Psychometric Testing of the MDASI-HF: A Symptom Assessment Instrument for Patients With Cancer and Concurrent Heart Failure

Abstract 

Background

The debilitating symptoms of cancer and heart failure (HF) can adversely affect the patient's quality of life. This study evaluated the psychometric properties of the MD Anderson Symptom Inventory – Heart Failure (MDASI-HF), a 27-item self-report assessment instrument for patients with cancer and concurrent HF.

Methods and Results

Psychometric testing used data from 156 patients (age 63.3 ± 13.2 years, 56% male) with a diagnosis of cancer and HF receiving care in a major cancer center. Reliability of the MDASI-HF for the 13 symptoms (α = 0.89), 8 HF-specific items (α = 0.83), and interference items (α = 0.92) was high. Criterion-related validity with the Eastern Cooperative Oncology Group performance scale (r = 0.63) and the New York Heart Association classification (r = 0.65) were statistically significant, P = .01. Construct validity supported two constructs for the additional HF specific items: covert HF factor and overt HF factor.

Conclusion

The MDASI-HF is a valid and reliable instrument for symptom assessment in patients with cancer and HF. This instrument can be used to identify symptom occurrence and enhance the provider's understanding of the prevalence and severity of symptoms from the patient's perspective.

Key Words: Heart Failure, cancer, instrument, symptom assessment