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Joseph F. Sobanko

Joseph F. Sobanko

University of Pennsylvania
USA

Title: Relationship between Patient Reported Quality of Life and Psychosocial Health: Identifying Benchmarks for the Skin Cancer Index

Biography

Biography: Joseph F. Sobanko

Abstract

Statement of the Problem: The Skin Cancer Index (SCI) is avalidated, patient-reported instrument used to measure quality of life (QOL) in skin cancer patients.1 Currently, the SCI does not have established clinical correlates nor are there validated benchmarks for normal scores. The Hospital Anxiety Depression Scale (HADS) is a validated instrument with previously established cut-offs to measure clinical anxiety and depression, and has been used in a variety of diseases including previous studies of patients with skin cancer.2-5 The objective of this study is to identify the relationship between the SCI and the HADS to create clinically meaningful cut-off scores for the SCI. These data may help to identify skin cancer patients who may benefit from counseling to both prevent and treat psychosocial distress.

Methodology & Theoretical Orientation: Cross-sectional study.

Findings: Analysis included 134 non-metastatic skin cancer patients. The SCI has a moderate inverse linear relationship with the HADS Anxiety subscale score (r=-0.39, p<0.001). In the ROC Curve for the HADS cut-off of ≥8/21, previously established to signify suspicion for clinical anxiety, AUC was 0.6821 (95% CI 0.5750-0.7892). A cut-off score of ≤78 for the SCI showed a sensitivity of 84.4% and nearly 4 times greater risk (p <0.01, 95% CI 1.50-8.87) of having a HADS Anxiety score of ≥8.

Conclusion & Significance: The SCI can be used as a singleinstrument screening tool for clinical anxiety, allowing physicians to risk-stratify those patients more likely to have psychosocial distress. In comparison to the HADS, the SCI is shorter in length, thus increasing its practicality, and also provides diseasespecific information about the impact of skin cancer on factors including emotional health, appearance concerns, and social interaction.