Abstract 4367: The MD Anderson Symptom Inventory (MDASI) survey discloses persistent moderate to high-level symptoms in cancer survivors
Authors: Gilmore Katherine , Chapman Patricia , Rollins Johnny , Lee-Kim Soo-Hyun , Robinson Justine , Mullen Ellen , Mistry Haleigh , Singh Prachee , Coyne Robin , Nelson Ana , Osai William , Stolar Karen , Knippel Susan , Fournier Danielle , Plair Tamera , Thoman Whittney , Peek Angela , Williams Loretta , Rodriguez Maria A. 
Published: April 2023

Abstract
Background: We implemented the integration of the MD Anderson Symptom Inventory (MDASI) survey into patient visits in our Survivorship Clinics to help manage long and late effects of cancer and its therapy. Patients are transitioned to Survivorship if they have completed treatment with curative intent, are in remission, and past the period of highest relapse risk, as determined by disease experts [average ~ 3 years past treatment].
Methods: The MD Anderson Symptom Inventory (MDASI) is a validated cancer specific symptom burden questionnaire. It was integrated into the electronic health record (EHR), and sent via the patient portal to patients 7 days prior to their clinic visit. High alerts (&gt= 7) were set for four key symptoms (pain, distress, sadness, and shortness of breath). Alerts triggered an automated message to the provider. From November 2019 to October 2022, 4322 patients completed PRO surveys.
Results: Table 1 summarizes the frequency of moderate (4-6) and high (7-10) level responses. Categories with more than 5% of respondents endorsing a moderate symptom value are bolded with those more than 10% bold and italic. There is significant variation of severity for the four key symptoms amongst patients with different disease types. Lymphoma and thyroid cancer patients have higher symptom severity, while prostate cancer patients report relatively low symptom severity. Overall, for this cohort of responders, the totals of moderate and high levels symptoms are: distress =12.5 %; pain = 9.5 %; sadness = 8.7 %; and shortness of breath = 8 %.
Conclusion: A subset of cancer survivors still experience moderate to high level symptoms, as measured by the MDASI survey, even years after treatment. There are notable differences across patient populations. Further study can identify at-risk patient groups who may require additional intervention.
Table 1. Moderate and High Values for Four Symptoms from the Survivorship MDASIs Clinic Total PROs Distress Mod % Distress High % Pain Mod % Pain High % Sad Mod % Sad High % SOB Mod % SOB High % Breast 915 7.65% 1.97% 8.96% 2.95% 6.56% 1.09% 5.79% 1.64% H&N 618 5.99% 2.27% 6.63% 4.21% 4.53% 2.10% 4.69% 3.07% Lymph 112 16.96% 1.79% 9.82% 6.25% 8.93% 0.89% 10.71% 1.79% Prostate 496 3.43% 0.60% 1.81% 1.18% 2.02% 0.40% 2.62% 0.60% SCT 229 8.73% 1.31% 7.86% 5.68% 5.68% 1.31% 7.86% 1.31% Thoracic 103 2.91% 1.94% 9.71% 1.94% 3.88% 2.91% 12.62% 3.88% Thyroid 1849 12.93% 5.08% 6.00% 2.49% 8.82% 2.97% 6.54% 2.11% Grand Total 4322 9.37% 3.15% 6.52% 3.01% 6.66% 2.01% 5.99% 1.97%
Citation Format: Katherine Gilmore, Patricia Chapman, Johnny Rollins, Soo-Hyun Lee-Kim, Justine Robinson, Ellen Mullen, Haleigh Mistry, Prachee Singh, Robin Coyne, Ana Nelson, William Osai, Karen Stolar, Susan Knippel, Danielle Fournier, Tamera Plair, Whittney Thoman, Angela Peek, Loretta Williams, Maria A. Rodriguez. The MD Anderson Symptom Inventory (MDASI) survey discloses persistent moderate to high-level symptoms in cancer survivors. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4367.