (alpha >0.80) and were highly correlated with the corresponding SCL‐90‐R subscales (correlations from 0.88 to 0.94). When subjects were classified as case positive (significantly distressed) using the BSI‐18 manual case‐rule, classification agreement with the SCL‐90‐R was poor as evidenced by low sensitivity (41.78%). An alternative BSI‐18 case‐rule previously developed for cancer patients using the General Severity Index (GSI; GSI t ‐score ⩾57) demonstrated better sensitivity (83.54%). ROC analysis indicated the BSI‐18 had strong diagnostic utility relative to the SCL‐90‐R (AUC = 0.98) and several possible GSI cut‐off scores were evaluated. The optimal cut‐of score was a t ‐score ⩾50 which had a sensitivity of 97.47% and a specificity of 85.21%. Results support use of the BSI‐18 with adult survivors of childhood cancer but indicate an alternative case‐rule must be used. Copyright © 2006 John Wiley & Sons, Ltd.