{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:05:11Z","timestamp":1789571111540,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pelvic exenteration (PE) is a radical surgery for advanced pelvic malignancies that carries substantial psychosocial impacts. Assessing distress is critical for timely support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the responsiveness\u2010to\u2010change and convergent validity of the distress thermometer (DT), and to determine an optimal cutoff score for detecting clinically significant distress in a PE cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Secondary analyses of cohort study data involving adult patients who underwent PE at a quaternary referral hospital. Responsiveness was evaluated by determining whether the DT differentiated cases of decreased emotional well\u2010being and health\u2010related quality of life from pre\u2010 to post\u2010surgery, using the Functional Assessment of Cancer Therapy\u2010General (FACT\u2010G), FACT\u2010Colorectal, and Emotional Well\u2010Being (EWB) subscale as external criteria. Convergent validity was evaluated using the correlation between the DT and the EWB subscale scores. Cutoff scores were examined by reviewing the following indices, using an existing EWB cutoff as an external anchor: sensitivity, specificity, positive\/negative predictive values, and clinical utility index (CUI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis included 377 patients (mean age: 61\u00a0years, 56% male; 41% recurrent rectal cancer). The DT demonstrated responsiveness, with AUCs &gt; 0.7 for detecting emotional and quality\u2010of\u2010life decline post\u2010surgery. Convergent validity was demonstrated through a moderate correlation between the DT and the EWB subscale scores (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sub>s<\/jats:sub>\n                      \u00a0=\u00a0\u22120.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The optimal DT cutoff score was 4: Sensitivity; 87.0%, Specificity; 52.7%, CUI\u2212 value; 0.49 (ruling out cases: satisfactory utility), CUI+\u00a0value; 0.33 (case finding: poor utility).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The DT is a valid and responsive tool for detecting psychological distress in PE patients. Its high sensitivity supports its use in routine screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70565","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T08:46:05Z","timestamp":1786697165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the Distress Thermometer in Pelvic Exenteration: Responsiveness\u2010To\u2010Change, Convergent Validity, and Clinical Cutoff"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5424-7120","authenticated-orcid":false,"given":"Nicholas","family":"Melander","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery The University of Notre Dame Australia  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Rutherford","sequence":"additional","affiliation":[{"name":"Susan Wakil School of Nursing and Midwifery The University of Sydney  Sydney NSW Australia"},{"name":"The Daffodil Centre The University of Sydney, a Joint Venture With Cancer Council  Sydney NSW Australia"},{"name":"Cancer Care Research Unit  Sydney Local Health District NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9715-860X","authenticated-orcid":false,"given":"Daniel","family":"Steffens","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre (SOuRCe) Royal Prince Alfred Hospital  Sydney NSW Australia"},{"name":"Faculty of Medicine and Health Central Clinical School The University of Sydney  Sydney NSW Australia"},{"name":"Sydney Clinical Trials Centre Faculty of Medicine and Health, The University of Sydney  NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0716-596X","authenticated-orcid":false,"given":"Judith","family":"Fethney","sequence":"additional","affiliation":[{"name":"Susan Wakil School of Nursing and Midwifery The University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sascha","family":"Karunaratne","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre (SOuRCe) Royal Prince Alfred Hospital  Sydney NSW Australia"},{"name":"Faculty of Medicine and Health Central Clinical School The University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7163-097X","authenticated-orcid":false,"given":"Kate","family":"Alexander","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre (SOuRCe) Royal Prince Alfred Hospital  Sydney NSW Australia"},{"name":"Faculty of Medicine and Health Central Clinical School The University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2547-0204","authenticated-orcid":false,"given":"Cherry","family":"Koh","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre (SOuRCe) Royal Prince Alfred Hospital  Sydney NSW Australia"},{"name":"Faculty of Medicine and Health Central Clinical School The University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5602-6045","authenticated-orcid":false,"given":"Michael","family":"Solomon","sequence":"additional","affiliation":[{"name":"Surgical Outcomes Research Centre (SOuRCe) Royal Prince Alfred Hospital  Sydney NSW Australia"},{"name":"Faculty of Medicine and Health Central Clinical School The University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7843-5106","authenticated-orcid":false,"given":"Bora","family":"Kim","sequence":"additional","affiliation":[{"name":"Susan Wakil School of Nursing and Midwifery The University of Sydney  Sydney NSW Australia"},{"name":"The Daffodil Centre The University of Sydney, a Joint Venture With Cancer Council  Sydney NSW Australia"},{"name":"Cancer Care Research Unit  Sydney Local Health District NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13246162"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2016.01.007"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4832"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.1061327"},{"key":"e_1_2_13_6_1","unstructured":"N. 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