Effects of Two Translated Phrases of Distress Thermometer on Screening Distress in Chinese Cancer Patients: A Comparative Study.

Aims and objectives To compare the screening effectiveness of two translated phrases of the Distress Thermometer (DT), namely the XinLiTongKu Thermometer (DT-X) and KunRao Thermometer (DT-K), in Chinese patients with cancer. Background The DT is one of the most commonly used tools to screen cancer patients' psychological states. However, translations of the DT are not uniform in China; this may affect the screening effectiveness of this tool. Design Cross-sectional survey with randomisation and self-control. Methods A sample of 172 cases was screened using the two DT translations, to check and compare the screening effectiveness of the two translations. The correlation between them was also investigated. The causes of the differences in screening effectiveness of the two translations were analysed, using 90 of the above 172 cases and an additional 68 cases. STROBE guidelines were used in reporting this study. Results For the DT-X (using a cut-off score of 4), the sensitivity value was 0.82 and the specificity value was 0.95, where for the DT-K (using a cut-off score of 3), the values were 0.78 and 0.79, respectively. The area under the receiver operating characteristic curve (AUC) was 0.914 and 0.797, respectively. Scores of the DT-X and the DT-K were positively correlated. In concepts of the participants, for both phrases, the sequences of the first three meanings were the same-worried, anxious and tired-while the fourth to sixth meanings were differed between phrases. Conclusion The DT-X and DT-K were both effective screening tools. However, in this study, the DT-X had a larger AUC than the DT-K. Relevance to clinical practice This study may be useful for enabling better measurement of distress in Chinese patients and improving the indigenisation of the DT.