WP 2.2. Depression Assessment and classification

Major aims WP 2.2 Overall: To improve assessment and classification of depression by computer assisted approach Sub-objectives: To define depression in palliative care To determine the optimal set of items to classify and assess depression in palliative care To develop a computer-based pilot version for classification and assessment in palliative care

WP the milestones No DueSpecifications D2.2.1Month 9-Systematic literature rev. -Incl. experts’ opinions D2.2.2 Month 9-Protocol for data collection Month 12-Approval from ethical committees obtained D2.2.3 Month 24-Data collection finalized D2.2.4 Month 30-Selected the set of items for diagnosis of depression -Software for computer ass. D2.2.5Month 36-Final report

WP 2.2 – where are we now? 8 months’ delay winter 2007 Personnel not available at start WP-leader changed position Research group operative august 2007 Post–doc research fellow 80% PhD-research fellow 100% for 6 months Main effort autumn 2007 Preparation for literature search on tools Good news – protocol, schemes, workplan etc. finalized Literature search starts now

Challenges WP 2.2 so far Lack of personnel Too ambitious time-line in proposal Group not operative at start for the EPCRC-project i.e. 8 months to find and employ post-doc research fellow Trivialities –Time-consuming to become operative even with personnel in place Coordination with other WP-groups WP 2.1 WP 3.2 including common expert groups

Aspirations for this EPCRC meeting Discussions with other WP’s 2.1.& 3.2 Status, shared aspects of EPCRC Discuss common challenges Methodological Materials Finalise discussion on expert group Depression – WP 3.2 Start preparatory discussions on data collection

One finding so far – What is a palliative care population? Descriptions of palliative cancer patient samples According to disease status: –Non-curative patients. Inclusion criteria involve to be “newly admitted to undergo first-line chemotherapy” (Wedding et al. 2007) –Patients referred to Palliative day care. No information regarding e.g. length of survival (Lloyd-Williams, 2002) –Patients with recurrent gynaecologic malignancies receiving chemotherapy (von Gruenigen, 2006) –In general, survival time or expected time to live is seldom reported

One finding so far – What is a palliative care population? II According to heterogeneity of the sample: –Non-curative and curative (Wedding et al. 2007) –Cancer and non-cancer (Ewing 2004) –Curative patients, patients receiving palliative chemotherapy or palliative radiotherapy, and patients in palliative care not receiving anti-cancer treatment (Salminen 2007) The palliative phase shorter due to prolonged oncological treatment How to define the palliative population –Of lesser relevance in WP2.2 –What about the WP 3’s?

Inclusion criteria Exclusion criteria Sample size Age Gender Performance status Previous history of depression Current anti-depressant medication Amount of patients with cancer within the sample Amount of palliative cancer patients within the cancer sample Clear definition of the palliative cancer sample: Should contain more information than e.g. “non-curative” Status: Inpatient, Outpatient, Both Survival time from baseline to death Expected time to live from baseline From WP2.2 Extraction Sheet: Sample Description

Next steps Modification of DSMIV criteria – needed? How to use or modify existing criteria – guideline Expert group – methodology as in other WPs Standardized interviews – for research Which are available – guideline? Expert group – methodology as for other symptoms Assessment & screening Collect items – as described in protocol Must probably expand beyond PM Screening – a need for guideline? 2 items form QLQ C30 (Groenvold et al 2004)?