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Palliative Medicine
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research-article

The Edmonton Symptom Assessment System: a 15-year retrospective review of validation studies (1991–2006)

Cheryl Nekolaichuk

Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada

Sharon Watanabe

Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada

Crystal Beaumont

Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada

Introduction: The purpose of this review was to identify and critique validation studies focusing on the Edmonton Symptom Assessment System (ESAS), a commonly used symptom assessment tool for advanced cancer and palliative patients. Methods: Using a comprehensive literature search, the authors identified and screened 87 publications. Thirteen articles were selected for in-depth review, based on the following inclusion criteria: psychometric studies with a primary focus on the ESAS, 1991–2006 publication dates and peer-reviewed English language publications. Results: Most studies involved cancer patients (n = 11). The ESAS format varied across studies, in terms of scale format, item number, item selection and language. Studies focused on gathering reliability estimates (n = 8), content validity evidence (n = 1), concurrent validity evidence (n = 5), predictive validity evidence (n = 1), and sensitivity and/or specificity (n = 3). None of these studies involved patients’ perspectives as a source of validity evidence. Discussion: The use of varying instrument formats and limited psychometric evidence support the need for further ESAS validation studies, including the involvement of patients.

Key Words: Edmonton Symptom Assessment System • ESAS • instrument development • literature review • psychometrics • validation studies

Palliative Medicine, Vol. 22, No. 2, 111-122 (2008)
DOI: 10.1177/0269216307087659


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