Development of a Novel Location-Based Assessment of Sensory Symptoms in Cancer Patients: Preliminary Reliability and Validity Assessment

We report on the development of a novel location-based assessment of sensory symptoms in cancer (L-BASIC) instrument, and its initial estimates of reliability and validity. L-BASIC is structured so that patients provide a numeric score and an adjectival description for any sensory symptom, including both pain and neuropathic sensations, present in each of the 10 predefined body areas. Ninety-seven patients completed the baseline questionnaire; 39 completed the questionnaire on two occasions. A mean of 3.5 body parts was scored per patient. On average, 2.7 (of 11) descriptor categories were used per body part. There was good internal consistency (Cronbach's alpha = 0.74) for a four-item scale that combined location-specific metrics. Temporal stability was adequate (k > 0.50 and r > 0.60 for categorical and continuous variables, respectively) among patients without observed or reported subjective change in clinical status between L-BASIC administrations. We compared our four-item scale against scores obtained from validated pain and quality-of-life (QOL) scales, and as expected, correlations were higher for pain-related items than for QOL-related items. We detected differences in L-BASIC responses among patients with cancer-related head or neck pain, chemotherapy-related neuropathy and breast cancer-related lymphedema. We conclude that L-BASIC provides internally consistent and temporally stable responses, while acknowledging that further refinement and testing of this novel instrument are necessary. We anticipate that future versions of L-BASIC will provide reliable and valid symdrome-specific measurement of defined clinical pain and symptom constructs in the cancer population, which may be of particular value in assessing treatment response in patients with such multiple complaints. J Pain Symptom Manage 2009;37:848-862. (C) 2009 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.