Symptom burden of cancer patients: validation of the German M. D. Anderson Symptom Inventory: a cross-sectional multicenter study.

Cancer patients frequently suffer from various symptoms often impairing functional status and quality of life. To enable timely supportive care, these symptoms must be assessed adequately with reliable tools. This study aimed to validate the German version of the M. D. Anderson Symptom Inventory (MDASI). This was a multicenter, cross-sectional, observational study. At five German university hospitals, 697 cancer patients aged from 18 to 80 years undergoing active anticancer treatment were recruited to participate in the study. For the validation, reliability (Cronbach's alpha), construct validity (factor analysis), known group validity (Eastern Cooperative Oncology Group Performance Status), and convergent divergent analyses were calculated. Of the 980 patients who were eligible, 697 patients were included and agreed to participate in the study (71%). Reliability analysis showed good internal consistencies for the MDASI set of symptoms (Cronbach's alpha coefficient = 0.82; 95% CI = 0.78, 0.84) and for the set of interference items (Cronbach's alpha coefficient = 0.857; 95% CI = 0.484, 0.87). Factor analysis resulted in a one-factor solution (general symptoms; eigenvalue = 4.26) with a psychological (distress and sadness) and a gastrointestinal subscale (nausea and vomiting). Convergent and divergent analyses showed significant correlations between symptom burden and distress and global health-related quality of life (subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 Version 3.0.). The MDASI-German version is a valid tool for measuring patient-reported symptom severity and symptom interference in German cancer patients. It is easily applicable and can be used by German clinicians and researchers for screening and monitoring purposes and the comparison of international data.

Schmidt H ，Cleeland CS ，Bauer A ，Landenberger M ，Jahn P ... -  《-》

Validation of the Amharic Version of the M. D. Anderson Symptom Inventory and Assessment of Symptoms in Ethiopian Cancer Patients.

Cancer patients often face a variety of symptoms that impact their quality of life. The management of these symptoms is highly dependent on the accurate appraisal of their severity through the use of a standardized symptom assessment tool. The M. D. Anderson Symptom Inventory (MDASI), developed in English, is one of such tools that contain 13 core cancer related symptoms that can easily be rated on a scale of 0-10. The present study tried to develop and validate the Amharic language version of the MDASI (MDASI-Am). The MDASI-Am was developed by the standard forward/backward translation of the original English version of the MDASI. The MDASI-Am was completed by or administered to 145 randomly selected Ethiopian cancer patients. Factor analysis, Cronbach α coefficient, and mean comparison, respectively, were used to establish construct validity, internal consistency, and known-group validity (Eastern Cooperative Oncology Group Performance Status). Factor analysis identified three symptom constructs interpreted as general, gastrointestinal, and neuropsychiatric symptoms, with Cronbach α coefficients of 0.70, 0.80, and 0.82, respectively. The MDASI-Am significantly detected differences in symptom severity and interference levels in patient groups categorized according to Eastern Cooperative Oncology Group Performance Status (P < 0.01), establishing known-group validity. The most prevalent severe symptoms identified in the current sample were pain, sadness, numbness, distress, and fatigue. The MDASI-Am is a valid and reliable tool for measuring symptom severity and symptom interference with daily living in Ethiopian cancer patients.

Anshabo AT ，Migbaru S ，Mulu A ，Negusu D ，Asfaw AA ，Awoke D ，Tigeneh W ，Engidawork E ... -  《-》

Cancer-related symptom assessment in France: validation of the French M. D. Anderson Symptom Inventory.

This multicenter study was intended to validate the French version of the M. D. Anderson Symptom Inventory (MDASI-Fr) in French cancer patients (n=162) with solid tumors or hematological malignancies. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used as a part of the validation. Factor analysis showed three underlying constructs for symptom items: general symptoms (pain, fatigue, disturbed sleep, shortness of breath, drowsiness, dry mouth, and numbness or tingling items); emotional and cognitive components (distress, sadness, and remembering items); and a gastrointestinal component (nausea, vomiting, and lack of appetite items), with Cronbach's alphas of 0.79, 0.73, and 0.71, respectively. Convergent validity was established by comparing MDASI-Fr items with the EORTC QLQ-C30 scale and the Brief Pain Inventory (BPI). Overall, the 19-item MDASI-Fr score correlated well with the QLQ-C30 global health status, and the pain item of the MDASI-Fr was highly correlated with the short form of the BPI. The most prevalent symptoms were fatigue, distress, dry mouth, and pain. Twenty-five percent of patients reported moderate or severe pain (numeric rating scale >4 on 0-10 severity ratings). Physician ratings of global change on a second visit were significantly associated with changes in patient ratings on the MDASI-Fr, supporting the sensitivity of the measure. Symptoms interfered most with work and general activity. The MDASI-Fr is a valid and reliable tool for measuring symptom severity and interference in French cancer patients.

Guirimand F ，Buyck JF ，Lauwers-Allot E ，Revnik J ，Kerguen T ，Aegerter P ，Brasseur L ，Cleeland CS ... -  《-》

Linguistic Validation of the M. D. Anderson Symptom Inventory in Persian-Speaking Iranian Cancer Patients.

Various symptoms frequently affect cancer patients' quality of life. Appropriate assessment of these symptoms provides valuable data for cancer management. This study aimed to validate the Persian version of the M. D. Anderson Symptom Inventory (MDASI-P). This cross-sectional study was conducted at four cancer treatment centers in two cities in Iran. Breast cancer and colorectal cancer patients aged 18 years and older were consecutively included in the study. The standard forward-backward translation method was applied. Patients completed the MDASI-P along with the previously validated Persian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Construct validity (factor analysis), criterion validity (against the EORTC QLQ-C30), and reliability (Cronbach's alpha) were analyzed. A total of 146 breast cancer and 94 colorectal cancer patients were studied. Factor analysis for the symptom severity items resulted in a three-factor solution, further reduced to a two-factor solution: general symptoms and gastrointestinal symptoms. Correlation of the MDASI-P symptom severity items with corresponding EORTC QLQ-C30 symptom items (r = 0.48-0.75) and MDASI-P interference items with corresponding EORTC QLQ-C30 functioning domains (r = -0.46 to -0.23) supported the criterion validity. Cronbach's alpha was 0.90, 0.88, and 0.77 for the total questionnaire, symptom severity items, and the interference subscale, respectively. The MDASI-P is a feasible, valid, and reliable instrument for evaluation of symptoms in Persian-speaking cancer patients and can be used to improve symptom management in these patients.

Saadatpour L ，Hemati S ，Habibi F ，Behzadi E ，Hashemi-Jazi MS ，Kheirabadi G ，Mirbagher L ，Gholamrezaei A ... -  《-》

A Cross-sectional Study on the Symptom Burden of Patients With Spinal Tumor: Validation of the Chinese Version of the M.D. Anderson Symptom Inventory-Spine Tumor Module.

Tumors involving the spine are associated with unique symptoms affecting both patient survival and health-related quality of life. Currently, there is no disease-specific instrument in Chinese to assess the symptom burden of these patients. The objective of this study was to translate and validate a Chinese version of the M.D. Anderson Symptom Inventory-Spine Tumor Module (MDASI-SP-C) to assess the symptom burden of Chinese-speaking patients with spinal tumors. MDASI-SP-C was forward-and-backward translated according to standard protocols and administered to patients fulfilling study criteria at a major referral center of spine tumor between November 2014 and September 2015. The generic instruments of Short Form 36 Quality of Life Questionnaire (SF-36), Functional Assessment of Cancer Therapy-General Version (FACT-G), and Karnofsky Performance Scale were used along with MDASI-SP-C. Prevalence and severity distribution of each item were analyzed. Psychometric assessment and hierarchical cluster analysis were performed for the translated instrument. One hundred forty-two patients were enrolled. High interdependency and relatively low intra-cluster distances were identified. Cronbach's alpha of the entire instrument, the symptom severity subscale, and the interference subscale was 0.93, 0.91, and 0.92, respectively. Principal axis factoring resulted in a four-factor solution, which was reduced to a three-factor (general symptoms, spine-specific symptoms, and gastrointestinal symptoms) solution on account of clinical interpretation. Correlation coefficients between MDASI-SP-C items and their corresponding domains in SF-36 and/or FACT-G were all greater than 0.3. MDASI-SP-C was able to distinguish patients with different Karnofsky Performance Scale levels. MDASI-SP-C demonstrated satisfactory psychometric properties and could be used to better assess the symptom burden of Chinese-speaking patients with spine tumors for improved management of their medical needs.

Xu N ，Li Z ，Wei F ，Liu X ，Jiang L ，Meng N ，Jiang P ，Yu M ，Wu F ，Dang L ，Zhou H ，Li Y ，Liu Z ... -  《-》