THE MEMORIAL SYMPTOM ASSESSMENT SCALE - AN INSTRUMENT FOR THE EVALUATION OF SYMPTOM PREVALENCE, CHARACTERISTICS AND DISTRESS

The Memorial Symptom Assessment Scale (MSAS) is a new patient-rated in strument that was developed to provide multidimensional information ab out a diverse group of common symptoms. This study evaluated the relia bility and validity of the MSAS in the cancer population. Randomly sel ected inpatients and outpatients (n=246) with prostate, colon, breast or ovarian cancer were assessed using the MSAS and a battery of measur es that independently evaluate phenomena related to quality of life. S ymptom prevalence in the 218 evaluable patients ranged from 73.9% for lack of energy to 10.6% for difficulty swallowing. Based on a content analysis, three symptoms were deleted and two were added; the revised scale evaluates 32 physical and psychological symptoms. A factor analy sis of variance yielded two factors that distinguished three major sym ptom groups and several subgroups. The major groups comprised psycholo gical symptoms (PSYCH), high prevalence physical symptoms (PHYS H), an d low prevalence (PHYS L). Internal consistency was high in the PHYS H and PSYCH groups (Cronback alpha coefficients of 0.88 and 0.83, respe ctively), and moderate in the PHYS L group (alpha = 0.58). Although th e severity, frequency and distress dimensions were highly intercorrela ted, canonical correlations and other analyses demonstrated that multi dimensional assessment (frequency and distress) augments information a bout the impact of the symptoms. High correlations with clinical statu s and quality of life measures support the validity of the MSAS and in dicate the utility of several subscale scores, including PSYCH, PHYS, and a brief Global Distress Index. The MSAS is a reliable and valid in strument for the assessment of symptom prevalence, characteristics and distress. It provides a method for comprehensive symptom assessment t hat may be useful when information about symptoms is desirable, such a s clinical trials that incorporate quality of life measures or studies of symptom epidemiology.