The MD Anderson Symptom Inventory
The MD Anderson Symptom Inventory (MDASI) is a multi-symptom patient-reported outcome (PRO) measure for clinical and research use. Use the MDASI to assess the severity of symptoms experienced by patients with cancer and the interference with daily living caused by these symptoms.
MDASI Symptom Items | MDASI Interference Items |
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Pain Fatigue Nausea Disturbed sleep Distress/feeling upset Shortness of breath Difficulty remembering Lack of appetite Drowsiness Dry mouth Sadness Vomiting Numbness/tingling |
Walking Activity Working (including housework) Relations with other people Enjoyment of life Mood |
The core MDASI’s 13 symptom items are those found to have the highest frequency and/or severity in patients with various cancers and treatment types. Disease site-specific and treatment-specific MDASI modules are available (sidebar, right).
The MDASI has several advantages over other symptom-assessment scales:
- It assesses both symptom severity and symptom interference with daily life
- It applies broadly across cancer types and treatments
- It can be adapted to specific cancer types, sites, and treatments (MDASI modules)
- Its 0-10 scale is easy for patients to understand and complete
- It is easily translated into other languages
The MDASI is available in paper-and-pencil, electronic, and telephone-based interactive voice response (IVR) formats, all of which are equally effective.
Order the MDASI
The MDASI Symptom Library
Individual and sets of symptom items from the MDASI Symptom Library may be added to the core MDASI or a MDASI module (sidebar, right) to create an experimental MDASI that is tailored to your clinical research or practice. Items are added to the end of the original questionnaire to maintain the integrity of its psychometric validity.
All symptom items are available in English, as well as in other languages.
Contact us to obtain permission to use any of the MDASI Symptom Library items to create a tailored questionnaire (REQUIRED). Our expert faculty can assist you with:
- Design of a customized MDASI that meets the needs of your study or practice;
- Available linguistically and psychometrically validated language translations of your selected items;
- Information about the sensitivity of particular items in specific populations.
Charges will apply for consultation services. Charge will depend on the scope of the request.
ITEMS MAY NOT BE USED WITHOUT CONSULTATION.
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 (less for electronic administration)
- Scoring: Please see the MDASI User's Guide
- Reliability: Cronbach alpha reliability ranges from 0.82 to 0.94
The MDASI is available in paper-and-pencil, electronic, and telephone-based interactive voice response (IVR) formats, all of which are equally effective. Electronic MDASI data capture offers several benefits:
- Allows symptoms to be monitored when the patient is away from the hospital
- Is convenient for patients, who may use their choice of web access, personalized patient portals, or smart phones to access questionnaires
- Minimizes missing data, especially in longitudinal studies
- Provides more accurate, real-time symptom data at expected time points
- The availability of immediate feedback could allow caregivers to address severe symptoms more effectively.
MDASI Language Versions
Click on a linked language to view a sample in PDF format.
Don't see a language you need? Contact us at symptomresearch@mdanderson.org.
Psychometrically and Linguistically Validated | Linguistically Validated |
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Arabic Chinese (Simplified) Chinese (Traditional) English Filipino French Greek Japanese Korean Russian |
Afrikaans Amharic Bosnian/Herzegovinian Croatian Czech Danish Dutch Estonian Finnish French (Canada) German Hebrew Hebrew (Hadassah) Hindi Hungarian Icelandic Italian Malay Norwegian Polish Portuguese (Brazil) Portuguese (Portugal) Romanian Serbian Slovak Spanish Swedish Tamil Thai Turkish Ukranian Vietnamese |
The MDASI User's Guide
In response to the FDA's 2009 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 document the development and psychometric properties of the MDASI and its modules. The User Guide addresses the recommendations in the FDA guidance and establishes the MDASI's adequacy as a measure to support medical product claims.
Selected MDASI References
Validation
Cleeland CS, Mendoza TR, Wang XS, et al. Assessing symptom distress in cancer: The M. D. Anderson Symptom Inventory. Cancer 89:1634-1646, 2000.
Guirimand F, Buyck JF, Lauwers-Allot E, et al. 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, et al. 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, et al. 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, et al. 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, et al. 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, et al. 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, et al. Cancer symptom assessment instruments: a systematic review. J Clin Oncol 24(9): 1459-1473, 2006.
Wang XS, Rhines LD, Shiu AS, et al. 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, et al. 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, et al. 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, et al. 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, et al. 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, et al. Symptom burden after autologous stem cell transplantation for multiple myeloma. Cancer 112(7): 1617-1624, 2008.
Wang XS, Fairclough DL, Liao Z, et al. 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.
Did You Know?
MDASI Modules
MDASI modules augment the 19 core MDASI symptom and interference items with additional symptoms that are unique to a particular patient population.
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MDASI-AML/MDS
Acute Myeloid Leukemia/Myelodysplastic Syndrome Module
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MDASI-BT
Brain Tumor Module
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MDASI-cGVHD
Chronic Graft-versus-Host Disease Module
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MDASI-CML
Chronic Myeloid Leukemia Module
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MDASI-GI
Gastrointestinal Cancer Module
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MDASI-GIST
Gastrointestinal Stromal Tumor Module
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MDASI-HF
Cancer with Heart Failure Module
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MDASI-HN
Head and Neck Cancer Module
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MDASI-LC
Lung Cancer Module
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MDASI-MM
Multiple Myeloma Module
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MDASI-OC
Ovarian Cancer Module
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MDASI-SP
Spine Tumor Module
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MDASI-TCM
Traditional Chinese Medicine Module
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MDASI-Thy
Thyroid Cancer Module
We are developing brief ‘fit-for-purpose’ patient-reported outcomes questionnaires that capture a patient's symptoms, their severity and their interference with functioning and quality of life.
Charles S. Cleeland, Ph.D.
Professor, Symptom Research