为了调查三种系统性方法对于癌症康复者中伴有癌症复发恐惧、抑郁症状和/或与癌症相关的疲劳的症状优先权的范围，进而得出相似的治疗建议，心理治疗建议基于三种方法：患者偏好、症状严重程度以及基于实时评估的症状优先性。根据Kappa统计量计算了一致性水平。总体而言，我们发现三种方法之间的一致性有限。成对比较显示患者偏好和症状严重程度之间存在中等程度的一致性。大多数患者更喜欢针对疲劳进行治疗。当基于症状严重程度时，更倾向于指示癌症复发恐惧的治疗。与其他方法相比，时间优先性和其他方法之间的一致性很小。在57%的病例中，基于时间优先性的明确治疗建议是可能的。在可能的情况下，所有症状被指示的可能性大致相等。这三种方法导致不同的治疗建议。未来的研究应该确定这些方法与治疗结果的关系。我们建议在共享决策过程中讨论每种方法的结果，从而做出明智且个性化的决策，决定在心理治疗中针对哪种症状进行干预。该研究对于通过提供和比较三种不同的系统性方法来确定具有共同症状的癌症康复者的心理治疗重点，从而为选择心理治疗重点的系统方法的发展做出了贡献。© 2023. 作者们。

To investigate the extent to which three systematic approaches for prioritizing symptoms lead to similar treatment advices in cancer survivors with co-occurring fear of cancer recurrence, depressive symptoms, and/or cancer-related fatigue.Psychological treatment advices were was based on three approaches: patient preference, symptom severity, and temporal precedence of symptoms based on ecological momentary assessments. The level of agreement was calculated according to the Kappa statistic.Overall, we found limited agreement between the three approaches. Pairwise comparison showed moderate agreement between patient preference and symptom severity. Most patients preferred treatment for fatigue. Treatment for fear of cancer recurrence was mostly indicated when based on symptom severity. Agreement between temporal precedence and the other approaches was slight. A clear treatment advice based on temporal precedence was possible in 57% of cases. In cases where it was possible, all symptoms were about equally likely to be indicated.The three approaches lead to different treatment advices. Future research should determine how the approaches are related to treatment outcome. We propose to discuss the results of each approach in a shared decision-making process to make a well-informed and personalized decision with regard to which symptom to target in psychological treatment.This study contributes to the development of systematic approaches for selecting the focus of psychological treatment in cancer survivors with co-occurring symptoms by providing and comparing three different systematic approaches for prioritizing symptoms.© 2023. The Author(s).