Chronic GVHD Symptoms

Sandra A. Mitchell, CRNP, M.Sc.N., AOCN

National Institutes of Health
Bethesda, MD
 Self-Report Measures in Chronic
Illness Outcome Evaluation
• Self-report measures are increasingly a component of
outcome evaluation.
• Decisions about approving new therapies often incorporate
data about the effects of a therapy on symptoms, function
or quality of life as primary or secondary outcome
measures.
• Improved understanding of the impact of chronic GVHD
and its symptoms on self-reported health, functional status
and quality of life, will contribute to better supportive care.
 Lee Chronic GVHD Symptom
Scale
• Instrument developed and psychometrically evaluated by
Stephanie J. Lee, M.D., M.P.H. and colleagues1.
• Assesses the degree to which respondents are bothered
by each of 30 common chronic GVHD symptoms:
– Skin
– Eyes and Mouth
– Breathing
– Eating and Digestion
– Arthralgias/Myalgias/Limitations in ROM
– Fatigue and Asthenia
– Emotional Distress
1. Lee, S., Cook, E., Soiffer, R., & Antin, J. (2002). Development and validation of a scale to measure symptoms of chronic
graft-versus-host disease. Biol Blood Marrow Transplant, 8(8), 444-452.
 Lee Chronic GVHD Symptom
Scale
• Responses are captured on a five-point Likert scale:
– “no symptoms or not bothered at all”
– “slightly bothered”
– “moderately bothered”
– “quite a bit bothered”
– “extremely bothered”
• Time frame of response based on: LAST FOUR WEEKS.
• Scores normalized on a 0–100 point scale, and summary
and subscale scores can be created.
• Higher scores indicate more bothersome symptoms.
• Takes about five minutes to complete.
 Lee Chronic GVHD Symptom
Scale: Modifications for Pediatrics
• Validity evidence supports Lee Chronic GVHD Symptom
Scale as a self-report measure for adults.1
• Adolescents 13 years and older: independent self-report.
• Children 8-12 years: measure completed with assistance
from health care provider.
1. Lee, S., Cook, E., Soiffer, R., & Antin, J. (2002). Development and validation of a scale to measure symptoms of chronic
graft-versus-host disease. Biol Blood Marrow Transplant, 8(8), 444-452.