Intraclass correlation metrics for the accuracy of algorithmic definitions in a computerized decision support system for supportive cancer care.

As part of the development of a computerized clinical decision support system for anemia management in cancer patients, we applied psychometric principles and techniques to assess the accuracy of the algorithmic operationalizations of a set of evidence-based practice guidelines. In an iterative rating process, five medical and nursing experts rated 27 algorithmic sets derived from 18 guidelines, the objective being an intraclass coefficient (ICC) exceeding 0.90.

Cancer-related anaemia and fatigue: assessment and treatment.

Anaemia is common in patients with cancer, but is often under-diagnosed and under-treated. Fatigue is frequently associated with cancer-related anaemia and has a significant impact on patients' quality of life. Many patients regard the treatment of fatigue as more important than the treatment of pain, in contrast with the opinions of many physicians.

New EORTC guidelines for the treatment of anaemia in patients with cancer: implications for nursing practice.

Anaemia and associated fatigue are common problems in patients with cancer, and fatigue is considered by patients with cancer to be their most limiting symptom. The introduction of erythropoiesis-stimulating proteins (ESPs) has greatly improved the management of anaemia; however, many European patients with cancer-related anaemia are untreated because of a lack of awareness among healthcare professionals of the benefits of anaemia treatment to patients, or because of regional differences in treatment practices. Recently, the European Organisation for Research and Treatment of Cancer (EORTC) developed the first European evidence-based guidelines for the use of ESPs in cancer-related anaemia in order to facilitate and standardize the assessment and management of the condition.

Knowledge of haematological toxicities amongst European nurses--a learning needs assessment.

Haematological toxicities such as neutropenia, anaemia and thrombocytopenia have a significant impact on patients with cancer. They can have a life-threatening effect on the health of the patient and, importantly, may lead to the interruption and/or dose reduction of ongoing cancer therapies, such as chemotherapy. Nurses play a pivotal role in haematological toxicity prevention, detection and management, however, the current level of involvement and understanding varies widely across Europe.

Nausea: the neglected symptom?

Advances in antiemetic therapy over the past decade have undoubtedly eased the burden of radiotherapy- and chemotherapy-induced nausea and vomiting. Despite this, these distressing side-effects of cancer therapy are still experienced by some patients. Moreover, nausea has both a higher incidence and a greater effect on patient quality of life than vomiting.

Comparison of proposed diagnostic criteria with FACT-F and VAS for cancer-related fatigue: proposal for use as a screening tool.

The objective was to validate the use of the proposed International Statistical Classification of Diseases and Related Health Problems (10th revision) (ICD-10) criteria for fatigue (P-ICD10) through comparison with the Functional Assessment of Cancer Therapy Fatigue (FACT-F) subscale and three visual analogue scale (VAS) qualities in cancer patients thought to be fatigued. Fatigue was assessed in 834 cancer patients at three clinical centres in Belgium, using P-ICD10, FACT-F, and VAS to assess: level of energy (VAS1), quality of life (VAS2), and ability to perform daily activities (VAS3). Of the 834 interviewed cancer patients, 54% were classified as fatigued by the P-ICD10 criteria.

Anemia impact and management: focus on patient needs and the use of erythropoietic agents.

Anemia is a common complication associated with cancer and cancer treatment. As many as 50% to 60% of cancer patients will develop this condition. Fatigue is a major symptom of anemia and is a primary complaint in patients with cancer.