Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jan 24;109(4):djw253.
doi: 10.1093/jnci/djw253. Print 2017 Apr.

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Christine Miaskowski  1 , Andrea Barsevick  1 , Ann Berger  1 , Rocco Casagrande  1 , Patricia A Grady  1 , Paul Jacobsen  1 , Jean Kutner  1 , Donald Patrick  1 , Lani Zimmerman  1 , Canhua Xiao  1 , Martha Matocha  1 , Sue Marden  1
Affiliations
Review

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Christine Miaskowski et al. J Natl Cancer Inst. .

Abstract

An overview of proceedings, findings, and recommendations from the workshop on "Advancing Symptom Science Through Symptom Cluster Research" sponsored by the National Institute of Nursing Research (NINR) and the Office of Rare Diseases Research, National Center for Advancing Translational Sciences, is presented. This workshop engaged an expert panel in an evidenced-based discussion regarding the state of the science of symptom clusters in chronic conditions including cancer and other rare diseases. An interdisciplinary working group from the extramural research community representing nursing, medicine, oncology, psychology, and bioinformatics was convened at the National Institutes of Health. Based on expertise, members were divided into teams to address key areas: defining characteristics of symptom clusters, priority symptom clusters and underlying mechanisms, measurement issues, targeted interventions, and new analytic strategies. For each area, the evidence was synthesized, limitations and gaps identified, and recommendations for future research delineated. The majority of findings in each area were from studies of oncology patients. However, increasing evidence suggests that symptom clusters occur in patients with other chronic conditions (eg, pulmonary, cardiac, and end-stage renal disease). Nonetheless, symptom cluster research is extremely limited and scientists are just beginning to understand how to investigate symptom clusters by developing frameworks and new methods and approaches. With a focus on personalized care, an understanding of individual susceptibility to symptoms and whether a "driving" symptom exists that triggers other symptoms in the cluster is needed. Also, research aimed at identifying the mechanisms that underlie symptom clusters is essential to developing targeted interventions.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kim HJ, Barsevick AM, Beck SL, Dudley W.. Clinical subgroups of a psychoneurologic symptom cluster in women receiving treatment for breast cancer: A secondary analysis. Oncol Nurs Forum. 2012;391:E20–E30. - PubMed
    1. Illi J, Miaskowski C, Cooper B, et al. Association between pro- and anti-inflammatory cytokine genes and a symptom cluster of pain, fatigue, sleep disturbance, and depression. Cytokine. 2012;583:437–447. - PMC - PubMed
    1. Doong SH, Dhruva A, Dunn LB, et al. Associations between cytokine genes and a symptom cluster of pain, fatigue, sleep disturbance, and depression in patients prior to breast cancer surgery. Biol Res Nurs. 2015;173:237–247. - PMC - PubMed
    1. Kwekkeboom KL, Abbott-Anderson K, Cherwin C, Roiland R, Serlin RC, Ward SE.. Pilot randomized controlled trial of a patient-controlled cognitive-behavioral intervention for the pain, fatigue, and sleep disturbance symptom cluster in cancer. J Pain Symptom Manage. 2012;446:810–822. - PMC - PubMed
    1. Hermens DF, Naismith SL, Chitty KM, et al. Cluster analysis reveals abnormal hippocampal neurometabolic profiles in young people with mood disorders. Eur Neuropsychopharmacol. 2015;256:836–845. - PubMed