12093 Background: Caregivers of patients receiving an allogeneic hematopoietic stem cell transplant (HSCT) play a vital role in the care and recovery of patients. They must be present with the patient 24/7 for up to 100 days post-transplant, and they often report levels of distress higher than patients. Importantly, caregiver and patient distress are interdependent. Thus, knowing when to deploy appropriate resources and support to a distressed caregiver is essential. To date, the NCCN Distress Thermometer (DT) is a validated, single-item clinical measure consistently used in the oncology setting to assess and intervene upon patient distress. If such a tool was available for HSCT caregivers, oncology providers could assess and provide support for those in heightened distress. To date, limited research has been conducted in this area. This study examines the relationship of DT with self-reported depression and anxiety in a large sample of HSCT caregivers with the goal of proposing a potential clinical cut-point of elevated distress on the DT. Methods: Caregivers completed the DT, Center for Depression Studies Depression Scale (CESD), and Generalized Anxiety Disorder 7 (GAD7) 1-2 weeks pre-transplant as part of a larger study. Spearman correlation coefficients evaluated the association of the DT with CESD and GAD7. Logistic regression evaluated DT as a predictor of clinically elevated levels of depression (CESD >16) and anxiety (GAD7 >10). DT cut points (e.g., ≥4) as predictors of clinically elevated depression and anxiety were evaluated using sensitivity, specificity, and area under the curve (AUC). Results: Caregivers (N = 287) were 73% female, 75% spouse/partner of the patient, and ranged in age from 22-87 years (M = 58.2, SD = 13.4). The DT ranged from 0-10 with M = 4.5 (SD = 2.6). The CESD ranged from 0-51 with M = 13.3 (SD = 10.3) and 36% scored >16. The GAD7 ranged from 0-21 with M = 6.4 (SD = 5.5) and 24% scored >10. The DT was very strongly correlated ( p ’s < .0001) with the CESD ( r s = .69) and GAD7 ( r s = .76). DT score significantly predicted elevated depression (OR = 1.92, 95% CI1.64-2.24) and elevated anxiety (OR = 2.30, 95% CI1.84-2.86). Table 1 presents sensitivity, specificity, and AUC for DT cut points of 4-7. Conclusions: Findings suggest that although a cut-point of 4 on the DT has high specificity and a cut-point of 7 has high sensitivity, a cut-point of 6 indicates more balanced specificity and sensitivity when considering both depression and anxiety. In the clinical setting, providing the single-item DT as a measure of caregiver distress should allow for a brief and useful assessment indicating a greater need to provide support resources. DT CESD GAD7 cut point: N (%) Sensitivity Specificity AUC Sensitivity Specificity AUC 4: 173 (60%) .60 .95 .77 .52 .99 .75 5: 148 (52%) .69 .88 .78 .61 .93 .77 6: 114 (40%) .80 .75 .78 .74 .85 .80 7: 80 (28%) .89 .58 .73 .86 .73 .80
Vinci et al. (Wed,) studied this question.