Intra- and Interrater Reliability and Concurrent Validity of a New Tool for Assessment of Breast Cancer-Related Lymphedema of the Upper Extremity.
Bryan Spinelli, Michael J Kallan, Xiaochen Zhang and 9 others
PMID 30291828WHAT IT FOUND
A standardized physical exam for breast cancer arm swelling scored 0 to 72 agreed with arm volume and stayed consistent across repeat exams.
It is not proven to detect early swelling or change over time.
Key findings
01The CLUE total score showed agreement values of 0.88 when the same therapist repeated it 7 to 21 days later and 0.90 when two therapists compared it.
02The CLUE total score had a 0.79 correlation with arm volume difference measured by perometry.
03Average CLUE scores were 1.53±6.77 in participants with no lymphedema, 14.11±10.30 in stage 1, and 30.07±17.59 in stages 2 and 3.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 71 women were studied, and the team did not reach the planned 24 women in each lymphedema stage. Reliability was tested with only two experienced certified lymphedema therapists who had worked together for more than a decade, so agreement may be higher than in usual clinics. The study tested measurement agreement and correlation, not diagnostic accuracy, sensitivity to change, or how to interpret a single score. Women with unstable lymphedema or current lymphedema treatment were excluded, so this does not apply to those patients. Recruitment came through therapist referrals, word of mouth, and participants ineligible for other laboratory studies, which may not represent all breast cancer survivors.
Declared interests
The paper is listed as NIH extramural research support. The article text does not include a conflict-of-interest declaration.
The easy way to misread this
Do not use the CLUE score as proof that a treatment works or that it can detect early lymphedema. This paper tested measurement agreement and correlation with arm volume in 71 women, not diagnostic accuracy or change over time.