Cleeland C S, Mendoza T R, Wang X S, Chou C, Harle M T, Morrissey M, Engstrom M C
Pain Research Group, Division of Anesthesiology and Critical Care, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2000 Oct 1;89(7):1634-46. doi: 10.1002/1097-0142(20001001)89:7<1634::aid-cncr29>3.0.co;2-v.
The purpose of this project was to develop the M. D. Anderson Symptom Inventory (MDASI), a brief measure of the severity and impact of cancer-related symptoms.
A list of symptoms was generated from symptom inventories and by panels of clinicians. Twenty-six symptoms and 6 interference items were rated by a validation sample of 527 outpatients, a sample of 30 inpatients from the blood and bone marrow transplantation service, and a cross-validation sample of 113 outpatients. Clinical judgment and statistical techniques were used to reduce the number of symptoms. Reliability, validity, and sensitivity of the MDASI were examined.
Cluster analysis, best subset analysis, and clinical judgment reduced the number of symptoms to a "core" list of 13 that accounted for 64% of the variance in symptom distress. Factor analysis demonstrated a similar pattern in both outpatient samples, and two symptom factors and the interference scale were reliable. Expected differences in symptom pattern and severity were found between patients with "good" versus "poor" performance status and between patients in active therapy and patients who were seen for follow-up. Patients rated fatigue-related symptoms as the most severe. Groups of patients classified by disease or treatment had severe symptoms that were not on the "core" list.
The core items of the MDASI accounted for the majority of symptom distress reported by cancer patients in active treatment and those who were followed after treatment. The MDASI should prove useful for symptom surveys, clinical trials, and patient monitoring, and its format should allow Internet or telephone administration.
本项目旨在开发安德森癌症中心症状量表（MDASI），这是一种用于简要评估癌症相关症状严重程度及影响的工具。
从症状量表及临床医生小组处获取症状清单。由527名门诊患者的验证样本、30名血液和骨髓移植科住院患者样本以及113名门诊患者的交叉验证样本，对26种症状和6项干扰项目进行评分。运用临床判断和统计技术减少症状数量，并对MDASI的信度、效度和敏感性进行检验。
聚类分析、最佳子集分析和临床判断将症状数量缩减至13种的“核心”清单，这些症状占症状困扰方差的64%。因子分析在两个门诊样本中呈现出相似模式，两个症状因子和干扰量表具有可靠性。在功能状态“良好”与“较差”的患者之间，以及正在接受积极治疗的患者与接受随访的患者之间，发现了症状模式和严重程度的预期差异。患者将与疲劳相关的症状评为最严重。按疾病或治疗分类的患者群体存在未在“核心”清单上的严重症状。
MDASI的核心项目涵盖了正在接受积极治疗的癌症患者以及治疗后接受随访患者所报告的大部分症状困扰。MDASI在症状调查、临床试验和患者监测中应会证明有用，其形式应允许通过互联网或电话进行管理。
