{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T23:09:40Z","timestamp":1792364980374,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T00:00:00Z","timestamp":1522368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005972","name":"Deutsche Krebshilfe","doi-asserted-by":"publisher","award":["107465"],"award-info":[{"award-number":["107465"]}],"id":[{"id":"10.13039\/501100005972","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Anxiety in cancer patients may represent a normal psychological reaction. To detect patients with pathological levels, appropriate screeners with established cut\u2010offs are needed. Given that previous research is sparse, we investigated the diagnostic accuracy of 2 frequently used screening tools in detecting generalized anxiety disorder (GAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data of a multicenter study including 2141 cancer patients. Diagnostic accuracy was investigated for the Generalized Anxiety Disorder Screener (GAD\u20107) and the anxiety module of the Hospital Anxiety and Depression Scale (HADS\u2010A). GAD, assessed with the Composite International Diagnostic Interview for Oncology, served as a reference standard. Overall accuracy was measured with the area under the receiver operating characteristics curve (AUC). The AUC of the 2 screeners were statistically compared. We also calculated accuracy measures for selected cut\u2010offs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diagnostic accuracy could be interpreted as adequate for both screeners, with an identical AUC of .81 (95% CI: .79\u2010.82). Consequently, the 2 screeners did not differ in their performance (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.86). The best balance between sensitivity and specificity was found for cut\u2010offs \u22657 (GAD\u20107) and \u22658 (HADS\u2010A). The officially recommended thresholds for the GAD\u20107 (\u2265 10) and the HADS\u2010A (\u226511) showed low sensitivities of 55% and 48%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The GAD\u20107 and HADS\u2010A showed AUC of adequate diagnostic accuracy and hence are applicable for GAD screening in cancer patients. Nevertheless, the choice of optimal cut\u2010offs should be carefully evaluated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.4681","type":"journal-article","created":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T01:39:41Z","timestamp":1519349981000},"page":"1509-1516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":172,"title":["The\n                    <scp>Generalized Anxiety Disorder Screener (GAD\u20107<\/scp>\n                    ) and the anxiety module of the\n                    <scp>Hospital and Depression Scale (HADS\u2010A<\/scp>\n                    ) as screening tools for generalized anxiety disorder among cancer patients"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4944-8020","authenticated-orcid":false,"given":"Peter","family":"Esser","sequence":"first","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology University Medical Center Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5929-4643","authenticated-orcid":false,"given":"Tim J.","family":"Hartung","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology University Medical Center Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology University Medical Center Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoffer","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology University Medical Center Leipzig  Leipzig Germany"},{"name":"Oncology Clinic, Rigshospitalet University of Copenhagen  Copenhagen Denmark"},{"name":"Unit of Survivorship The Danish Cancer Society Research Center  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Ulrich","family":"Wittchen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Psychology and Psychotherapy Technical University Dresden  Dresden Germany"},{"name":"Psychiatric University Hospital Ludwig\u2010Maximilians\u2010Universit\u00e4t  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Faller","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken University of W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Koch","sequence":"additional","affiliation":[{"name":"Deanery University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"H\u00e4rter","sequence":"additional","affiliation":[{"name":"Department and Outpatient Clinic of Medical Psychology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Keller","sequence":"additional","affiliation":[{"name":"Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine University Hospital Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department and Outpatient Clinic of Medical Psychology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Wegscheider","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry and Epidemiology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Weis","sequence":"additional","affiliation":[{"name":"University Clinic Center Comprehensive Cancer Center Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6872-9805","authenticated-orcid":false,"given":"Anja","family":"Mehnert","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology University Medical Center Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.08.549"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.2000.1405"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.4611"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2007.12.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3322\/CA.2008.0003"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4492"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2015.11.005"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(98)00308-6"},{"key":"e_1_2_8_12_1","unstructured":"Robert Koch\u2010Institut.Krebs in Deutschland 2011\/2012. Gesundheitsberichterstattung des Bundes [Cancer in Germany 2011\/2012. Health Report of the State of Germany] 10th ed.: RKI\u2010Bib1 (Robert Koch\u2010Institut);2015."},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(03)00198-8"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291703001399"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30846"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-12-70"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318160d093"},{"key":"e_1_2_8_18_1","first-page":"995","article-title":"HADS\u2010D: Hospital Anxiety and Depression Scale\u2010German Version","volume":"1","author":"Herrmann C","year":"1995","journal-title":"Bern: Hans Huber"},{"key":"e_1_2_8_19_1","first-page":"101","article-title":"Adaptation des Composite International Diagnostic Interview (CIDI) zur Erfassung komorbider psychischer Storungen in der Onkologie: das CIDI\u2010O","volume":"64","author":"Hund B","year":"2014","journal-title":"Psychother Psychosom Med Psychol"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.56.0086"},{"key":"e_1_2_8_21_1","first-page":"1","article-title":"Maximum likelihood from incomplete data via the EM algorithm","author":"Dempster AP","year":"1977","journal-title":"J R Stat Soc Series B Stat Methodology"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.4.3.257"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-11-37"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2014.06.002"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.309.6947.102"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1373\/49.1.7"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmn051"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1611(199706)6:2<95::AID-PON250>3.0.CO;2-B"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604952"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.200410135"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.230"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4825"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpon.4681","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.4681","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T19:18:03Z","timestamp":1695496683000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.4681"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,30]]},"references-count":33,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1002\/pon.4681"],"URL":"https:\/\/doi.org\/10.1002\/pon.4681","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,30]]},"assertion":[{"value":"2017-10-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}