title: Validation and application of a module of the M. D. Anderson Symptom Inventory for measuring multiple symptoms in patients with gastrointestinal cancer (the MDASI-GI).
abstract: BACKGROUND
  The M. D. Anderson Symptom Inventory (MDASI) was developed as a brief yet comprehensive tool to assess patient-reported symptom severity and interference in patients with cancer. The authors report the development of an MDASI module for use in patients with gastrointestinal (GI) cancer (the MDASI-GI).
  
  
  METHODS
  Patients with GI cancer (N = 184) participated in module development and validation. The process included: 1) generating GI-specific candidate items with input from GI oncologists and from qualitative interviews with patients and adding those items to the core MDASI for testing; 2) dropping candidate GI items that lacked sensitivity; 3) validating the psychometric properties (validity, reliability, sensitivity) of the resulting MDASI-GI; and 4) conducting cognitive debriefing interviews with patients to confirm the questionnaire's ease of comprehension, relevance, and acceptability.
  
  
  RESULTS
  Five GI-specific symptom items (constipation, diarrhea, difficulty swallowing, change in taste, and feeling bloated) were added to the original 19 MDASI symptom and interference items to form the MDASI-GI. Sixty-one percent of the sample had 1 or more moderate-to-severe symptom(s) (>or=5 on a severity scale from 0 to 10). Cronbach alpha values were .80 and .87 for symptom severity items and interference items, respectively. Known-group validity (sensitivity) was supported by the ability of the MDASI-GI to detect significant differences in symptom and interference levels according to performance status (P < .001). Cognitive debriefing demonstrated that, for patients, the MDASI-GI was an easy-to-use and understandable tool.
  
  
  CONCLUSIONS
  The current results indicated that the MDASI-GI is a valid, reliable, and concise tool for measuring symptom severity and interference with function in patients with GI cancer.
authors.affiliation: Department of Symptom Research, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. xswang@mdanderson.org
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Loretta A
authors.initials: LA
authors.lastname: Williams
authors.forename: Cathy
authors.initials: C
authors.lastname: Eng
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.forename: Nyma A
authors.initials: NA
authors.lastname: Shah
authors.forename: Karyn J
authors.initials: KJ
authors.lastname: Kirkendoll
authors.forename: Pankil K
authors.initials: PK
authors.lastname: Shah
authors.forename: Peter C
authors.initials: PC
authors.lastname: Trask
authors.forename: Guadalupe R
authors.initials: GR
authors.lastname: Palos
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods*; D011795:Surveys and Questionnaires