The Edmonton Symptom Assessment System: A narrative review of a standardized symptom assessment tool in head and neck oncology

Christopher W Noel; David Forner; Douglas B Chepeha; Elif Baran; Kelvin K W Chan; Ambica Parmar; Zain Husain; Irene Karam; Julie Hallet; Natalie G Coburn; Antoine Eskander

doi:10.1016/j.oraloncology.2021.105595

The Edmonton Symptom Assessment System: A narrative review of a standardized symptom assessment tool in head and neck oncology

Oral Oncol. 2021 Dec:123:105595. doi: 10.1016/j.oraloncology.2021.105595. Epub 2021 Nov 11.

Authors

Affiliations

¹ Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada.
² Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; Division of Otolaryngology Head & Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
³ Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Otolaryngology Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
⁴ Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
⁵ Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
⁶ Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
⁷ Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
⁸ Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; Department of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
⁹ Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada; Department of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Otolaryngology - Head & Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital, University of Toronto, Toronto, Ontario, Canada. Electronic address: antoine.eskander@mail.utoronto.ca.

PMID: 34775181
DOI: 10.1016/j.oraloncology.2021.105595

Abstract

Objective: Symptom burden is common in head and neck cancer patients though it frequently remains undetected and untreated. The Edmonton Symptom Assessment System - revised version (ESAS-r) is a generic symptom scale deployed in many outpatient settings worldwide. The ESAS-r is meant to improve symptom detection and management. We sought to review the ESAS-r and its psychometric properties in a head and neck oncology population.

Methods: Narrative Review.

Results: Over the past 30 years, the ESAS-r has emerged as one of the most used symptom scales for cancer patients. Its psychometric properties in a heterogenous cancer population are well supported, proving to be reliable and valid in a variety of settings. The linking of ESAS-r scores with Ontario administrative health data has led to a detailed assessment of validity in head and neck cancer. The ESAS-r can discriminate between high and low levels of symptom burden and is responsive to change over time in this patient population. ESAS-r scores have also been shown to be a strong predictor of future emergency department use and unplanned hospitalization in head and neck cancer patients.

Conclusions: The ESAS-r is reliable and valid in the head and neck cancer population and may serve as a useful clinical endpoint in research studies.

Keywords: Dyspnea; Edmonton symptom assessment system; Fatigue; Head and neck cancer; Pain; Patient reported outcomes; Surveys and questionnaires; Symptom assessment.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Emergency Service, Hospital
Head and Neck Neoplasms* / complications
Head and Neck Neoplasms* / diagnosis
Hospitalization
Humans
Neoplasms* / diagnosis
Palliative Care
Psychometrics
Surveys and Questionnaires
Symptom Assessment

Grants and funding

CIHR/Canada