{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:36:21Z","timestamp":1792532181476,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T00:00:00Z","timestamp":1383609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA026582"],"award-info":[{"award-number":["CA026582"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CA016672"],"award-info":[{"award-number":["CA016672"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The effective management of fatigue in patients with cancer requires a clear delineation of what constitutes nontrivial fatigue. The authors defined numeric cutpoints for fatigue severity based on functional interference and described the prevalence and characteristics of fatigue in patients with cancer and survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In a multicenter study, outpatients with breast, prostate, colorectal, or lung cancer rated their fatigue severity and symptom interference with functioning on the M. D. Anderson Symptom Inventory numeric scale of 0 to 10. Ratings of symptom interference guided the selection of numeric rating cutpoints between mild, moderate, and severe fatigue levels. Regression analysis identified significant factors related to reporting moderate\/severe fatigue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The statistically optimal cutpoints were \u2265\u20094 for moderate fatigue and \u2265\u20097 for severe fatigue. Moderate\/severe fatigue was reported by 983 of 2177 patients (45%) undergoing active treatment and was more likely to occur in patients receiving treatment with strong opioids (odds ratio [OR], 3.00), those with a poor Eastern Cooperative Oncology Group performance status (OR, 2.00), those who had &gt;\u20095% weight loss within 6 months (OR, 1.60), those who were receiving &gt;\u200910 medications (OR, 1.58), those with lung cancer (OR, 1.55), and those with a history of depression (OR, 1.42). Among survivors (patients with complete remission or no evidence of disease, and not currently receiving cancer treatment), 29% of patients (150 of 515 patients) had moderate\/severe fatigue that was associated with poor performance status (OR, 3.48) and a history of depression (OR, 2.21).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>\n                      The current study statistically defined fatigue severity categories related to significantly increased symptom interference. The high prevalence of moderate\/severe fatigue in both actively treated patients with cancer and survivors warrants the promoting of the routine assessment and management of patient\u2010reported fatigue.\n                      <jats:bold>\n                        <jats:italic>Cancer<\/jats:italic>\n                        2014;120:425\u2013432\n                      <\/jats:bold>\n                      . \u00a9\n                      <jats:italic>2013 American Cancer Society<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.28434","type":"journal-article","created":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T15:48:57Z","timestamp":1383666537000},"page":"425-432","source":"Crossref","is-referenced-by-count":315,"title":["Prevalence and characteristics of moderate to severe fatigue: A multicenter study in cancer patients and survivors"],"prefix":"10.1002","volume":"120","author":[{"given":"Xin Shelley","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Symptom Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengmin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology Dana\u2010Farber Cancer Institute Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Fisch","sequence":"additional","affiliation":[{"name":"Department of General Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"O'Mara","sequence":"additional","affiliation":[{"name":"Community Oncology and Prevention Trials Research Group Division of Cancer Prevention National Cancer Institute Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cella","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences Northwestern University Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tito R.","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Department of Symptom Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles S.","family":"Cleeland","sequence":"additional","affiliation":[{"name":"Department of Symptom Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds539"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq097"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2011.03.025"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19990301)85:5<1186::AID-CNCR24>3.0.CO;2-N"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1120"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.41.7238"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn250"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20423"},{"issue":"32","key":"e_1_2_7_10_1","first-page":"9","article-title":"National Institutes of Health State\u2010of\u2010the\u2010Science Conference Statement: symptom management in cancer: pain, depression, and fatigue, July 15\u201017, 2002","author":"Patrick DL","year":"2004","journal-title":"J Natl Cancer Inst Monogr."},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.14.3385"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10245"},{"key":"e_1_2_7_13_1","unstructured":"US Food and Drug Administration.Guidance for Industry. 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