scholarly journals Translation and validation of the Chinese version of the MD Anderson symptom inventory for measuring perioperative symptom burden in patients with gynecologic cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Zhang ◽  
Ying-ying Zheng ◽  
Zhi-rong Yang ◽  
Qiuling Shi ◽  
Xin Shelley Wang ◽  
...  

Abstract Background Gynecologic cancers are among the most prevalent malignancies in China. Cervical and uterine cancer respectively account for the sixth and eighth highest incidence of cancer among Chinese women. Abdominal surgery is one of the important treatment methods for gynecological tumors. However, the tumor- and surgery-related symptom burden are not well studied owing to a lack of a standardized and validated assessment tool in the Chinese population. The study aimed to translate and validate the MD Anderson Symptom Inventory for measuring perioperative symptom burden in gynecologic cancer patients (MDASI-PeriOp-GYN) and examine the utility of the Chinese version of MDASI-PeriOp-GYN. Methods The MDASI-PeriOp-GYN was translated in a stepwise manner. First, two native speakers independently translated the 9 PeriOp-GYN symptom items. Then the nine items were translated back into English by two different bilingual translators. After discussion and revision, the four translators reached an agreement. Finally, the finalized Chinese version was administered to women with three common gynecologic cancer types (cervical, ovarian, and endometrial cancers) recruited from the gynecological oncology department of Sichuan Cancer Hospital & Institute between July and October 2019. The reliability and validity of the translated version were assessed. Results Overall, 324 women with gynecologic cancers were enrolled. Cronbach’s α values were 0.826 and 0.735 for the symptom severity and interference scales, respectively. Test–retest reliability values were 0.885, 0.873, and 0.914 for symptom severity, PeriOp-GYN, and interference scales. Significant correlations were found between the MDASI-PeriOp-GYN-C and EORTC QLQ-C30 along with the QLQ-OV28 module (− 0.608–0.871, P < 0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by time intervals, surgery type, and functional status (all P < 0.01). Conclusions The MDASI-PeriOp-GYN-C is a valid and reliable tool for measuring symptoms in Chinese patients undergoing surgery for gynecologic cancers. The tool could be used in clinical practice and clinical trials to instantly gather patients’ health and quality of life data.

2021 ◽  
Author(s):  
Ting Zhang ◽  
Ying-ying Zheng ◽  
Zhi-rong Yang ◽  
Qiuling Shi ◽  
Xin Shelley Wang ◽  
...  

Abstract Background: Gynecologic cancers are among the most prevalent malignancies in China, and millions of gynecologic cancer patients are expected to undergo open abdominal surgery as initial treatment. The tumor- and surgery-related symptom burden are not well studied owing to a lack of a standardized and validated assessment tool in Chinese. The study was to translate and validate the MD Anderson Symptom Inventory for measuring perioperative symptom burden in gynecologic cancer patients (MDASI-PeriOp-GYN) and examine the utility of the Chinese version.Methods: The MDASI-PeriOp-GYN was translated in a stepwise manner. First, two native speakers independently translated the 9 PeriOp-GYN symptom items. Then the 9 items were translated back into English by another two bilingual translators. After discussion and revision, the four translators reached an agreement. The finalized Chinese version was administered to women with three common gynecologic cancer types (cervical, ovarian, and endometrial cancers) recruited from the gynecological oncology department of Sichuan Cancer Hospital & Institute between July and October 2019. Reliability and validity of the translated version were assessed. Results: Overall, 324 women with gynecologic cancers were enrolled. Cronbach’s α values were 0.826 and 0.735 for the symptom severity and interference scales, respectively. Test-retest reliability values were 0.885, 0.873, and 0.914 for the symptom severity, PeriOp-GYN, and interference scales, respectively. Significant correlations were found between the MDASI-PeriOp-GYN-C and EORTC QLQ-C30 along with the QLQ-OV28 module (-0.608–0.871, P<0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by time intervals, surgery type, and functional status (all P<0.01). Conclusions: The MDASI-PeriOp-GYN-C is a valid and reliable tool for measuring symptoms in Chinese patients undergoing surgery for gynecologic cancers. The tool could be used in clinical practice and clinical trials to instantly gather patients’ health and quality of life data.


2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 78-78
Author(s):  
Diane Denny ◽  
Brandon Bosch ◽  
Kayla Alston ◽  
Maurie Markman

78 Background: Cancer Treatment Centers of America, (CTCA) is a national network of five hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients’ perceived symptom burden for real time clinical intervention and provides longitudinal data to demonstrate how effectively we meet our patient’s needs, from the point of no intervention (baseline) and every 21 days or greater. The SIT is comprised of 27 questions utilizing the MD Anderson Symptom Inventory tool, a validated assessment instrument with 8 questions added and a free text box by CTCA. The SIT became an integral part of patient care at CTCA in September 2012. Methods: A multidisciplinary team convened to evaluate how best to deliver the SIT data to facility leadership to assist with program development. The data needed to perform each calculation was obtained using analytical software that interfaces the database, electronic health record, and cancer registry. A Quality Research Associate prepares the operational summary providing a monthly update for the leadership at each facility with data included for the previous month, cumulatively for the facility, and cumulatively for the network. Results: The summary includes mean time to complete an assessment, assessments by timeframe (i.e. baseline, 2nd, 3rd assessments, etc.), gender and age percentages, and patients categorized by cancer type. The top three average scoring symptoms and interference issues by baseline, 2nd, and 3rd assessment are highlighted along with the top areas of improvement and diminishment in score defined by a change of 2 or more points reflecting clinical relevance. The top areas scored at 8 or greater that improved and the top areas where patients continued to score at 8 or greater on return are presented to focus upon the most severe needs. Graphs and tables are accompanied by explanation. Conclusions: In addition to consistency in presentation of the data across centers, the SIT operational summary provides visibility and insight on key emerging trends. Meaningful discussion of programmatic opportunities for focus on the most problematic and severe symptom by patient group has occurred.


2019 ◽  
Vol 152 (3) ◽  
pp. 492-500 ◽  
Author(s):  
Xin Shelley Wang ◽  
Qiuling Shi ◽  
Loretta A. Williams ◽  
Charles S. Cleeland ◽  
Araceli Garcia-Gonzalez ◽  
...  

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5000-5000
Author(s):  
Xin Shelley Wang ◽  
Alessandra Ferrajoli ◽  
Jackie B. Broadway ◽  
Gary M. Mobley ◽  
Tito R. Mendoza ◽  
...  

Abstract CLL is the most prevalent form of adult leukemia. The life expectancy of patients affected by CLL varies significantly, with a large fraction of patients with survival expectation of 10 years or longer. Furthermore a number of patients are observed without treatment intervention. These patients have been labeled as “asymptomatic” and very little attention has been placed to the symptom burden that accompanies CLL. In order to measure the quality of life of patients with CLL, we explored the reliability and validity of the M. D. Anderson Symptom Inventory (MDASI). We enrolled 99 consecutive patients followed at our outpatient center. To assess and construct validity, we performed principal axis factor analysis with oblimin rotation. To assess reliability, we calculated separate coefficient alphas for the severity and interference subscale items. Patients were 63% male with a mean age of 59 years (range 29–79), with 43% age 60 years or older. 94% were White Non-Hispanic patients. 61% were employed. 83% had higher than high school education. 75% had Rai staging 0–1, and 53% had received prior treatment. Factor analysis of the MDASI items resulted in a two-factor solution (symptom severity and interferences) that satisfied criteria for interpretability and model fit in a confirmatory setting. Cronbach coefficient alphas for the MDASI were 0.91 for severity and 0.96 for interference. We also examined the criterion validity of the two MDASI subscales by investigating their correlation to similar subscales of the SF-12. MDASI “worst pain” was highly correlated with the “body pain” subscale of the SF-12 (r=−.84, p=.000). MDASI “fatigue” was significantly correlated with the SF-12 “energy” item (r=.79, p=.000). The patient self reported most severe symptoms were fatigue, sleeping disturbance, drowsiness, distress, and shortness of breath. There were no significant differences of symptom severity by age group (more or less than 60 years old) and by staging (Rai 0–1, 2–3). However, fatigue severity was significantly higher in patients who had more than 2 therapies than patients without prior therapy (4.26 vs 2.07 on 0 to 10 fatigue scale on MDASI, P=.003). The most burdensome symptoms were interference of working, activity and enjoyment of life. Moderate to severe symptoms that would be the targeted area of symptom control in CLL patients were fatigue (25%), drowsness, (13%), shortness of breath (11%), and sleeping disturbance (12%). In conclusion this preliminary data analysis showed that the MDASI is a reliable and valid tool for assessing symptom severity and interference with daily functioning in CLL patients. This versatile assessment tool can be used to measure CLL-related symptom burden in the clinical practice of symptom management as well as to measure changes in symptom burden in patients enrolled in therapeutic clinical trials.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1393-1393
Author(s):  
Xin Shelley Wang ◽  
Tito R. Mendoza ◽  
Jackie B Broadway ◽  
Gary M. Mobley ◽  
Michael Keating ◽  
...  

Abstract Abstract 1393 Poster Board I-415 Chronic lymphocytic leukemia (CLL) is the most prevalent form of adult leukemia. Patients with CLL have a long life expectancy and little attention has been paid to the symptom burden that accompanies this disease. We, therefore, wanted to explore the reliability and validity of the M. D. Anderson Symptom Inventory (MDASI) in measuring the symptom burden of patients with CLL. The MDASI is an established, reliable and validated tool for assessing cancer-related symptoms regardless of therapy or specific cancer diagnosis.1 The MDASI measures the most common symptoms across most cancer types and treatments: 13 items assess symptom severity at its worst in the last 24 hours and 6 items assess symptom-related interference in the last 24 hours, all rated on a 0–10 numeric scale. These 19 symptom and interference items comprise the “core” MDASI. We enrolled 126 consecutive patients with CLL being followed at our outpatient center. Patients eligible for this study were required to be speak English and have a pathological diagnosis of CLL. A clinical nurse conducted interviews, had patients complete self-administered MDASI, and collected information from patients' medical record. Sixty-three % of the patients were male, 95% were white non-Hispanic, the mean age was 59 years (range 29-79) with 27% of them age 65 years or older. Eighty-three % of the patients had Rai stage 0-2, and 56% were untreated. Factor analysis of the MDASI items resulted in a three-factor solution (physical symptoms, psychological symptoms, and gastrointestinal symptoms), which satisfied criteria for interpretability and model fit in a confirmatory setting. Cronbach coefficient alphas for the MDASI were 0.89 for the symptom severity subscale and 0.94 for the interference subscale. Convergent validity showed that the two MDASI subscales were significantly correlated with similar subscales of the SF-12 (12-Item Short-Form Health Survey). The most severe patient-reported MDASI symptoms were fatigue, disturbed sleep, drowsiness, distress, and difficulty remembering. Patients with poorer performance status (ECOG PS 2 vs. 1 vs. 0) reported significantly higher severity for both core MDASI and total interferences (all P < .001). Patients with higher Rai staging [3-4 vs 0-2] reported significantly higher severity on core symptoms and interferences (P<.01), especially on fatigue, nausea, sleep, shortness of breath, drowsiness (All P<.05), and lack of appetite (P<.001). Older patients (aged 65 years and older) had significantly higher fatigue, shortness of breath, and lack of appetite [P<.001], but lower sadness. We observed that female reported significantly higher pain and sadness (All <.05). Patients with more prior chemotherapy [1 or more vs. 0 cycles chemotherapy) reported significantly higher symptom severity for core items on MDASI [P=.013] and higher symptom interferences [P=.001], especial on fatigue, shortness of breath, and drowsiness (All P<.01). Sixty-one percent of the sample rated at least one symptom as moderate to severe (≥5 on the MDASI's 0–10 scale). In cluster analysis, approximately 30% of patients belonged to the high-symptom group (Fig 1: symptom severity by items on MDASI for both high and low symptom group). The most burdens from symptoms were interference of working, enjoyment of life and activity. In conclusion, our data analysis showed that the MDASI is a reliable and valid tool for assessing symptom severity and interference with daily functioning in patients with CLL. The MDASI symptom profile demonstrated that almost one-third of patients had significantly higher symptom severity. This validated MDASI provides a useful tool for measuring symptom burden and monitor symptom control in patients with CLL. Figure Patient reported symptom severity (0-10 scale) on MDASI: majority of patient (70%) had multiple low symptom profile Figure. Patient reported symptom severity (0-10 scale) on MDASI: majority of patient (70%) had multiple low symptom profile Disclosures: No relevant conflicts of interest to declare.


2021 ◽  
Vol 33 (1) ◽  
pp. 1-7
Author(s):  
Riaan Van tonder ◽  
Lovemore Kunorozva ◽  
Pierre Viviers ◽  
Wayne Derman ◽  
James Brown

Background: Sports-related concussion (SRC) is an injury with important implications, especially in collision and contact sports, and has a high symptom burden. Student athletes face particular psychosocial challenges, especially female students with pre-existing anxiety/depression are at increased risk for SRC, and have a higher symptom burden before and after injury. Objectives: Describing female SRC presenting features at a collegiate campus-based sports medicine service; examining the association of prior concussion history (PCONC) and pre- existing anxiety/depression (PMHDx) with SRC. Methods: A retrospective cohort and statistical analysis (including corrected effect sizes) of Sport Concussion Assessment Tool (versions 3/5) data (Step 1: PCONC and PMHDx history; Step 2: symptom evaluation) of collegiate female athletes with SRC between 2012 and 2018. Results: Forty females with SRC were identified (age 23 ± 3). The five most frequent symptoms were headache (n = 34; 85%), feeling slowed down (n = 33; 83%), pressure in head (n = 33; 83%), don't feel right (n = 32; 80%) and fatigue/low-energy (n = 32; 80%). These five symptoms also had the highest self-rated severity (median (IQR): headache (3 (2-4)), feeling slowed down (3 (1-4)), fatigue/low-energy (3 (1-5)), don't feel right (3 (1-4)) and pressure in head (3 (2-4)). PMHDx (n = 8; 62.9 vs 38.6; p = 0.0192; Hedges' gs = 0.95; large ES), and not PCONC (n = 13; 51.0 vs 39.8; p = 0.2183; Hedges' gs = 0.48; small ES) was associated with increased mean total symptom severity. Conclusion: Headache, feeling slowed down, pressure in head, don't feel right and fatigue/low-energy had the highest symptom burden. Total symptom severity was no different in those with and without PCONC, but significantly higher in those with PMHDx.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17054-17054
Author(s):  
X. S. Wang ◽  
C. Lu ◽  
Q. Shi ◽  
D. Fariclough ◽  
G. Mobley ◽  
...  

17054 Background: Improving survival and quality of life is the primary treatment goal for patient with advanced NSCLC receiving palliative chemotherapy. The optimal treatment duration remains to be determined, and there are few studies that examine longitudinal symptom burden in this population. Methods: We prospectively collected self-reported symptom data from advanced stage NSCLC patients receiving chemotherapy. Symptom data was collected weekly utilizing the MD Anderson Symptom Inventory (15 symptoms) pre chemotherapy until therapy discontinuation or up to 26 weeks. Principal components analysis of symptoms measures with a Varimax rotation were used to identify symptom clusters. A piecewise linear mixed-effect regression model was used to estimate the changes over time in symptom severity, and Cox modeling was used for data analysis. Results: Data from 102 subjects were available for analysis. Chemotherapy was primarily discontinued because of tumor progression or a decline in the patient's functional status. Seventy patients received only 2 cycles of chemotherapy, while 46 and 29 patients received 4 and 6 cycles of chemotherapy, respectively. Four clusters of symptoms were identified prior to therapy, including: general symptoms (such as pain, fatigue, sleeping disturbance), GI distress (nausea, vomiting, lack of appetite & constipation), affective symptoms (sadness & distress) and specific disease related symptoms (coughing & shortness of breath). In patients who received = 3 cycles of chemotherapy, a rapid increased in symptom severity was observed, compared to those who received > 3 cycles (P<.05). Patients who received =3 cycles of chemotherapy demonstrated shorter survival compared to those who received > 3 of chemotherapy (HR=9.9, CI=4–22.7, P<.001). Conclusion: Patients with advanced NSCLC who received more than 3 cycles of chemotherapy demonstrated more stable symptom burden and longer survival compared to those who received = 3 cycles of chemotherapy. No significant financial relationships to disclose.


2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 290-290
Author(s):  
Kemi Morenikeji Doll ◽  
Ke Meng ◽  
Ethan M Basch ◽  
Paola A. Gehrig ◽  
Wendy R. Brewster ◽  
...  

290 Background: Women ≥ 65 years dually enrolled in Medicare and Medicaid (‘Duals’) represent an at-risk group in cancer care, yet their outcomes across the spectrum of gynecologic cancers have not been studied. Our goal was to compare the association of insurance type to stage at diagnosis and mortality of older women after a gynecologic cancer diagnosis. Methods: Population-based, retrospective cohort study of women ≥ 65 years, diagnosed with gynecologic cancers from 2003 – 2009 in North Carolina Central Cancer Registry files. Medicare, Medicaid, and claims from privately insured health plans were linked with census data. Multiple logistic regression, Cox proportional hazard models, and Kaplan Meier survival curves were constructed comparing Medicare, Medicare HMO, and Medicare/Medicaid populations. Results: Among 4,554 patients in the cohort, 3,403 (74%) Medicare+/- supplemental private, 531(11%) Medicare HMO, and 620 (14%) Medicare + Medicaid (Dual). There were 2,215(49%) cases of early stage disease and 1,447(32%) deaths. Dual enrollees had increased mortality rates vs. Medicare overall (HR 1.61, 95%CI:1.4–1.8), and within each cancer site: uterine HR 1.50 (95%CI:1.2-1.9); ovarian HR 1.46 (95%CI:1.1-1.9); cervical HR 1.54 (95%CI:1.0–2.3); and vulvar/vaginal HR 2.84 (95%CI:1.9–4.2). Duals also had increased odds of advanced stage diagnosis in uterine cancer (OR 1.48, 95%CI:1.1–2.0). Stratified survival curves demonstrate the largest disparities amongst women with early stage uterine, advanced stage ovarian, and early stage vulvar/vaginal cancers. Conclusions: Dually enrolled gynecologic cancer patients have a 60% increased mortality rate compared to non-duals despite equivalent stage distribution at the time of diagnosis. Specific site/stage subgroups drive these results and should be the focus of future studies elucidating mediators of these disparate outcomes, including barriers in access to specialty surgical care.


2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 100-100 ◽  
Author(s):  
Brian D. Badgwell ◽  
Loretta A. Williams ◽  
Eduardo Bruera

100 Background: Gastrointestinal obstruction (GIO) is the most common indication for palliative surgical consultation in patients with advanced cancer. The purpose of this study was to delineate the symptom burden and experience of patients with GIO. Methods: Twenty patients with advanced cancer and GIO described symptoms at the time of surgical consultation. We used content analysis of interview transcripts and symptoms were ranked by frequency and compared to a general symptom assessment survey (MD Anderson Symptom Inventory). Results: Malignancy type included colorectal (N = 9), gastric (N = 4), urothelial/renal (N = 3), and other (N = 4), while site of obstruction was small bowel in 11 (55%), gastric outlet in 3 (15%), and large bowel in 6 (30%). Thirteen patients (65%) had received chemotherapy within 6 weeks. Imaging evidence of a primary/recurrent tumor, carcinomatosis, or ascites was documented in 13 (65%), 11 (55%), and 16 (80%) patients, respectively. Thirty symptoms were identified on qualitative interviewing. MD Anderson Symptom Inventory symptoms of pain, nausea, and vomiting were frequently noted. Frequently mentioned GIO-specific symptoms included bloating, cramping, not having a bowel movement, and inability to eat. Conclusions: Qualitative research methodology can identify symptoms of importance to patients which can be used to assess improvement after treatment of GIO. Expert panel rating will be used to develop the final symptom item list prior to psychometric testing of the survey.


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