The MDASI Score in Thyroid Conditions
The M.D. Anderson Symptom Inventory-Thyroid Cancer module (MDASI-THY) is a validated assessment tool specifically designed to measure symptoms related to thyroid cancer and its treatment, evaluating both symptom severity and interference with daily life. 1
What is the MDASI-THY?
The MDASI-THY is a specialized version of the broader M.D. Anderson Symptom Inventory (MDASI) that has been tailored specifically for thyroid cancer patients. It includes:
- Core symptom items from the original MDASI
- Thyroid-specific symptom items
- Interference items that measure how symptoms affect daily functioning
Key Components and Scoring
The MDASI-THY measures:
- Symptom severity on a scale of 0-10 (0 = not present, 10 = as bad as you can imagine)
- Symptom interference with daily activities on a similar 0-10 scale
- Both general cancer-related symptoms and thyroid-specific symptoms
Most Common Symptoms Measured
Research has identified the following as the most prevalent and severe symptoms in thyroid cancer patients as measured by the MDASI-THY:
- Fatigue
- Drowsiness
- Sleep disturbance
- Distress
- Difficulty remembering 1
In a 2009 validation study, approximately 28% of thyroid cancer patients reported moderate to severe fatigue (≥5 on the 0-10 scale), with average severity scores of 1.28 for symptoms and 1.29 for interference 1.
Clinical Utility
The MDASI-THY has several important clinical applications:
- Symptom monitoring: Allows clinicians to track symptom burden over time
- Treatment planning: Helps identify which symptoms need intervention
- Quality of life assessment: Measures impact of disease and treatment on daily functioning
- Research tool: Enables standardized measurement of outcomes in clinical trials
Validation and Reliability
The MDASI-THY has demonstrated strong psychometric properties:
- Content validity: Items were developed through focus groups and interviews with thyroid cancer patients, clinicians, and researchers 1
- Construct validity: Shows appropriate correlations with other quality of life measures 2
- Known-group validity: Successfully distinguishes between patients with different performance status levels 1
- Reliability: High internal consistency with Cronbach's alpha values of:
- 0.76 for thyroid-specific symptom items
- 0.85 for core symptom subscale
- 0.92 for interference subscale 1
International Validation
The MDASI-THY has been translated and validated in multiple languages:
- A Chinese version demonstrated favorable validity and reliability (Cronbach's alpha = 0.966) 2
- A recent 2024 study in China used the MDASI-THY to assess symptoms in advanced thyroid cancer patients, finding disturbed sleep (74.4%) and mood distress (63.3%) as the most prevalent symptoms 3
Clinical Implications
While thyroid guidelines don't specifically mention the MDASI-THY as part of standard assessment, its use can help identify symptoms that may warrant intervention. For example:
- Patients with subclinical hypothyroidism may experience subtle symptoms that affect quality of life, which the MDASI-THY could help quantify 4
- The tool could help monitor symptom burden in patients undergoing treatment for thyroid cancer, particularly those with more advanced disease 3
Practical Application
The MDASI-THY can be incorporated into routine clinical care for thyroid cancer patients to:
- Establish baseline symptom burden at diagnosis
- Monitor changes in symptoms during and after treatment
- Identify patients who may benefit from supportive care interventions
- Evaluate treatment effectiveness from a patient-centered perspective
The instrument is designed to be clear, concise, and easy to understand, making it practical for clinical use 1.