Evidence mapPaperPMID 36738867Full record

Trial reportJournal of pain and symptom management2023

Prevalence, Severity, and Co-Occurrence of SPPADE Symptoms in 31,866 Patients With Cancer.

Kurt Kroenke, Veronica Lam, Kathryn J Ruddy, Deirdre R Pachman, Jeph Herrin, Parvez A Rahman, Joan M Griffin, Andrea L Cheville

Abstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in Journal of pain and symptom management, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

  1. Trial
  2. Observational
  3. Article
  4. Article
  5. Patient health engagement as a predictor of symptom outcomes in patients receiving chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  6. Symptom experience and management in patients with differentiated thyroid cancer during initial treatment: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Article
  14. Article
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kurt KroenkeIndiana University School of Medicine (K.K.), Indianapolis, Indiana, USA; Regenstrief Institute, Inc. (K.K.), Indianapolis, Indiana, USA. Electronic address: kkroenke@regenstrief.org.
Veronica LamDepartment of Physical Medicine and Rehabilitation (V.L., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA.
Kathryn J RuddyDivision of Medical Oncology (K.J.R.), Mayo Clinic, Rochester, Minnesota, USA.
Deirdre R PachmanDivision of Community Internal Medicine, Geriatrics, and Palliative Care (D.R.P.), Mayo Clinic, Rochester, Minnesota, USA.
Jeph HerrinYale University School of Medicine (J.H.), New Haven, Connecticut, USA.
Parvez A RahmanRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery (P.A.R., J.M.G., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA.
Joan M GriffinRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery (P.A.R., J.M.G., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA; Division of Health Care Delivery Research (J.M.G.), Mayo Clinic, Rochester, Minnesota, USA.
Andrea L ChevilleDepartment of Physical Medicine and Rehabilitation (V.L., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery (P.A.R., J.M.G., A.L.C.), Mayo Clinic, Rochester, Minnesota, USA.

Funding

NCI NIH HHS UM1 CA233033
6 · The paper itself

Abstract

objectivesTo examine the prevalence, severity, and co-occurrence of SPPADE symptoms as well as their association with cancer type and patient characteristics.

backgroundThe SPPADE symptoms (sleep disturbance, pain, physical function impairment, anxiety, depression, and low energy /fatigue) are prevalent, co-occurring, and undertreated in oncology and other clinical populations.

methodsBaseline SPPADE symptom data were analyzed from the E2C2 study, a stepped wedge pragmatic, population-level, cluster randomized clinical trial designed to evaluate a guideline-informed symptom management model targeting the six SPPADE symptoms. Symptom prevalence and severity were measured with a 0-10 numeric rating (NRS) scale for each of the six symptoms. Prevalence of severe (NRS ≥ 7) and potential clinically relevant (NRS ≥ 5) symptoms as well as co-occurrence of clinical symptoms were determined. Distribution-based methods were used to estimate the minimally important difference (MID). Associations of cancer type and patient characteristics with a SPPADE composite score were analyzed.

resultsA total of 31,886 patients were assessed for SPPADE symptoms prior to, during, or soon after an outpatient medical oncology encounter. The proportion of patients with a potential clinically relevant symptom ranged from 17.5% for depression to 33.4% for fatigue. Co-occurrence of symptoms was high, with the proportion of patients with three or more additional clinically relevant symptoms ranging from 45.2% for fatigue to 68.6% for depression. The summed SPPADE composite score demonstrated good internal reliability (Cronbach's alpha of 0.86), with preliminary MID estimates of 4.1-4.3. Symptom burden differed across several types of cancer but was generally similar across most sociodemographic characteristics.

conclusionThe high prevalence and co-occurrence of SPPADE symptoms in patients with all types of cancer warrants clinical approaches that optimize detection and management.

Indexed as

NeoplasmsSleep Wake DisordersDepressionFatigueHumansPrevalenceReproducibility of ResultsanxietyCancerdepressionfatiguepainphysical functionpsychometricssleep

Identifiers

PMID36738867
PMCPMC10106386

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.