Measuring the Symptom Distress of Cancer Patients: Development of a New Assessment System

Principal Investigator: Charles S. Cleeland, Ph.D.

Common symptoms of cancer and cancer treatment significantly impair the function and quality of life of patients. Despite the tremendous impact that symptoms can have on quality of life, symptom assessment is rarely a part of routine cancer care. Healthcare professionals may wait until patients spontaneously complain of symptoms before formally assessing them. And they are more apt to rely on their own experience or professional judgment instead of using a standard and valid assessment tool. The Pain Research Group developed the MD Anderson Symptom Inventory (MDASI), a multiple symptom assessment measure that examines common symptoms patients may experience and how these symptoms impact daily function. Consistent measurement of symptoms over time could be useful in developing symptom management pathways and thus lead to better symptom control.

Our Objectives

  • To examine how the MD Anderson Symptom Inventory (MDASI) performs in various sample populations including community dwelling adults and patients who have different cancer types, who have undergone various treatments and who have different and/or more severe symptoms (Complete)

  • To evaluate the MDASI as an estimate of functional status and quality of life (Complete)

  • To assess the impact of symptom severity on standard function and health-related quality of life measures, including both quantitative and qualitative measures (patient interviews)

  • To assess the pattern and severity of symptoms over multiple time points in order to assay the system’s responsiveness to changes due to therapy or disease

  • To explore the utility of an Interactive Voice Response (IVR) system in enhancing the clinical care of outpatients

  • To explore the effect of information from an IVR symptom assessment system on a) the pattern of care and b) development of interdisciplinary protocols

  • To explore the feasibility of developing symptom management pathways for patients based on these symptom and quality of life data


Screening and enrollment for this survey study is ongoing in outpatient clinics, inpatient units, the Emergency Center, and in community organizations. Community dwelling adults and patients have been be surveyed at single time points for tool validity and reliability. Patient data is also being evaluated for the effect of symptom severity on quality of life and function. Data will be collected at multiple time points for some patient populations to test the system’s responsiveness to changes due to therapy or disease. Some patients will also complete an interview that will be taped and transcribed later.


Instruments include Brief Fatigue Inventory (BFI), Brief Pain Inventory (BPI), the MD Anderson Symptom Inventory (MDASI), Beck’s Depression Inventory, Function Assessment after Cancer Therapy (FACT), the Medical Outcomes Study Short Form Health Survey SF-12 and SF-36 and the Profile of Mood States (POMS).

For more information

Contact Marilyn Morrissey, M.P.H., at