title: Measuring the symptom burden of lung cancer: the validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory.
abstract: We conducted a study to establish the psychometric properties of a module of the M. D. Anderson Symptom Inventory (MDASI) developed specifically for patients with lung cancer (MDASI-LC). The MDASI measures 13 common "core" symptoms of cancer and its treatment. The MDASI-LC includes the 13 core MDASI symptom items and three lung cancer-specific items: coughing, constipation, and sore throat. MDASI-LC items were administered to three cohorts of patients with lung cancer undergoing either chemotherapy or chemoradiotherapy. Known-group validity and criterion (concurrent) validity of the MDASI-LC were evaluated using the Eastern Cooperative Oncology Group performance status and the 12-item Short-Form Health Survey. The internal consistency and test-retest reliability of the module were adequate, with Cronbach coefficient α-values of 0.83 or higher for all module items and subscales. The sensitivity of the MDASI-LC to changes in patient performance status (disease progression) and to continuing cancer treatment (effects of treatment) was established. Cognitive debriefing of a subset of participants provided evidence for content validity and indicated that the MDASI core items and three additional lung cancer-specific items were clear, relevant to patients, and easy to understand; only two patients suggested additional symptom items. As expected, the item "sore throat" was sensitive only for patients receiving chemoradiotherapy. The MDASI-LC is a valid, reliable, and sensitive symptom-assessment instrument whose use can enhance clinical studies of symptom status in patients with lung cancer and epidemiological and prevalence studies of symptom severity across various cancer types.
authors.affiliation: Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, Texas 77030, USA. tmendoza@mdanderson.org
authors.forename: Tito R
authors.initials: TR
authors.lastname: Mendoza
authors.forename: Xin Shelley
authors.initials: XS
authors.lastname: Wang
authors.forename: Charles
authors.initials: C
authors.lastname: Lu
authors.forename: Guadalupe R
authors.initials: GR
authors.lastname: Palos
authors.forename: Zhongxing
authors.initials: Z
authors.lastname: Liao
authors.forename: Gary M
authors.initials: GM
authors.lastname: Mobley
authors.forename: Shitij
authors.initials: S
authors.lastname: Kapoor
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
mesh_terms: D015897:Comorbidity; D003248:Constipation / Q000453:epidemiology; D017281:Cost of Illness; D005163:Factor Analysis, Statistical; D006305:Health Status Indicators; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D017063:Outcome Assessment, Health Care; D010612:Pharyngitis / Q000453:epidemiology; D011594:Psychometrics / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires / Q000145:classification