Li Zhandong, Shi Qiuling, Liu Meng, Jia Liqun, He Bin, Yang Yufei, Liu Jie, Lin Hongsheng, Lin Huei-Kai, Li Pingping, Wang Xin Shelley
Department of Integrative Medicine, Beijing Cancer Hospital, Peking University, Beijing, PR China; Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX; China-Japan Friendship Hospital, Beijing, PR China; Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China; Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China.
J Natl Cancer Inst Monogr. 2017 Nov 1;2017(52). doi: 10.1093/jncimonographs/lgx010.
The MD Anderson Symptom Inventory (MDASI) is a brief, yet thorough, patient-reported outcomes measure for assessing the severity of common cancer-related symptoms and their interference with daily functioning. We report the development of an MDASI version tailored for use with Traditional Chinese Medicine in China (the MDASI-TCM).
Chinese-speaking patients with mixed cancer types (n = 317) participated in the study. The development and validation process included four steps: 1) identify candidate TCM-specific items, with input from patients, oncologists, and TCM specialists; 2) eliminate candidate TCM items lacking relevance, based on patient report; 3) psychometrically examine the MDASI-TCM's validity and reliability in cancer patients receiving TCM-based care; and 4) cognitively debrief patients to assess the MDASI-TCM's relevance, understandability, and acceptability.
Seven TCM-specific symptom items (sweating, feeling cold, constipation, bitter taste, coughing, palpitations, and heat in palms/soles) were clinically and psychometrically meaningful to add to the core MDASI. Approximately 61% of patients had moderate to severe symptoms (rated ≥5 on the MDASI-TCM's 0-10 scale). Cronbach α coefficients were .90 for symptom-severity items and .93 for interference items, indicating internal consistency reliability. Known-group validity was substantiated by the MDASI-TCM's detection of differences in symptom severity according to performance status (P < .001) and interference levels by cancer stage (P < .05). Cognitive debriefing indicated that patients found the MDASI-TCM to be an understandable, easy-to-use tool.
The Chinese MDASI-TCM is a valid, reliable, and concise measure of symptom severity and interference that can be used to assess Chinese cancer patients and survivors receiving TCM-based care.
MD安德森症状问卷（MDASI）是一种简短但全面的患者报告结局指标，用于评估常见癌症相关症状的严重程度及其对日常功能的干扰。我们报告了一种专为在中国使用的中医（MDASI-TCM）量身定制的MDASI版本的开发情况。
说中文的混合癌症类型患者（n = 317）参与了该研究。开发和验证过程包括四个步骤：1）在患者、肿瘤学家和中医专家的参与下，确定候选的中医特定项目；2）根据患者报告，剔除缺乏相关性的候选中医项目；3）从心理测量学角度检验MDASI-TCM在接受中医治疗的癌症患者中的有效性和可靠性；4）对患者进行认知反馈，以评估MDASI-TCM的相关性、可理解性和可接受性。
七个中医特定症状项目（出汗、畏寒、便秘、口苦、咳嗽、心悸和手足心热）在临床和心理测量学上对核心MDASI具有重要意义。约61%的患者有中度至重度症状（在MDASI-TCM的0-10量表上评分≥5）。症状严重程度项目的克朗巴赫α系数为0.90，干扰项目的为0.93，表明内部一致性可靠性。MDASI-TCM根据表现状态检测症状严重程度差异（P < 0.001）以及根据癌症分期检测干扰水平差异（P < 0.05），证实了已知组有效性。认知反馈表明患者认为MDASI-TCM是一个易于理解、易于使用的工具。
中文版MDASI-TCM是一种有效、可靠且简洁的症状严重程度和干扰评估指标，可用于评估接受中医治疗的中国癌症患者和幸存者。
