title: Chinese version of the M. D. Anderson Symptom Inventory: validation and application of symptom measurement in cancer patients.
abstract: BACKGROUND
  Symptom management is an essential component of cancer treatment for patients of every culture and nationality. Symptom assessment depends on subjective reporting, mandating linguistically equivalent versions of symptom assessment scales. Because disease-related and treatment-related symptoms most often occur in clusters, there is a global need for a standardized multiple-symptom assessment tool.
  
  
  METHODS
  The authors sought to validate the Chinese version of the M. D. Anderson Symptom Inventory (MDASI-C) by enrolling patients who had received various diagnoses of and different types of treatment for cancer (n = 249) in a cross-sectional symptom study conducted at an urban cancer center in China.
  
  
  RESULTS
  Factor analysis identified 2 underlying constructs, general symptoms and gastrointestinal symptoms, which had Cronbach alpha coefficients of 0.86 and 0.84, respectively. These results were consistent with English- and Japanese-language MDASI validation studies. Known-group validity was supported by the MDASI-C's ability to detect significant differences in symptom and interference levels according to Eastern Cooperative Oncology Group performance status (ECOG PS; P < 0.001) and chemotherapy status (P < 0.05). Fifty-five percent of the study cohort had > or = 1 symptom that was considered severe (score > or = 7 on a 0-10 scale). ECOG PS was strongly associated with symptom burden (total interference score: R(2) = 0.26; P < 0.001). Fatigue, sadness, drowsiness, and lack of appetite accounted for most of the variability in the total interference score (R(2) = 0.49; P < 0.05).
  
  
  CONCLUSIONS
  The authors demonstrated that the MDASI-C is a valid, reliable, and concise tool for measuring symptom severity and interference with functioning in Chinese cancer patients.
authors.affiliation: Division of Internal Medicine, Department of Symptom Research, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. swong@mdanderson.org
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Guo
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.forename: Xi-Shan
authors.initials: XS
authors.lastname: Hao
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires / Q000592:standards*