Shorter symptom assessment instruments: the Condensed Memorial Symptom Assessment Scale (CMSAS).
BACKGROUND
Rapid and efficient symptom assessment is an important aspect of palliative care. The objective was to determine whether a smaller number of symptoms from the 32-item Memorial Symptom Assessment Scale Short-Form (MSAS-SF) could convey equivalent quality of life (QOL) information.


METHODS
Responses from 479 medical oncology patients who completed the MSAS-SF and the Functional Assessment Cancer Therapy (FACT-G) were analyzed. Canonical correlations were performed to assess the relationships of 32 MSAS-SF symptoms to quality of life (FACT-G domains) and clinical variables [age, Karnofsky performance status (KPS), stage of disease, and inpatient status]. The relation of the subscales of the Condensed MSAS (CMSAS) and FACT-G to survival was assessed in a multivariate model.


RESULTS
The median age was 67 years (range, 20-89) and median KPS was 80% (range, 20-100). Primary sites were prostate in 141 (29%) patients, lung in 121 (26%) patients, colorectal in 53 (11%) patients, hematologic in 50 (10%) patients, head and neck in 30 (6%) patients and other in 84 (18%) patients. Median survival was 245 days (range, 1-2,215 days). Canonical correlation analyses identified a five-dimensional QOL factor structure. Symptoms important for QOL also correlated significantly with survival and provided the basis for the CMSAS with 14 symptoms and 3 subscales (CMSAS SUM, CMSAS PHYS, and CMSAS PSYCH). In multivariate analyses, the CMSAS PSYCH predicted survival independently of stage, performance status, and QOL. The CMSAS takes 2-4 minutes to complete.


CONCLUSIONS
The CMSAS contains both QOL and survival information approximately equivalent to the original 32 items.
Chang
Victor T
VT
Section of Hematology/Oncology (111), VA New Jersey Health Care System at East Orange, East Orange 07019, New Jersey, USA. victor.chang@med.va.gov
Hwang
Shirley S
SS
Kasimis
Basil
B
Thaler
Howard T
HT
D000328:Adult; D000368:Aged; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D016016:Proportional Hazards Models; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D015996:Survival Rate