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.
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. They include pain, fatigue, nausea, disturbed sleep, distress, shortness of breath, difficulty remembering, lack of appetite, drowsiness, dry mouth, sadness, vomiting, and numbness/tingling. The 6 interference items include interference with walking, activity, working, relations with others, enjoyment of life, and mood. 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.
The MDASI Symptom Library
Individual and sets of symptom items from the MDASI Symptom Library may be added to the core MDASI to create symptom-assessment questionnaires that are tailored to your clinical research and practice. These MDASI symptom items were derived from psychometrically validated MDASI modules (sidebar, right). Items were generated via patient interview and were cognitively debriefed. All symptom items are available in English, as well as in various languages.
Contact the MD Anderson Department of Symptom Research to obtain permission to use any of the MDASI Symptom Library items to create a tailored questionnaire (REQUIRED).
Order the MDASI
Did You Know?
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.
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
MDASI modules augment the 19 core MDASI symptom and interference items with additional symptoms that are unique to a particular patient population.
- 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.
Click on a linked language to view a sample in PDF format.
Don't see a language you need? Contact us at firstname.lastname@example.org.
|Psychometrically and Linguistically Validated||Linguistically Validated|
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.
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.