Introduction/Objective: The Distress Thermometer (DT) evaluates distress on a single 11-point scale, ranging from 0 (no distress) to 10 (extreme distress). This presentation examines the validity of the DT as a method of detecting distress in Australian men with prostate cancer.

Methods: Receiver operating characteristics analyses were used to evaluate the diagnostic accuracy of the DT compared to 3 “gold standard” scales in 2 prospective studies and 1 cross-sectional study: the Impact of Events Scale - Revised (IES-R, Study 1); the Hospital Anxiety and Depression Scale (HADS, Study 2); and the Brief Symptom Inventory-18 (BSI-18, Study 3).

Results: For Study 1, the DT showed good accuracy against the IES-R at baseline, 1-year and 3 years post-diagnosis (area under curves (AUCs) ranging from 0.84 to 0.88) and sensitivity was high (>85%). The DT also performed well against both the anxiety and depression subscales for HADS at baseline in Study 2 (AUC=0.84 and 0.82, respectively), but sensitivity was found to decrease substantially after 12 months. For Study 3, validity was high for the anxiety (AUC=0.90, sensitivity=90%) and depression (AUC=0.85, sensitivity=74%) subscales of the BSI-18; however, comparison with the somatization subscale was less effective (AUC=0.67, sensitivity=52%). The cut-off for the DT that maximised sensitivity and specificity varied from >=3 to >=6 across the analyses.

Conclusions: Although these results need to be interpreted with some caution due to the relatively small number of distressed cases in each of the samples combined with variation in the optimal cut-off, they consistently point towards the DT being a valid tool to detect anxiety and depression among prostate cancer patients, particularly when it is used close to the time of a PCa diagnosis. The DT is therefore likely to be an appropriate alternative to screen for distress amongst this population compared to longer and more expensive psychometric measures.