A comparison of the prevalence of dry mouth and other symptoms using two different versions of the Edmonton Symptom Assessment System on an inpatient palliative care unit

Table 3 Comparisons of symptom intensity ratings on ESAS-m^a (used in 2013) and ESAS-r^b (used in 2017) among patients reporting each symptom as present (NRS > 0)

Symptoms	Symptom Severity Rating, mean (SD) [n]		p-value (95% CI of the group difference)	Cohen’s d (95% CI)
Symptoms	ESAS-m^a (n = 184)	ESAS-r^b (n = 156)	p-value (95% CI of the group difference)	Cohen’s d (95% CI)
Items in both versions
Tiredness	5.9 (2.3) [170]	5.9 (2.2) [151]	p = .93 (-0.47, 0.52)	d = 0.01 (-0.21, 0.23)
Nausea	3.4 (2.4) [90]	3.3 (2.2) [69]	p = .87 (− 0.67, 0.79)	d = 0.03 (-0.29, 0.34)
Lack of appetite	5.4 (2.7) [153]	5.9 (2.8) [135]	p = .12 (-1.14, 0.13)	d=-0.18 (-0.42, 0.05)
Shortness of breath	4.6 (2.7) [136]	4.5 (2.3) [121]	p = .55 (− 0.43, 0.80)	d = 0.07 (-0.17, 0.32)
Anxious	4.2 (2.4) [136]	4.1 (2.6) [100]	p = .72 (-0.52, 0.76)	d = 0.05 (-0.21, 0.31)
Depressed	4.3 (2.5) [141]	4.0 (2.4) [115]	p = .41 (-0.35, 0.86)	d = 0.10 (-0.14, 0.35)
Wellbeing	4.6 (2.2) [152]	4.8 (2.3) [125]	p = .45 (-0.73, 0.32)	d=-0.09 (-0.33, 0.15)
Items mentioned in both versions but in different ways
Pain at rest ^c	3.4 (2.1) [131]		p = .11 (-0.94, 0.12)	d=-0.20 (-0.44, 0.05)
Pain on movement ^c	4.5 (2.2) [149]		p = .02 (0.13, 1.23)	d = 0.29 (0.05, 0.53)
Pain ^c		3.8 (2.2) [127]
Constipation ^d	4.8 (2.7) [129]	5.8 (2.4) [24]	p = .11 (-2.10, 0.21)	d=-0.36 (-0.80, 0.08)
Items in only one version
Dry mouth ^d	5.2 (2.6) [151]	7.2 (2.0) [5]	p = .09 (-4.38, 0.35)	d=-0.77 (-1.66, 0.13)
Sleep problems ^d	4.5 (2.4) [126]	5.0 (-) [1]	p = .82 (-5.24, 4.26)	d=-0.21 (-2.17, 1.76)
Drowsiness ^f		5.3 (2.3) [147]	n/a	n/a

Note: ESAS, Edmonton Symptom Assessment Scale; NRS, Numeric Rating Scale (range 0–10); CI, confidence interval
^a ESAS-m is a modified version of the original ESAS in use at the palliative care unit in 2013 and included 12 items as described in this table
^b ESAS-r is the revised version of the original ESAS in use at the palliative care unit in 2017 and included 10 items as described in this table
^c The pain at rest and pain on movement items in the ESAS-m were replaced by a single pain item in the ESAS-r. Each of the ESAS-m pain items was compared to the ESAS-r pain item
^d Constipation was not systematically assessed in the ESAS-r, but was given as an example of an “Other problem” and some patients reported it
^e Dry mouth and sleep problems were not mentioned in the ESAS-r, but a few patients reported them as an “Other problem”
^f Drowsiness was omitted from the ESAS-m, but was included in the ESAS-r. Because the ESAS-m did not allow for additional symptoms to be written in, its severity using the ESAS-m could not be determined

ISSN: 1472-684X