The MD Anderson Symptom Inventory (MDASI)

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The MD Anderson Symptom Inventory (MDASI; Cleeland et al., 2000) is a multi-symptom patient-reported outcome (PRO) measure for clinical and research use. The MDASI’s 13 core symptom items include those found to have the highest frequency and/or severity in patients with various cancers and treatment types. The MDASI has several advantages over other symptom-assessment scales in that it applies broadly across cancer types and treatments, is easy for patients to complete, includes items related to symptom interference with daily life, and it is easily translated into other languages.

In response to the FDA draft guidance for the pharmaceutical industry on the use of PRO measures in medical product development to support labeling claims, we have prepared a MDASI User's Guide to provide documentation of the development and psychometric properties of the MDASI and its modules. The information offered therein addresses the recommendations in the FDA draft guidance and establishes the MDASI's adequacy as a measure to support medical product claims.

MDASI Features

  • Purpose: To assess the severity of multiple symptoms and the impact of symptoms on daily functioning
  • Population: Patients with symptoms caused by cancer and cancer treatment
  • Assessment areas: Severity of multiple symptoms and the impact of symptoms on daily functioning during the last 24 hours
  • Method: Self-report, interview or via telephone-based interactive voice response (IVR) system
  • Time required: Five minutes
  • Scoring: Please see the MDASI User's Guide
  • Reliability: Cronbach alpha reliability ranges from 0.82 to 0.94

MDASI Modules

MDASI modules augment the 19 core MDASI symptom and interference items with additional items identified as unique to a particular patient population. MDASI modules may be disease-specific, disease-site-specific, or treatment-specific. Visit the links below for module-specific validation information and language availability.

MDASI Language Versions

The MDASI is available in the languages shown below. Click on a linked language to view a sample in PDF format.

Psychometrically and Linguistically ValidatedLinguistically Validated
Chinese (Simplified)
Chinese (Traditional)
French (Canada)
Hebrew (Hadassah)
Portuguese (Brazil)
Portuguese (Portugal)

Future Validation Studies: We would like to collaborate with other investigators to develop and validate new language versions of the MDASI. Contact us at for more information. NOTE: The MDASI may not be modified or translated into another language without express written consent (see Notice of Copyright below).  

To Order the MDASI

To use the MDASI in a publication or clinical or research trial, you must obtain permission by filling out our order form and you must comply with the copyright. Fees may apply: 

Type of UseFirst Language Version (Per Project)Additional Language Versions (Per Project)
Non-funded academic researchNo chargeNo charge
Individual clinical practiceNo chargeNo charge
Funded academic research$300$150
Commercial research$2,000$1,200

The MDASI will be e-mailed to you as a PDF file within 7 to 10 business days. If your request is urgent or the language version you seek is not shown, contact us to make special arrangements:

Department of Symptom Research
Attn: Assessment Tools
The University of Texas MD Anderson Cancer Center
1515 Holcombe Boulevard, Unit 1450
Houston, Texas 77030 

If applicable, an invoice will be e-mailed to you. Reference the invoice number on your payment and include on the memo line, "MD Anderson Assessment Tool Distribution."

Notice of Copyright

The M. D. Anderson Symptom Inventory (MDASI) copyright is held by The University of Texas MD Anderson Cancer Center and administered by the MDASI's developer, Charles S. Cleeland, PhD. The copyright applies to the MDASI, its modules, and all its derivatives in any language. 

The MDASI and its modules may not be used or reproduced without permission from the copyright administrator or his designee. Fees for use may apply (see above).

Neither the MDASI nor any of its modules may not be modified or translated into another language without the express written consent of the copyright administrator or his designee. Failure to comply may result in legal action. Contact us via e-mail at or at the address shown above to obtain permission to alter or translate the instrument.

Selected References


Cleeland CS, Mendoza TR, Wang XS, Chou C, Harle M, Morrissey M, & Engstrom MC. Assessing symptom distress in cancer: The M. D. Anderson Symptom Inventory. Cancer 89:1634-1646, 2000.

Guirimand F, Buyck JF, Lauwers-Allot E, Revnik J, Kerguen T, Aegerter P, Brasseur L, Cleeland CS. Cancer-related symptom assessment in France: validation of the French M. D. Anderson Symptom Inventory. J Pain Symptom Manage 39(4): 721-733, 2010.

Nejmi M, Wang XS, Mendoza TR, Gning I, Cleeland CS. Validation and application of the Arabic version of the M. D. Anderson Symptom Inventory in Moroccan patients with cancer. J Pain Symptom Manage 40(1): 75-86, 2010.

Lin CC, Chang AP, Cleeland CS, Mendoza TR, Wang XS. Taiwanese version of the M. D. Anderson Symptom Inventory: symptom assessment in cancer patients. J Pain Symptom Manage 33(2): 180-188, 2007.

Wang XS, Laudico AV, Guo H, Mendoza TR, Matsuda ML, Yosuico VD, Fragante EP, Cleeland CS. Filipino version of the M. D. Anderson Symptom Inventory (MDASI-F): Validation and multisymptom measurement in cancer patients. J Pain Symptom Manage 31(6): 542-552, 2006.

Yun YH, Mendoza TR, Kang IO, You CH, Roh JW, Lee CG, Lee WS, Lee KS, Bang S-M, Cleeland CS, Wang XS. Validation study of the Korean version of the M. D. Anderson Symptom Inventory. J Pain Symptom Manage 31(4): 345-352, 2006.

Ivanova MO, Ionova TI, Kalyadina SA, Uspenskaya OS, Kishtovich AV, Guo H, Mendoza TR, Novik A, Cleeland CS, Wang XS. Cancer-related symptom assessment in Russia: Validation and utility of the Russian M. D. Anderson Symptom Inventory. J Pain Symptom Manage 30(5): 443-453, 2005.

Mystakidou K, Cleeland C, Tsilika E, Primikiri A, Parpa E, Vlahos L, Mendoza T. Greek M. D. Anderson Symptom Inventory: validation and utility in a cancer patient population. Oncology 67: 203-210, 2004.

Wang XS, Wang Y, Guo H, Mendoza TR, Hao XS, Cleeland CS. Chinese version of the M. D. Anderson Symptom Inventory (MDASI-C): Validation and application of symptom measurement in cancer patients. Cancer 101(8):1890-1901, 2004.

Okuyama T, Wang XS, Akechi T, Mendoza TR, Hosaka T, Cleeland CS, Uchitomi Y. Japanese version of the M. D. Anderson Symptom Inventory: a validation study. J Pain Symptom Manage 26(6): 1093-1104, 2003.

Clinical Application

Kirkova J, Davis MP, Walsh D, Tiernan E, O'Leary N, LeGrand SB, Lagman RL, Russell KM. Cancer symptom assessment instruments: a systematic review. J Clin Oncol 24(9): 1459-1473, 2006. 

Wang XS, Rhines LD, Shiu AS, Yang JN, Selek U, Gning I, Liu P, Allen PK, Azeem SS, Brown PD, Sharp HJ, Weksberg DC, Cleeland CS, Chang EL. Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1-2 trial. Lancet Oncol 13(4): 395-402, 2012.

Wang XS, Williams LA, Krishnan S, Liao Z, Liu P, Mao L, Shi Q, Mobley GM, Woodruff JF, Cleeland CS. Serum sTNF-R1, IL-6, and the development of fatigue in patients with gastrointestinal cancer undergoing chemoradiation therapy. Brain Behav Immun 26(5): 699-705, 2012.

Wang XS, Cleeland CS, Mendoza TR, Yun YH, Wang Y, Okuyama T, Johnson VE. Impact of cultural and linguistic factors on symptom reporting by patients with cancer. J Natl Cancer Inst 102(10): 732-738, 2010.

Wang XS, Shi Q, Williams LA, Mao L, Cleeland CS, Komaki RR, Mobley GM, Liao Z. Inflammatory cytokines are associated with the development of symptom burden in patients with NSCLC undergoing concurrent chemoradiation therapy. Brain Behav Immun 24(6): 968-974, 2010.

Shi Q, Trask PC, Wang XS, Mendoza TR, Apraku WA, Malekifar M, Cleeland CS. Does recall period have an effect on cancer patients' ratings of the severity of multiple symptoms? J Pain Symptom Manage 40(2): 191-199, 2010.

Campagnaro E, Saliba R, Giralt S, Roden L, Mendoza F, Aleman A, Cleeland C, Weber D, Brown J, Anderson KO. Symptom burden after autologous stem cell transplantation for multiple myeloma. Cancer 112(7): 1617-1624, 2008.

Wang XS, Fairclough DL, Liao Z, Komaki R, Chang JY, Mobley GM, Cleeland CS. Longitudinal study of the relationship between chemoradiation therapy for non-small-cell lung cancer and patient symptoms. J Clin Oncol 24(27): 4485-4491, 2006.

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