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Development and validation of a short version of the MD Anderson Symptom Inventory for upper gastrointestinal surgery
Taisuke Imamura1, Koichi Tomita1, Paula Marincola Smith2
1Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Background:
The MD Anderson Symptom Inventory for upper gastrointestinal surgery (MDASI-UGI-Surg) is a validated 27-item patient-reported outcome instrument designed to assess perioperative symptom burden and functional status in patients undergoing surgery for upper gastrointestinal cancers. This study aimed to develop a shortened version (Short-MDASI-UGI-Surg) that preserves the sensitivity of the original tool while reducing respondent burden.
Methods:
Prospectively collected longitudinal patient-reported outcome data obtained using the MDASI-UGI-Surg or the MDASI in patients with gastrointestinal cancer (MDASI-GI) from patients who underwent oesophagectomy, gastrectomy, or pancreatectomy for cancer were retrospectively analysed. Symptom severity and temporal patterns were examined using hierarchical clustering, and representative symptoms were selected based on clinical relevance and symptom severity through correlation analysis.
Results:
Time series clustering of the 27 items collected from 302 patients revealed three distinct symptom/interference clusters based on relative peak timing: acute, with items peaking on postoperative day (POD) 3; subacute, peaking on POD 21; and persistent, extending through postoperative months 3-6. Within each symptom/interference cluster, items were identified that were highly correlated with other items (r ≥ 0.55), from which 13 representative symptom or interference items were selected. The 13 selected items were incorporated into the Short-MDASI-UGI-Surg and demonstrated high concurrent validity with the harmonized full MDASI reference (r = 0.98) and strong concordance in time series trends across all timepoints (r = 0.96-0.98). Known groups validity was supported by significant differences in scores between the oesophagectomy, pancreatectomy, and gastrectomy groups using both the harmonized full MDASI instrument and the Short-MDASI-UGI-Surg.
Conclusions:
The 13-item Short-MDASI-UGI-Surg, may reduce respondent burden and enhance clinical implementation while promoting patient engagement in perioperative symptom monitoring.
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