• Cheryl Nekolaichuk, Sharon Watanabe, and Crystal Beaumont.
• Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada. cheryl.nekolaichuk@ualberta.ca
• Palliat Med. 2008 Mar 1; 22 (2): 111-22.

IntroductionThe purpose of this review was to identify and critique validation studies focusing on the Edmonton Symptom Assessment System (ESAS), a commonly used symptom assessment tool for advanced cancer and palliative patients.MethodsUsing a comprehensive literature search, the authors identified and screened 87 publications. Thirteen articles were selected for in-depth review, based on the following inclusion criteria: psychometric studies with a primary focus on the ESAS, 1991--2006 publication dates and peer-reviewed English language publications.ResultsMost studies involved cancer patients (n = 11). The ESAS format varied across studies, in terms of scale format, item number, item selection and language. Studies focused on gathering reliability estimates (n = 8), content validity evidence (n = 1), concurrent validity evidence (n = 5), predictive validity evidence (n = 1), and sensitivity and/or specificity (n = 3). None of these studies involved patients' perspectives as a source of validity evidence.DiscussionThe use of varying instrument formats and limited psychometric evidence support the need for further ESAS validation studies, including the involvement of patients.

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