Polaris Health Direction

To establish an optimal cutoff point for the National Comprehensive Cancer Network’s Distress Thermometer (DT) as a screening measure to identify and address psychological distress in individuals with cancer, and to examine whether distress as measured by the DT significantly changes across the treatment trajectory. Secondary analyses of baseline data from a longitudinal parent study examining a computerized psychosocial assessment. Three diverse comprehensive cancer centers across the United States. 836 patients with a current or past diagnosis of cancer. Study participants were selected from a randomized clinical trial. Patients during any stage of the cancer treatment trajectory were recruited during a chemotherapy infusion or routine oncology appointment. The Behavioral Health Status Index and the DT were administered and compared using receiver operating characteristic analyses. Results support a cutoff score of 3 on the DT to indicate patients with clinically elevated levels of distress. In addition, patients who received a diagnosis within the 1–4 weeks prior to the assessment indicated the highest levels of distress. Providers may wish to use a cutoff point of 3 to most efficiently identify distress in a large, diverse population of patients with cancer. In addition, results indicate that patients may experience a heightened state of distress within 1–4 weeks postdiagnosis compared to other stages of coping with cancer. Using a brief measure of distress can help streamline the process of screening for psychosocial distress.

In response to our description of a computer-assisted outcomes management tool for outpatient psychotherapy, Stickle (2006) and Lueger (2006) offer informed and provocative commentaries about both the conceptual and practical aspects of the Polaris-MH system. While we share their enthusiasm for the importance of outcomes data and agree with many of their comments, we differ on some points. In the end, empirical evidence in support of outcomes management generally, and the Polaris-MH specifically, should carry the day.

This paper discusses the value of using self-report strength and symptomology outcome data from three informants to guide clinical decisions for troubled youth. We discuss the theoretical and scientific foundation for an outcome system where data can be used to make programmatic changes in the delivery of care for youth. We discuss the design requirements for the development of outcome instrumentation. Finally, we present predictive modeling data that show the importance of collecting information from multiple informants and using strengths to help youth.