Symptom Assessment Questionnaires
Despite the tremendous impact that symptoms can have, comprehensive symptom assessment is rarely a part of routine cancer care. Health care professionals may wait until patients spontaneously complain of symptoms before formally assessing them, and they are more apt to rely on their own experience or professional judgment instead of soliciting input from the patient about what symptoms the patient is experiencing.
Moreover, cancer patients across the globe are often undertreated because validated, linguistically appropriate questionnaires for assessing their cancer symptoms are lacking.
Symptom reports are part of a larger group of measures designated as patient-reported outcomes (PROs). As with any measure used to make clinical or research decisions, PRO questionnaires — including symptom reports — must be shown to be valid (measure the construct they represent), sensitive (responsive to expected changes produced by treatment or clinical condition), and reliable (stable when no change is expected).
The PROs measured by questionnaires that meet these criteria have been recognized by the U.S. Food and Drug Administration as legitimate primary outcome variables for clinical trials.
Questionnaire-development experts in the Department of Symptom Research:
- Design, validate, and license the PRO-based assessment questionnaires shown below to identify the symptoms experienced by specific patient groups, measure symptom severity at given timepoints, and assess how these symptoms affect patient quality of life.
- Conduct studies to establish the linguistic and psychometric validity of our PRO questionnaires in various languages for use across various countries and cultures.
- Develop various methods for deploying our PRO questionnaires electronically and collecting their data, including apps, web interfaces, and telephone response systems, so that patients can report symptoms at any time from any place.
- Create PRO displays for clinical use, enabling patient care teams to quickly and easily access and interpret patient symptom reports.
Don't see what you need?
Our team of experts can help you build a fit-for-purpose questionnaire that captures symptoms specific to a given disease or treatment, including drugs in development.
Our Symptom Assessment Questionnaires
Click on a questionnaire below to learn more about its development, properties, use and licensing. Use our convenient online form to order any of our symptom assessment questionnaires for use in your clinical research, clinical practice, funded and non-funded academic research, commercial research, or reproduction in educational materials or other publications.
Did You Know?
The U.S. Food and Drug Administration's 2009 guidance on the use of patient-reported outcomes in drug labeling claims states that the optimal time to understand symptomatic impact and to design assessment questionnaires is early in drug development.
Experts in the Department of Symptom Research can help you build a fit-for-purpose assessment questionnaire that captures symptoms specific to a given disease or treatment, including drugs in development. Your questionnaire will:
- Provide early information about symptomatic impact and tolerability
- Identify reduction in symptomatic impact compared to standard of care
- Document delayed onset of symptom progression
- Show symptom palliation in combination with approved chemotherapy
- Support clinical meaningfulness of progression-free survival through symptomatic benefit
- Can be administered in various formats, including electronic (web and smartphone apps), paper-and-pencil and telephone-based interactive response systems
Future Language Validation Studies
We are interested in collaborating with other investigators to develop and validate new language versions of our questionnaires. Contact us at symptomresearch@mdanderson.org for more information.
NOTE: Our questionnaires may not be modified or translated into another language without the express written consent of the copyright holder (see Notice of Copyright below).
Notice of Copyright
The MD Anderson Symptom Inventory (MDASI), Brief Pain Inventory (BPI), Brief Fatigue Inventory (BFI), Treatment-Induced Neuropathy Assessment Scale (TNAS), and the Alopecia Areata Symptom Impact Scale (AASIS), along with all of their variants, derivatives, and modules, are copyrighted questionnaires. The copyright applies to all language versions of these tools.
The MDASI, BPI, BFI, TNAS, AASIS, and their derivatives may not be used or reproduced without permission. Failure to comply may result in legal action. Please use our order form to request the questionnaire(s) you need. Fees may apply.
The MDASI, BPI, BFI, TNAS, AASIS, and their derivatives may not be modified or translated into another language without express written consent. Failure to comply may result in legal action. Contact us to request permission to alter or translate the questionnaire.
Ease of Use and Readability
Our symptom assessment questionnaires are understandable even by grade-school children, according to the Flesch scoring systems described below.
Flesch Reading Ease score: Rates text on a 100-point scale; the higher the score, the easier it is to understand the document. Most standard documents aim for a score of approximately 60 to 70.
Flesch-Kincaid Grade Level score: Rates text on a U.S. grade-school level. For example, a score of 8.0 means that an eighth grader can understand the document. Most standard documents aim for a score of approximately 7.0 to 8.0.
| Flesch Reading Ease | Flesch-Kincaid Grade Level | |
|---|---|---|
| MDASI | 82.3 | 3.6 |
| BPI (short form) | 83.5 | 5.1 |
| BFI | 70.7 | 6.4 |
| TNAS | 67.8 | 6.3 |
| AASIS | 56.2 | 9.3 |
The simplicity of our questionnaires facilitates cross-cultural studies of pain and other patient-reported cancer-related symptoms. Other than for the MDASI, validation studies have not been conducted using our assessment questionnaires in the pediatric population, aged 18 years and younger.