title: A Cross-sectional Study on the Symptom Burden of Patients With Spinal Tumor: Validation of the Chinese Version of the M.D. Anderson Symptom Inventory-Spine Tumor Module.
abstract: Tumors involving the spine are associated with unique symptoms affecting both patient survival and health-related quality of life. Currently, there is no disease-specific instrument in Chinese to assess the symptom burden of these patients.
  
  
  
  The objective of this study was to translate and validate a Chinese version of the M.D. Anderson Symptom Inventory-Spine Tumor Module (MDASI-SP-C) to assess the symptom burden of Chinese-speaking patients with spinal tumors.
  
  
  
  MDASI-SP-C was forward-and-backward translated according to standard protocols and administered to patients fulfilling study criteria at a major referral center of spine tumor between November 2014 and September 2015. The generic instruments of Short Form 36 Quality of Life Questionnaire (SF-36), Functional Assessment of Cancer Therapy-General Version (FACT-G), and Karnofsky Performance Scale were used along with MDASI-SP-C. Prevalence and severity distribution of each item were analyzed. Psychometric assessment and hierarchical cluster analysis were performed for the translated instrument.
  
  
  
  One hundred forty-two patients were enrolled. High interdependency and relatively low intra-cluster distances were identified. Cronbach's alpha of the entire instrument, the symptom severity subscale, and the interference subscale was 0.93, 0.91, and 0.92, respectively. Principal axis factoring resulted in a four-factor solution, which was reduced to a three-factor (general symptoms, spine-specific symptoms, and gastrointestinal symptoms) solution on account of clinical interpretation. Correlation coefficients between MDASI-SP-C items and their corresponding domains in SF-36 and/or FACT-G were all greater than 0.3. MDASI-SP-C was able to distinguish patients with different Karnofsky Performance Scale levels.
  
  
  
  MDASI-SP-C demonstrated satisfactory psychometric properties and could be used to better assess the symptom burden of Chinese-speaking patients with spine tumors for improved management of their medical needs.
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Nanfang
authors.initials: N
authors.lastname: Xu
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Zhehuang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wei
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
authors.forename: Na
authors.initials: N
authors.lastname: Meng
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Jiang
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Fengliang
authors.initials: F
authors.lastname: Wu
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Dang
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Peking University Third Hospital, Beijing, China. Electronic address: puthliuzhongjun@163.com.
authors.forename: Zhongjun
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000523:psychology; D014175:Translating; D055815:Young Adult
keywords: Spinal tumor; assessment; health-related quality-of-life; instrument; symptom