SPPADE症状（睡眠障碍、疼痛、身体功能受损、焦虑、抑郁和低能量/疲劳）在肿瘤学和其他临床人群中普遍存在、共同出现且得不到足够治疗。E2C2研究分析了基线SPPADE症状数据，该研究是一项阶梯式楼群随机临床试验，以人群为基础，旨在评估针对6种SPPADE症状的指南管理模型。使用0到10的数字评级（NRS）量表测量每种症状的患病率和严重程度。确定了严重症状（NRS≥7）和潜在临床相关症状（NRS≥5）的患病率以及临床症状的共存情况。采用基于分布的方法估计最小重要差异（MID）。分析了癌症类型和患者特征与SPPADE综合评分的关联。共评估了31,886名患者在门诊医疗肿瘤学接诊之前、期间或之后的SPPADE症状。潜在临床相关症状患病率从17.5％的抑郁症到33.4％的疲劳不等。症状的共存率很高，有3个或更多额外临床相关症状的患者比例从45.2％的疲劳到68.6％的抑郁不等。合计的SPPADE综合评分表现出良好的内部可靠性（Cronbach'sα为0.86），初步的MID估计为4.1至4.3。不同种类的癌症病人的症状负担不同，但在大多数社会人口特征中相似。所有癌症病人中高发率和共存症状的存在需要优化检测和管理的临床方法。版权所有©2023，Elsevier Inc.发布。

The SPPADE symptoms (sleep disturbance, pain, physical function impairment, anxiety, depression, and low energy /fatigue) are prevalent, co-occurring, and undertreated in oncology and other clinical populations.Baseline SPPADE symptom data were analyzed from the E2C2 study, a stepped wedge pragmatic, population-level, cluster randomized clinical trial designed to evaluate a guideline-informed symptom management model targeting the six SPPADE symptoms. Symptom prevalence and severity were measured with a 0 to 10 numeric rating (NRS) scale for each of the 6 symptoms. Prevalence of severe (NRS ≥ 7) and potential clinically relevant (NRS ≥ 5) symptoms as well as co-occurrence of clinical symptoms were determined. Distribution-based methods were used to estimate the minimally important difference (MID). Associations of cancer type and patient characteristics with a SPPADE composite score were analyzed.A total of 31,886 patients were assessed for SPPADE symptoms prior to, during, or soon after an outpatient medical oncology encounter. The proportion of patients with a potential clinically relevant symptom ranged from 17.5% for depression to 33.4% for fatigue. Co-occurrence of symptoms was high, with the proportion of patients with 3 or more additional clinically relevant symptoms ranging from 45.2% for fatigue to 68.6% for depression. The summed SPPADE composite score demonstrated good internal reliability (Cronbach's alpha of 0.86), with preliminary MID estimates of 4.1 to 4.3. Symptom burden differed across several types of cancer but was generally similar across most sociodemographic characteristics.The high prevalence and co-occurrence of SPPADE symptoms in patients with all types of cancer warrants clinical approaches that optimize detection and management.Copyright © 2023. Published by Elsevier Inc.