The assessment of anorexia in patients with cancer: cut-off values for the FAACT-A/CS and the VAS for appetite

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The assessment of anorexia in patients with cancer: cut-off values for the FAACTA/CS and the VAS for appetite

S. Blauwhoff-Buskermolen1,2 & C. Ruijgrok1 & R. W. Ostelo3,4 & H. C. W. de Vet3 &

H. M. W. Verheul2 & M. A. E. de van der Schueren1,5 & J. A. E. Langius1,6

Received: 23 March 2015 /Accepted: 16 June 2015 /Published online: 10 July 2015 # The Author(s) 2015. This article is published with open access at Springerlink.com

AbstractPurpose Anorexia is a frequently observed symptom in patients with cancer and is associated with limited food intake and decreased quality of life. Diagnostic instruments such as the Anorexia/Cachexia Subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire and the visual analog scale (VAS) for appetite have been recommended in the assessment of anorexia, but validated cut-off values are lacking. This study aimed to obtain cut-off values of these instruments for the assessment of anorexia in patients with cancer.

Methods The FAACTA/CS and the VAS for appetite were administered to patients with cancer before start of

chemotherapy. As reference standard for anorexia, two external criteria were used: (1) a cut-off value of 2 on the anorexia symptom scale of the EORTC QLQ C-30 and (2) the question BDo you experience a decreased appetite?^ (yes/no). ROC curves were used to examine the optimal cut-off values for the FAACTA/CS and VAS.

Results A total of 273 patients (58 % male;64.0 10.6 years) were included. The median score on the FAACTA/CS was 38 (IQR 3242) points and 77 (IQR 4793) points on the VAS. Considering both external criteria, the optimal cut-off value for the FAAC TA/CS was 37 (sensitivity (se) 80 %, specificity (sp)

81 %, positive predictive value (PV+) 79 %, negative predictive value (PV) 82 %) and for the VAS was 70 (se 76 %, sp 83 %, PV+ 80 %, PV 79 %). Conclusions For the assessment of anorexia in patients with cancer, our study suggests cut-off values of 37 for the FAAC

TA/CS and...