Psychometric Validation of a new module of MD Anderson Symptom Inventory (MDASI) for Patients with Upper...

The MD Anderson Symptom Inventory (MDASI) is a well-established, validated patient-reported outcome survey that assesses cancer patient symptom burden for use in clinical care and research. Multiple MDASI modules have been developed and validated to tailor the survey to specific cancer/treatment types. We validated an MDASI survey specific to surgical patients with upper gastrointestinal (UGI) cancers (MDASI-UGI-Surg), including pancreatic and gastroesophageal cancers, and which is designed to capture dynamic changes in symptom burden in the perioperative period.

Following qualitative interviews and expert panel feedback, the MDASI-UGI-Surg module was developed and validated in 169 consecutive patients undergoing major surgical resection for UGI cancer. Surveys were administered preoperatively as well as 3, 7, 14, 21, and 28 days postoperatively, and again 24 hours later to measure test-retest reliability. Outcome measures were validity and reliability.

A total of 145 patients enrolled were deemed evaluable (6 patients withdrew, 18 operations were cancelled/aborted). Disease sites included 42 (28.97%) esophagus, 27 (18.62%) stomach, and 76 (52.41%) pancreas. Cronbach alpha was 0.79 and 0.92 for symptoms severity items and interference items, respectively. Known-group validity was supported by the ability of MDASI-UGI-Surg to detect significant differences in symptom and interference levels according to performance status. Test-retest reliability was confirmed with intraclass correlation (0.76 to 0.89). Composite scores for core, module, and interference items were not significantly different between patients from the three disease sites of interest.

The MDASI-UGI-Surg is a new, psychometrically validated tool that can be used to capture dynamic changes in symptom burden in UGI cancer patients.