Chinese version of the M. D. Anderson Symptom Inventory: Validation and application of symptom measurement in cancer patients

Division of Internal Medicine, Department of Symptom Research, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer (Impact Factor: 4.89). 11/2004; 101(8):1890-901. DOI: 10.1002/cncr.20448
Source: PubMed


Symptom management is an essential component of cancer treatment for patients of every culture and nationality. Symptom assessment depends on subjective reporting, mandating linguistically equivalent versions of symptom assessment scales. Because disease-related and treatment-related symptoms most often occur in clusters, there is a global need for a standardized multiple-symptom assessment tool.
The authors sought to validate the Chinese version of the M. D. Anderson Symptom Inventory (MDASI-C) by enrolling patients who had received various diagnoses of and different types of treatment for cancer (n = 249) in a cross-sectional symptom study conducted at an urban cancer center in China.
Factor analysis identified 2 underlying constructs, general symptoms and gastrointestinal symptoms, which had Cronbach alpha coefficients of 0.86 and 0.84, respectively. These results were consistent with English- and Japanese-language MDASI validation studies. Known-group validity was supported by the MDASI-C's ability to detect significant differences in symptom and interference levels according to Eastern Cooperative Oncology Group performance status (ECOG PS; P < 0.001) and chemotherapy status (P < 0.05). Fifty-five percent of the study cohort had > or = 1 symptom that was considered severe (score > or = 7 on a 0-10 scale). ECOG PS was strongly associated with symptom burden (total interference score: R(2) = 0.26; P < 0.001). Fatigue, sadness, drowsiness, and lack of appetite accounted for most of the variability in the total interference score (R(2) = 0.49; P < 0.05).
The authors demonstrated that the MDASI-C is a valid, reliable, and concise tool for measuring symptom severity and interference with functioning in Chinese cancer patients.

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Available from: Xin Shelley Wang, Jan 14, 2016
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    • "This instrument consists of an 18-item symptom scale and a 6-item interference scale. The reliability and validity of both the original version and the Chinese version have been demonstrated previously (Ye and Xu, 1993; Wang et al., 2004). The symptom scale scores the severity of each symptom in the previous 24 h, from 0 ( " Not at all " ) to 10 ( " I can't imagine it being any worse " ). "
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    • "Evaluation of QOL was performed using the MD Anderson Symptom Inventory (MDASI; Cleeland et al, 2000; Wang et al, 2004) and Functional Assessment of Cancer Therapy (FACT; Cella et al, 1993; Yu et al, 2000) pretreatment and then after every 8 weeks thereafter while on study. A TCM diagnosis was made at the study entry as part of the clinical trial but was not used to determine treatment randomisation. "
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