Assessing symptom distress in cancer patients - The M. D. Anderson Symptom Inventory
Assessing symptom distress in cancer patients - The M. D. Anderson Symptom Inventory
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DOI：
10.1002/1097-0142(20001001)89:7
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发表时间：
2000-10-01
期刊：
影响因子：
6.2
通讯作者：
Engstrom, MC
中科院分区：
文献类型：
--
作者：
Cleeland, CS;Mendoza, TR;Engstrom, MC
背景本项目的目的是开发M。D.安德森症状量表（MDASI），一个简单的衡量癌症相关疾病严重程度和影响的方法。症状列表由症状清单和临床医生小组生成。26个症状和6个干扰项目进行了评级的验证样本的527名门诊患者，30名住院患者的血液和骨髓移植服务，和交叉验证样本的113名门诊患者。临床判断和统计技术被用来减少症状的数量。MDASI的信度、效度和敏感性进行了检查。聚类分析、最佳子集分析和临床判断将症状数量减少到13个“核心”列表，占症状困扰方差的64%。因子分析表明，在两个门诊样本，两个症状因素和干扰规模是可靠的相似的模式。在“良好”与“较差”体能状态患者之间以及在积极治疗患者与随访患者之间发现了症状模式和严重程度的预期差异。患者认为疲劳相关症状最严重。按疾病或治疗分类的患者组有严重的症状，这些症状不在“核心”列表中。MDASI的核心项目占积极治疗的癌症患者和治疗后随访的癌症患者报告的大多数症状困扰。MDASI应证明对症状调查、临床试验和患者监测有用，其格式应允许互联网或电话管理。癌症2000;89：1634-46. (C)2000美国癌症协会
BACKGROUND. The purpose of this project was to develop the M. D. Anderson Symptom Inventory (MDASI), a brief measure of the severity and impact of cancer-related symptoms.METHODS. A list of symptoms was generated from symptom inventories and by panels of clinicians. Twenty-six symptoms and 6 interference items were rated by a validation sample of 527 outpatients, a sample of 30 inpatients from the blood and bone marrow transplantation service, and a cross-validation sample of 113 outpatients. Clinical judgment and statistical techniques were used to reduce the number of symptoms. Reliability, validity, and sensitivity of the MDASI were examined.RESULTS. Cluster analysis, best subset analysis, and clinical judgment reduced the number of symptoms to a "core" list of 13 that accounted for 64% of the variance in symptom distress. Factor analysis demonstrated a similar pattern in both outpatient samples, and two symptom factors and the interference scale were reliable. Expected differences in symptom pattern and severity were found between patients with "good" versus "poor" performance status and between patients in active therapy and patients who were seen for follow-up. Patients rated fatigue-related symptoms as the most severe. Groups of patients classified by disease or treatment had severe symptoms that were not on the "core" list.CONCLUSIONS. The core items of the MDASI accounted for the majority of symptom distress reported by cancer patients in active treatment and those who were followed after treatment. The MDASI should prove useful for symptom surveys, clinical trials, and patient monitoring, and its format should allow Internet or telephone administration. Cancer 2000;89:1634-46. (C) 2000 American Cancer Society.