Evidence map›Paper›PMID 40188892›Full record

Trial reportJournal of pain and symptom management2025

Depression and Anxiety as Moderators for a Behavioral Treatment for Dyspnea in Advanced Lung Cancer.

Stephen B Lo, Mia Holtze, Kathryn E Post, Ijeoma Julie Eche-Ugwu, Mary E Cooley, William F Pirl, Jennifer S Temel, Joseph A Greer

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of pain and symptom management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Stephen B LoCenter for Psychiatric Oncology & Behavioral Sciences (S.B.L., M.H., K.E.P. J.A.G.), Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School (S.B.L., K.E.P, I.J.E.U., M.E.C., W.F.P, J.S.T, J.A.G.), Boston, Massachusetts, USA. Electronic address: stephen_lo@dfci.harvard.edu.
Mia HoltzeCenter for Psychiatric Oncology & Behavioral Sciences (S.B.L., M.H., K.E.P. J.A.G.), Massachusetts General Hospital, Boston, Massachusetts, USA.
Kathryn E PostCenter for Psychiatric Oncology & Behavioral Sciences (S.B.L., M.H., K.E.P. J.A.G.), Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School (S.B.L., K.E.P, I.J.E.U., M.E.C., W.F.P, J.S.T, J.A.G.), Boston, Massachusetts, USA.
Ijeoma Julie Eche-UgwuHarvard Medical School (S.B.L., K.E.P, I.J.E.U., M.E.C., W.F.P, J.S.T, J.A.G.), Boston, Massachusetts, USA; Phyllis F. Cantor Center Research in Nursing and Patient Care Services (I.J.E.U., M.E.C.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Mary E CooleyHarvard Medical School (S.B.L., K.E.P, I.J.E.U., M.E.C., W.F.P, J.S.T, J.A.G.), Boston, Massachusetts, USA; Phyllis F. Cantor Center Research in Nursing and Patient Care Services (I.J.E.U., M.E.C.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
William F PirlHarvard Medical School (S.B.L., K.E.P, I.J.E.U., M.E.C., W.F.P, J.S.T, J.A.G.), Boston, Massachusetts, USA; Psychosocial Oncology (W.F.P.), Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Jennifer S TemelHarvard Medical School (S.B.L., K.E.P, I.J.E.U., M.E.C., W.F.P, J.S.T, J.A.G.), Boston, Massachusetts, USA; Department of Medicine (J.S.), Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Joseph A GreerCenter for Psychiatric Oncology & Behavioral Sciences (S.B.L., M.H., K.E.P. J.A.G.), Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School (S.B.L., K.E.P, I.J.E.U., M.E.C., W.F.P, J.S.T, J.A.G.), Boston, Massachusetts, USA.

Funding

Brief Behavioral Intervention for Dyspnea in Patients with Advanced Lung CancerR01NR016694 · NINR · MASSACHUSETTS GENERAL HOSPITAL · PI GREER, JOSEPH ANDREW, TEMEL, JENNIFER SUE · 2017 to 2021
$2.5M
NINR NIH HHS R01 NR016694
6 · The paper itself

Abstract

contextDyspnea (breathlessness) is a distressing and disabling symptom affecting over 70% of patients with advanced lung cancer. Although dyspnea treatments are limited, recent research on a brief, nurse-led behavioral intervention for dyspnea in patients with advanced lung cancer demonstrated improvements in dyspnea-related functioning compared to usual care.

objectivesWe examined whether depression and anxiety moderate the efficacy of a brief behavioral intervention for dyspnea in advanced lung cancer.

methodsThis secondary analysis of a randomized controlled trial examined a two-session, nurse-led behavioral intervention for dyspnea in 247 patients with advanced lung cancer. Patients self-reported dyspnea-related functioning (Modified Medical Research Council Dyspnea Scale), multidimensional dyspnea (Cancer Dyspnea Scale), and depression and anxiety (Hospital Anxiety and Depression Scale [HADS]) at baseline and post-treatment (8 weeks later). The PROCESS macro tested depression and anxiety as treatment moderators for dyspnea and probed interactions when P's < 0.15 using the Johnson-Neyman procedure due to reduced power in testing moderators.

resultsBaseline depressive symptoms moderated the intervention's impact on dyspnea functioning (b = -0.074, P = 0.075), with significant benefits observed in those reporting >6 on baseline scores of the HADS-Depression subscale. Any post-treatment improvement on the HADS-Anxiety subscale (b = 0.069, P = 0.135) and improvements of at least 3 on the HADS-Depression subscale (b = 0.671, P = 0.009) significantly enhanced outcomes for total dyspnea and dyspnea functioning, respectively.

conclusionsPatients with elevated baseline depression and improved distress may benefit more from this intervention for dyspnea. Considering treatment moderators helps optimize resources, but additional research on treatment adaptations is needed to enhance care for all.

Indexed as

AnxietyBehavior TherapyDepressionDyspneaLung NeoplasmsAgedFemaleHumansMaleMiddle AgedTreatment Outcomeanxietybehavioral interventiondepressionDyspnealung cancermoderator

Identifiers

PMID40188892
PMCPMC12229764

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.