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Summary
The Emotion Thermometers tool is a simple rapid
modular screening tool for detection and monitoring of emotional disorders in
clinical practice.
It was created by Prof Alex J Mitchell
with a visual-analogue design which is easy for most patients (including older people and
children) to understand, quick
to administer and simple to score.
It is currently royalty free for (departmental)
clinical use and for unfunded research (but please request permission via this link).
It
has been validated in over 1000 patients in Leicester and over 30 published
studies worldwide and more than 200 clinical centers.
New App! (https://etscale.glideapp.io/)
Our new app will take care of data entry,
scoring and interpretation
What's New?
...................New translations
available in Swedish, Persian, Malay, Turkish, Czechoslovakian, Greek, Romanian and Hungarian! (see below)
...................Mini printed booklets by
mail now
available! (email me ajm80@le.ac.uk)
  
Permission
Requests: New Form for 2019/2020!
Simply fill this form for unfunded research and
clinical use and you will automatically get permission to use it immediately!!
https://docs.google.com/forms/d/e/1FAIpQLSeMKTGUj3VaKxjYaH2WPRDVqjsedXXDsI2Mph1yUKH2_Lox7g/viewform
Simple
Data entry Form!
Use
this link for a local data collection form using google forms. We don't keep any
of your data.
https://bit.ly/etentry
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Scoring Now Simplified with
Our App!
Scoring
/ Interpretation: When looking for a specific emotion complication:
Method
A. Use our app: https://etscale.glideapp.io/
Method
B. Use fixed cut-offs of 0-3 (low) and 4-10 (high) on ANY thermometer. A
high score should be followed-up by further enquiry / assessment esp when
"help" is requested.
Method
D. Use specific individual cut-offs of 4-10 (high) on DT; 5-10 (high) on
DepT; 6-10 (high) on AnxT; 4-10
(high) on Help T or calculate these locally (using an appropriate gold standard).
Background
Visual-analogue scales have been successfully used
for decades in pain services. In 1998 the American Distress Thermometer (DT) was developed
and validated for evaluation of distress in cancer [Roth et al, 1998]. It was
adopted into recommendations by the US
National
Comprehensive Cancer Network. If you require
the DT permission request is here.
The DT is
a simple, self-report, pencil and paper measure consisting of a line or
thermometer image with a 0-10
scale anchored at the zero point with ‘No Distress’ and at scale point ten with
‘Extreme Distress’. Patients are given the instruction “How distressed have you
been during the past week on a scale of 0 to 10?” The recommended cut-off was
4v5, but in 2007 was revised to 3v4. In a comprehensive review of the accuracy
of the DT, it was found to have a sensitivity of 80.9% and a specificity of
60.2%, (positive predictive value (PPV) of 32.8 and negative predictive value (NPV)
of 92.9%) for depression, a sensitivity of 77.3% and specificity 56.6% (PPV of
55.2% and NPV of 80.25%) for anxiety it and a sensitivity of 77.1% and
specificity 66.1% (PPV 55.6% and NPV 84.0%) for broadly defined distress [Mitchell, 2007
J Clin
Oncol 2007; 25:4670-4681].
In 2007 we locally piloted and validated a new
multidomain extension and adaptation of the DT called the
Emotion Thermometers tool. This is a new dimensional tool retaining the
convenience of the innovative DT but with superior accuracy. It comprises five
visual analogue scales in the form of four predictor domains (distress, anxiety,
depression, anger) and one non-emotion domain (need for help). Each domain is
rated on an 11 point (0 to 10) Likert scale in a visual thermometer, namely the
Distress Thermometer (DT), Depression Thermometer (DepT), Anxiety Thermometer (AnxT)
and Anger Thermometer (AngT). In a pilot evaluation in the Leicester Cancer
Centre (UK), we found that the tool takes about 55 seconds (compared to about 30
seconds for the DT) for most patients for complete and is no less acceptable
than the DT alone.
ET Versions
The original 207 version (ET5) comprised four
emotion domains: DepT AnXT AngT DT and a help thermometer
The 2009 ET7 added duration of illness and burden to
the core thermometers above
The 2010 palliative ET7 added pain in place or
duration of illness (burden retained) to the core thermometers above
In 2012 we launched the DepT as a stand alone tool
go
here for the DepT
We currently have pilot versions adding domains of
function (work, social, family), pain, and QoL
We also have pilot versions including descriptive
text anchors for the thermometers of help and pain.
A version for older people was developed with "forgetfullness"
ET Modular
Versions
Choose your own set of thermometers, start with the
core set DepT AnXT AngT DT
........then choose any of
HelpT, BurdenT, DurationT, QoL-T, FunctionT, PainT
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2012 version
2013 version (with more explicit
help)
Download PDF Original Version
Download 2013 PDF Version
Download JPG Original Version
Download PDF Version in checklist format
Download Word Version (by request
only)
Translations
Download PDF Version in Spanish
(thanks Angelica DeSantiago!)
Download PDF Version in Portuguese
(thanks Margarid Branco!)
Download PDF Version in Dutch
(thanks Joke Fleer!)
Download PDF Version in German
(thanks Cord Spilker!)
Download PDF Version in French
(thanks Sylvie Lambert!)
Download PDF Version in Hindi
(thanks Priya Kanna and Abhijit Dam!)
Download PDF Version in Italian
(thanks Chiara Acquati!)
Download PDF Version in Polish
(thanks Karolina Kujawska-Debiec!)
Download PDF Version in Chinese
(thanks Chen Chen!)
Download PDF Version in Greek
(thanks Asimina
Kiropoulou)
Download PDF Version in Romanian
(thanks
Csaba Dégi)
Download PDF Version in Hungarian
(thanks
Csaba Dégi)
Download PDF Version in Czechoslovakian
(thanks
Alena Javurkova)
Download PDF Version in Turkish
(thanks
Ozan Bahcivan)
Download PDF Version in Malay
(thanks
Nur
Haidzat Abd Wahid)
Download PDF Version in Persian
(thanks
neda farahani )
Download PDF Version in Swedish
(thanks
Fia Hobbs; see Fia's new book here)
ET with a
Comprehensive Problem list
There are many versions of a problem list but we
prefer this open access "Concerns and Help Identifier for Medical Patients
(CHIMP)" scale
CHIMP
Problem list in cancer
CHIMP
Problem list in cardiology
CHIMP
Problem list in neurology
(The
CHIMP scale can be used freely and without restriction at the current time)
ET as part
of an implementation screener
We
trialed this form of the ET embedded into a short problem list and action plan
in this form
ET
screen and action
results
were presented in the MD thesis of Mitchell (2012)
Scientific Papers (Try this link)
https://www.ncbi.nlm.nih.gov/pubmed/19296462
https://www.ncbi.nlm.nih.gov/pubmed/21723618
https://www.ncbi.nlm.nih.gov/pubmed/25396697
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1528-1167.2012.03571.x
https://www.sciencedirect.com/science/article/abs/pii/S1876382013000619
https://link.springer.com/article/10.1007/s11136-018-2014-1
https://journals.lww.com/clinorthop/Fulltext/2018/04000/Does_a_Brief_Mindfulness_Exercise_Improve_Outcomes.29.aspx
http://researchrepository.murdoch.edu.au/id/eprint/36562/
https://estudogeral.sib.uc.pt/handle/10316/32939
https://onlinelibrary.wiley.com/doi/pdf/10.1111/ajco.12180
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1528-1167.2012.03571.x
Validation:
systemic review
https://onlinelibrary.wiley.com/doi/full/10.1002/pon.5172
A
new systematic review of 17 studies using the ET in cancer has just been
published in September 2019........
Objective
Physiological and psychological sequelae are frequent after a cancer
diagnosis and also on the long term. Screening could help detect
psychological distress early and thus enable timely provision of adequate
treatment. The emotion thermometer (ET) is a validated screening tool
including five dimensions (distress, anxiety, depression, anger, and
need-for-help). Reviewing the literature, we aimed to describe (a) the
validity and (b) the application of the ET.
Methods
Six databases were systematically searched for studies using the ET in
individuals diagnosed with cancer. Included studies were critically
appraised for methodological quality. ET validity and application were
narratively synthesized.
Results
We identified 580 records eligible for title-abstract screening. Seventeen
studies based on 13 different populations were included. Validation studies
(5 of 17) concluded that the ET is sensitive to distress detection,
delivering prompt and accurate results with no negative impact on clinic
visit time. Furthermore, its use is accepted in patients and clinicians. The
remaining 12 exploratory studies applied the ET for screening purposes (3 of
12), as outcome measure (6 of 12), or as predictor variable measure (3 of
12). Most studies were conducted in Europe (11 of 17), and 7 of the 12
exploratory studies used the recommended cutoff (greater than or equal to
4). Study populations were mostly female (9 of 13) with a mean age greater
than 50 years (12 of 13) at study.
ConclusionsPublications on distress screening with the ET are scarce, especially among
young populations. However, research and studies' recommendations support
the ET's utility as a valid and feasible tool for distress screening
including anxiety and depression and suggest its implementation as part of a
structured program for early screening in cancer care.
Examples of Validation Papers
(Try this link)
Mitchell et al. Psycho-oncology
2010 Feb;19(2):125-33 and
2010 Feb;19(2):134-140 and http://onlinelibrary.wiley.com/doi/10.1111/ajco.12180/abstract)
In our study in the Leicester Cancer Centre, 11.5%
of people scored three or below on all ET domains and 69.3% scored four or above
on at least one domain. Of low scorers on the DT about 50% recorded emotional
difficulties on the new Emotion Thermometers (ET) tool, suggesting added value
beyond the Distress thermometer (DT) alone. Using a cut-off of 3v4 on all
thermometers against the total HADS score (cut-off 14v15), the optimal
thermometer was the AngT (sensitivity 89% specificity 46%). Against HADS Anxiety
scale (cut-off 7v8), and judging by the Predictive Summary Index, the optimal
thermometer was AnxT (sensitivity 92% specificity 61%). Against the HADS
depression scale, the optimal thermometer was the depression thermometer
(sensitivity 60% specificity 78%). Finally, against the DSM-IV diagnosis of
major depression the optimal thermometer was the depression thermometer
sensitivity 80% specificity 79%) but no single method had good positive
predictive value (PPV). Further improvements can be made by adjusting the
cut-offs particularly for detection of anxiety (AnxT ROC = 0.867 at a cut-off of
5v6) and detection of depression (DepT ROC = 0.751 at a cut-off 4v5).
Independent
Validation:
Beck KR, Tan
SM, Lum SS, Lim LE, Krishna LK. Validation of the emotion thermometers and
hospital anxiety and depression scales in Singapore: Screening cancer patients
for distress, anxiety and depression. Asia Pac J Clin Oncol. 2014 Mar 27. doi:
10.1111/ajco.12180.
Aim
To validate the emotion thermometer (ET)
and hospital anxiety and depression scales (HADS) in Singapore, screening cancer
patients for distress, anxiety and depression. Methods Three hundred
fifteen cancer patients from National Cancer Centre and Singapore General
Hospital participated in the study. Interviews and assessments were conducted in
English, assessing patients' sociodemographic data and screening for emotional
symptoms using the ET, HADS and Mini-International Neuropsychiatric Interview
(MINI) tools.
Results
Fifty-three patients (16.83%)
fulfilled the MINI criteria for major depressive disorder and 30 patients
(12.77%) for generalized anxiety disorder. The ET depression thermometer
correlated positively with HADS depression subscale, r?=?0.645 (P?<?0.01),
with area under curve (AUC) value being 0.76, when cutoff score is 3. The ET
anxiety thermometer correlated positively with HADS anxiety subscale, r?=?0.632
(P?<?0.01), with an AUC value of 0.76, when cutoff score is 4. The ET
distress thermometer correlated positively with HADS depression subscale,
r?=?0.506 (P?<?0.01), with AUC value being 0.72, when cutoff score is 2, the
ET distress thermometer also correlated positively with HADS anxiety subscale,
r?=?0.652 (P?<?0.01), with the AUC value being 0.77, when cutoff score is 4.
Using MINI diagnoses for anxiety and depression as the gold standard, cutoff
score for HADS depression scale is 7, which yielded an AUC of 0.826. The cutoff
score for HADS anxiety scale is 5, yielding an AUC of 0.779.
Conclusion
Results from the study support the
use of both ET and HADS as valid and reliable instruments assessing for
distress, anxiety and depression in cancer patients.
Screening for Psychological
Distress in Surgical Breast Cancer Patients Jane R. Schubart PhD, MS, MBA,
Matthew Emerich BS, Michelle Farnan RN, MSN, OCN, J. Stanley Smith MD, Gordon L.
Kauffman MD, Rena B. Kass MD Breast Oncology Volume 21, Issue 10 / October ,
2014
Background
This
pilot study assessed the levels of patient emotional distress and impact on
clinic throughput time.
Methods
From
April through August 2012, 149 breast cancer patients at the Penn State Hershey
Breast Center were screened with the emotions thermometer (ET), a patient-rated
visual 0–10 scale that measures distress, anxiety, depression, anger, burden,
and need for help. Also, patients indicated their most pressing cancer-related
concerns. Clinic visit time was computed and compared with a control group.
Results
Using
a previously validated cut point ≥4 for any thermometer, we found
emotional difficulty in the following proportions: distress 22 %, anxiety
28 %, depression 18 %, anger 14 %, burden 16 %, and need for
help 10 %; 35 % scored above the cut point on at least 1 thermometer.
We found higher levels of distress in all domains associated with younger age at
diagnosis. More extensive surgery (bilateral mastectomy vs unilateral mastectomy
vs. lumpectomy) was correlated with higher levels of psychosocial distress. Most
often cited concerns, experienced by >20 %, included eating/weight,
worry about cancer, sleep problems, fatigue, anxiety, and pain. Mean clinic
visit time for evaluable patients screened using the ET (n = 109) was
43.9 min (SD 18.6), compared with 42.6 min (SD 16.2) for the control
group (n = 50).
Conclusions
Utilizing
the ET, more than one-third of women screened met criteria for psychological
distress. Younger age at diagnosis and more extensive surgery were risk factors.
The ET is a simple validated screening tool that identifies patients in need of
further psychological evaluation without impacting clinic throughput time.
Normative values for the distress
thermometer (DT) and the emotion thermometers (ET), derived from a German
general population sample
Quality of Life Research January
2019, Volume 28, Issue 1, pp 277–282
Purpose
The
distress thermometer (DT) and the emotion thermometers (ET) are short
screening instruments for use in oncological practice. The aim of this study
was to provide normative values and to analyze the correlational structure of
the ET.
Methods
A
representative sample of the adult German general population
(N = 2437) completed the ET, the PHQ-4, the FACIT-fatigue scale,
and the demoralization scale.
Results
The
percentages of people above the cutoff (≥ 4) and the mean scores
of the five ET scales were as follows: distress: 39.0%, M = 3.15 ± 2.62,
anxiety: 12.3%, M = 1.36 ± 1.93, depression:
16.1%, M = 1.65 ± 2.11, anger: 24.5%, M = 2.33 ± 2.16,
and need for help: 10.7%, M = 1.18 ± 1.90. Women
reported significantly higher levels of burden than men, with effect sizes
between 0.07 (anger) and 0.36 (anxiety). All ET dimensions were interrelated
(r between 0.44 and 0.69) and significantly correlated with the other
scales (r between 0.36 and 0.68).
Conclusions
The
normative scores can help qualify assessments of groups of patients. The new
four dimensions of the ET provide relevant additional information that is not
already covered by the DT.
Validation Posters
We have published a series of posters on the ET at
the IPOS and APOS conferences 2010-2014.
IPOS2010 Poster 130 (defining ET thresholds)
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IPOS2010 Poster 131 (defining ET reliability)
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IPOS2010 Poster 131 (ET re-validation)
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APOS2011 Poster 153 (ET validation vs depression)
IPOS2014 Poster 605 (ET large validation vs
distress)
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IPOS2016 Poster 450 (ET validation vs anxiety
disorder)
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IPOS2016 Talk 416 (ET correlation with unmet needs 
Copyright
The tool is subject to copyright (c) Alex J Mitchell
but freely available (royalty free) for non-commercial and clinical use.
If this (or related) tools are useful please
consider donating to help with our research and always cite your sources.
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Recent
Research on the ET
We welcome collaborations with other groups who are
interested in using the ET for research. Here are some examples of groups that have sought
permission to study the ET in various settings. Most of these studies are
ongoing.
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Author |
Title |
Setting |
Rampling J et al St George's Hospital
London
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Efficient Screening for Depression in
Epilepsy - Preliminary Comparison of Four Simple Methods
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Neurological |
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In-Fun Li, Supervisor of Nursing
Department, Taiwan |
Clinical application in Taiwan |
Cancer |
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Dalia Kamel, Drogheda and Beaumont
Hospital, Dublin |
The effect of chemotherapy on the ovarian
reserve of pre-menopausal women with breast cancer |
Cancer |
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Joana Gomes, Porto, Portugal |
Emotional Intelligence, Quality of Life
and its Correlates in Cancer Patients on Chemotherapy in Porto
Healthcare Centre
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Cancer |
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Kathryn Taylor, St Georges Cancer Care
Centre, NZ |
Screening for psychosocial distress in
patients attending the cancer care centre, St George’s hospital
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Cancer |
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Nancy J. Ames, Bethesda, Maryland 20892 |
The effect of music listening on the
amount of opioids used in surgical intensive care patients
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Cancer |
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Penelope Schofield, Peter MacCallum Cancer
Centre, AUZ |
Use of the emotion thermometers tool for
use in a remote monitoring system for haematological cancer patients
receiving chemotherapy |
Cancer |
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Sara Moreira, Porto, Portugal |
Distress in Oncologic Patients: Experience
of Patients with Coetaneous Lymphoma |
Cancer |
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Sylvie Lambert, Newcastle, Australia |
Clinical application of the ET on the
website Care Search Palliative Care Knowledge Network |
Cancer |
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Lorraine Webster, The Beatson West of
Scotland Cancer Centre, Glasgow |
Clinical application of the ET in Scotland |
Cancer |
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Robbert Sanderman, University of Groningen, the Netherlands
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Rapid Screening for Emotional
Complications of Cardiovascular disease
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Cardiovascular |
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Joshua Morgan, Loma Linda University
Medical Center, Loma Linda, CA |
Validation of Simple Visual-Analogue
Thermometer Screen for Mood Complications of Cardiovascular Disease
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Cardiovascular |
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Clare Carolan, Stirling University |
The experience of distress and
help-seeking for distress in palliative care families”. |
Cancer |
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Suzy Hudson, The Royal National
Orthopaedic Hospital Trust |
Provision for Primary Malignant Bone
Sarcoma Patients following Surgery” across 5 centres in England |
Cancer/Surgery |
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Karen, Kayser PhD University of Louisville |
Psychosocial Distress, Quality of Life and
Rest/Activity in Head and Neck Cancer” at University of Louisville |
Cancer |
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Elaine Youngman, WakeMed Health and
Hospital |
Use of Healing Touch, a complementary
energy therapy at WakeMed Health and Hospital |
Cancer |
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Dalia Kamel Drogheda and Beaumont
Hospital, Dublin |
The effect of chemotherapy on the ovarian
reserve of premenopausal women with breast cancer |
Cancer |
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Kent Hoskins, MD Department of Medicine,
University of Illinois |
How Do Underserved Minority Women Think
About Breast Cancer Risk? |
Cancer |
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Sharon Fabbri, Loma Linda University
Center |
Evaluation and implementation in clinical
practice |
Cancer |
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Hohee Nam, South Korea |
Relationships of depression, anxiety and
QoL in ACS (acute coronay syndrome) patients" |
Cardiac |
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Nicole Champagne, Naval Medical Center San
Diego |
Evaluation and implementation in clinical
practice |
Cancer |
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Simon Parrett, Dorothy House Hospice Care |
Dorothy House Hospice Care |
Cancer |
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Jessica Coyer, Psy.D. South Nassau
Communities Hospital |
Evaluation and implementation in clinical
practice |
Cancer |
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Linda McLellan Cleveland Clinic R32 |
Evaluation and implementation in clinical
practice |
Cancer |
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Dr Tracey Bullen Australian Catholic
University |
Does full warm water immersion in spa bath
positively impact on symptom scores/experience for people with
pain/anxiety? |
Cancer |
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Josefa C. Alquisada, Research Institure Philippines
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Factors Affecting the Coping Mechanism of
Cancer Patient |
Cancer |
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Gregory D. Garber, Kimmel Cancer Center |
Evaluation and implementation in
clinical practice |
Cancer |
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Tânia
Brandão, University of Porto, Portugal |
Clinical application of the ET |
Cancer |
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Ruth
Fleming, Royal Brompton. London |
Clinical application of the ET |
Cancer |
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Robert
Beecher, Temple University Hospital |
Clinical application of the ET |
Cancer |
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Michael
Green Penn State College of Medicine |
Clinical application of the ET |
Cancer |
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Courtney
Cook Baptist Hospital - Cancer Support Services |
Clinical application of the ET |
Cancer |
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Maureen
Evans Azusa Pacific University; Los Angeles. |
grandparents
providing support to their family |
Cancer |
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Karen
Kayser, University of Louisville |
Couples
Coping with Impaired Sexual Function during and after Treatment
for Rectal Cancer |
Cancer |
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Dégi
L. Csaba Cluj Napoca |
Babes
Bolyai University project |
Cancer |
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Prof.
Emanuela Saita Catholic University Milan |
Clinical application of the ET |
Cancer |
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ET
in Other Settings
The ET7 has been validated in a neurological setting
(epilepsy) see this poster
...and
paper in epilepsia
The ET5 has been validated in cardiovascular
settings (link)
References
Roth AJ, Kornblith AB, Batel-Copel L, et al. Rapid
screening for psychologic distress in men with prostate carcinoma: a pilot
study. Cancer 82:1904 –1908, 1998
NCCN Clinical Practice Guidelines in Oncology™ Distress
Management V.1.2007 http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf
(accessed 25 March 2007)
Mitchell
AJ. Pooled results from 38 analyses of the accuracy of distress thermometer
and other ultra-short methods of detecting cancer-related mood disorder. J
Clin Oncol 2007; 25:4670-4681.
Rampling
J, Mitchell AJ, Von Oertzen T, Docker J, Jackson J, Cock H, Agrawal N.
Screening for depression in epilepsy clinics. A comparison of conventional
and visual-analog methods. Epilepsia. 2012 Oct;53(10):1713-1721. doi:
10.1111/j.1528-1167.2012.03571.x. Epub 2012 Jul 5.
FAQ
on the ET
Q. Has the ET been validated?
A. Yes in cancer in around 17 studies (incl small palliative subsample),
neurology (epilepsy) and cardiovascular disease
Q. Can the ET be used clinically without
permission?
A. No, permission is required but don't worry it is
royalty free for clinical use at the current time using https://bit.ly/etpersmission
Q. Can the ET be used for funded/unfunded research without
permission?
A. Unfunded just use https://bit.ly/etpersmission;
if funded please write to me with the title and
duration and the number of applications of the ET that is intended for your proposed project. It is likely I will grant permission.
Q. Is the ET available with addition thermometer
domains?
A. Yes there is a modular ET (ET_mod) which
optionally adds customised assessments of QoL, function, pain.
Q. Is the ET sensitive to change?
A. Usually VAS are very sensitive to change, but
this requires formal study
Q. What is the best cut off on the ET?
A. Please refer to the validation papers, generally
we have used >3 on each scale but be aware fixed cut-offs are somewhat
arbitrary, and may require study in your setting
Q. How long does the ET take to administer
A. Usually about 1 to 2 minutes
Q. Has the ET been translated into.....my
language?
A. So far 17 languages eg Spanish, Portuguese, Polish, Dutch, German,
French Italian and Hindi if you need another, please consider doing this and
sending us your version
Q. Can the ET be read out by a caregiver or
clinician for those with visual (or other) impairment?
A. Yes but this really requires separate validation
Q. Can the ET be applied by clinician
A. Yes but the patient must indicate their own score
Q. What should happen when someone scores above
threshold?
A. We recommend a further assessment is made along
with clarification of unmet needs, and treatment as appropriate, but this is a
local decision
Q. How does the ET compare to the HADS?
A. Please see above poster on ET vs HADS in n=801
cancer subjects.
Q. How easy is it to adopt the ET into a
screening programme delivered by cancer clinicians?
A. Please feel free to use our screening programme
form and see our new paper on
here
Q. Can the ET be computerized to automated
screening?
A. Certainly, but no one has done this yet
Q. Can the ET be separated in individual
thermometers?
A. The original scale was 4 emotion domains and
help, ideally the 4 emotion domains should be kept, but yes each one can be
applied individually if essential.
Q. how does the ET differ from the NCCN's
distress thermometer?
A. The ET is multi-domain, the ET is colour coded,
the ET has half marks, the ET includes help, the ET is modular. The problem list
on the DT is unique to the DT. An optional "problem list" is available on the ET
embedded version.
Q. can the ET be applied with unmet needs,
depression interview, anxiety interview etc?
A. Yes the ET can be used as part of other tools.
Q. how many ET have been applied to patients in
Leicester?
A. To date about 1000
Q. Can we distribute the ET locally?
A. Only within the centre covered by your permission
letter.
Q. Can we distribute the ET on our internet?
A. No! but you can on your intranet (firewalled etc)
during your permission period.
Q. What is the best comparison tool to validate
the ET?
A. Ideally a clinical interview, but many have used
the PHQ, HADS. Anger has been tested against "hostility" rating
scales.
Q. Can the ET be combined into a new scale with other
questionnaires
A. Generally no, but discuss this with us.
Q. What is research use and what is clinical
use?
A. Research use, is applied by a researcher in a
research project (even if in a clinical centre); clinical use is use by a
clinical member of staff who is not conducting research but doing their normal
job. Clinical screening requires no permission; research screening usually is
for a defined period / in a defined project and requires permission and/or
funding license from us.
nccn distress thermometer in spanish national comprehensive cancer network distress thermometer
national comprehensive cancer network distress thermometercut-off
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